Hydrocodone Addiction and Abuse

Known by brand names Vicodin, Norco and Lortab, hydrocodone is a powerful painkiller with a high potential for abuse and addiction.

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    Understanding Hydrocodone

    hydrocodone pillHydrocodone is the powerful main ingredient in narcotic painkillers for moderate to severe pain. It is often administered orally to treat short-term dental and injury-related pain. People who use hydrocodone over a long period of time or in larger doses may start showing symptoms of hydrocodone addiction.

    Hydrocodone is considered an opioid. It’s similar to drugs like morphine, codeine and oxycodone.

    Hydrocodone relieves pain by binding pain receptors (opioid receptors) in the central nervous system. This weakens the signal for pain in the brain and can produce feelings of elation.

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    How Hydrocodone Is Used

    Hydrocodone is combined with acetaminophen (the active ingredient in Tylenol) or ibuprofen in brand names such as Vicodin, Norco and Lortab. The Food and Drug Administration has also approved a pure hydrocodone product known as Zohydro.

    Those abusing hydrocodone may crush up their pills and snort or inject the contents. In 2014, lawmakers recognized the increasing dangers of abuse and addiction of hydrocodone combination products such as Vicodin and changed them from a Schedule III to Schedule II controlled substance.

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    Hydrocodone Brand Names

    There are several versions of hydrocodone marketed in the United States. Those with an addiction to hydrocodone likely have a specific brand they prefer. This could be based on many reasons that are both practical and psychological.

    • Vicodin (5mg, 7.5mg, 10mg/300mg)

      Vicodin pillEach Vicodin tablet has 300 mg of acetaminophen and comes in three different dosage levels of hydrocodone—5 mg, 7.5 mg and 10 mg. Depending on the patient’s needs, Vicodin is usually prescribed within the range of 300mg to 750mg. It is generally prescribed for one tablet taken every 4 to 6 hours, though addicts may take much higher doses.

      Vicodin previously was manufactured with higher dosages of acetaminophen (up to 750mg per pill). However, in March 2014, the FDA announced that all manufacturers cease marketing products with more than 325mg of acetaminophen. This is due to the increased risk of liver damage and accidental acetaminophen overdose when taking acetaminophen daily. Previous formulations included 500 to 750 mg of acetaminophen per pill. Up to 131 million Americans were prescribed Vicodin in 2011, often unnecessarily.

      • Norco (7mg, 10mg/325mg)

        Norco pillNorco is most often prescribed in two strengths: either 7.5 mg or 10 mg of hydrocodone combined with 325 mg of acetaminophen.

        Prior to the FDA requiring lower levels of acetaminophen in hydrocodone medications, Norco had the least amount of acetaminophen in it. Some addicts chose Norco in an effort to avoid the increased risks of consuming too much acetaminophen. Currently, it has the highest amount of acetaminophen allowed of any hydrocodone variant. In 2012, almost 2 million people tried opioids like Norco recreationally for the first time.

      • Lortab (5mg, 7.5mg, 10mg/325mg)

        Lortab pillLortab is a prescription drug that combines hydrocodone with acetaminophen. The addition of acetaminophen increases the pain-relieving effects of the drug.

        Even those with a legitimate prescription may be abusing Lortab by taking more than recommended. Taking more than the prescribed dose of Lortab increases the risk of dependency and of developing a substance use disorder. The highest percentage of non-medical Lortab users are 18- to 25-year-olds.

      • Zohydro ER (10mg, 15mg, 20mg, 30mg, 40mg, 50mg)

        zohydroThe first purely hydrocodone product approved by the FDA, Zohydro ERis only prescribed for severe pain. Zohydro ERis only available as an extended release pill. Because hydrocodone can be addictive, use of Zohydro ER is carefully monitored and regulated.  This medication is designed to treat individuals with severe, chronic pain who are opioid tolerant and have not found relief with alternate treatment options.

        When Zohydro ER was approved, there was some backlash over its abuse potential. Because it has no acetaminophen, addicted people could turn to this powerful painkiller to reduce the risk of liver damage. New users, whether medical or recreational, can easily become addicted to this pure substance. However, the drug is manufactured to be abuse deterrent, and it cannot be crushed, snorted, or injected.

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      Hydrocodone Effects and Abuse

      Hydrocodone abuse can be difficult to recognize. Someone who has a legitimate hydrocodone prescription, but uses it outside of a doctor’s recommendation, is abusing it. Abuse can be taking more pills than prescribed, continuing to take them beyond their prescribed timeframe or taking them in a way other than how they were intended (such as snorting or injecting them). Many people abuse hydrocodone products for the “high” that comes from them.

      Some of the immediate effects of hydrocodone abuse include:

      • Relaxation
      • Decreased anxiety
      • Euphoria
      • Calmness
      • Happiness

      High doses of hydrocodone can create these effects more quickly. However, they can also lead to overdose.

      Overdosing on hydrocodone can cause drowsiness, confusion and nausea. The most dangerous side effect of hydrocodone is depressed or stopped breathing.

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      Addiction to Hydrocodone

      Hydrocodone interferes with the brain’s pain receptors and the brain’s limbic system, collectively known as the brain reward system. Abuse or misuse of hydrocodone may lead to a physical dependence or an addiction. A person who is physically dependent on hydrocodone will experience uncomfortable withdrawal symptoms if they reduce their dose or cease taking the medication entirely. Addiction is a chronic, neurobiological disease that is characterized by behaviors such as inability to control drug use, continuing to use despite negative consequences, and cravings.

      Once someone develops an addiction to hydrocodone, they need it to function normally and prevent withdrawal symptoms such as muscle aches and nausea.

      As their tolerance builds, people addicted to hydrocodone need higher doses to keep withdrawal symptoms at bay. Addiction is diagnosed on a spectrum from mild to severe. Some signs of hydrocodone addiction include taking more than intending to and prioritizing drug use over personal or professional responsibilities. Addictions to hydrocodone, Vicodin, Norco and Lortab can spiral out of control quickly.

      Hydrocodone and Other Drugs

      Abusing hydrocodone alongside other drugs can increase the likelihood of negative effects or overdose. Mixing hydrocodone with alcohol or benzodiazepines can be especially dangerous, as both substances are central nervous system depressants. In some cases, combining hydrocodone and either alcohol or benzodiazepines can lead to respiratory failure.

      Hydrocodone’s painkilling properties make it similar to heroin, which is often cheaper and more accessible. All too often, people who have developed an addiction to hydrocodone as a result of a prescription turn to heroin as a substitute afterward.

      Hydrocodone Abuse Statistics

      Prescription opioids such as hydrocodone are the fourth most common addiction in the U.S., accounting for approximately 1.8 million addicts.


      abused prescriptions

      About 20% of those abusing opioids like hydrocodone received the drug with a prescription.


      million first-timers

      In 2012, almost 2 million people tried opioids recreationally for the first time.


      medical emergencies

      Prescription opioids are the most common substance involved in drug-related medical emergencies. In 2013, 46% of drug-related medical emergencies involved opioids.

      Treating a Hydrocodone Addiction

      Hydrocodone powerfully addictive. Medical detox and a professional treatment program make it easier to break this addiction. If you or someone you care about is struggling to get out from under the pull of these drugs, then reach out to a dedicated treatment specialist today.

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