Recognizing the Signs of Hydrocodone Addiction
Hydrocodone is a pain-relieving central nervous system (CNS) depressant with high potential for misuse, abuse, dependency, and the development of a substance use disorder (SUD). Because hydrocodone is a potent semi-synthetic opioid, people can become dependent on the drug within a week of normal use. Typically, hydrocodone addiction starts with a prescription that many patients build a tolerance to within a short period of time. To overcome the body’s tolerance and feel the effects of hydrocodone, people may take increasing amounts of pills or crush and snort them for amplified effects. Despite knowing the negative consequences of their actions, people with a hydrocodone addiction feel a compulsive need to get hydrocodone. Below are the warnings signs and symptoms of a hydrocodone addiction.
The American Psychiatric Association (APA) determines the criteria for SUDs and releases the information in its Diagnostic and Statistical Manual of Mental Disorders (DSM). A SUD can be diagnosed as mild, moderate, or severe. In the most recent manual, the DSM-V, signs of an addiction to opioids, including hydrocodone and illicit opiates like heroin, involve:
- Taking more hydrocodone or taking it for longer than intended
- Wanting to reduce or stop using hydrocodone but failing to do so
- Spending lots of time getting, using, or recovering from using hydrocodone
- Experiencing cravings and urges to use hydrocodone
- Failing to fulfill obligations at work, home, or school because of hydrocodone use
- Continuing to use hydrocodone, even when it causes problems in relationships
- Giving up important social, occupational, or recreational activities because of hydrocodone use
- Continuing hydrocodone use, even when it puts you in danger
- Using hydrocodone, even when you know you have a physical or psychological problem that could have been caused or made worse by hydrocodone
- Needing more hydrocodone to get the effect you want (developing a tolerance)
- Development of withdrawal symptoms which can be relieved by taking more hydrocodone
- Taking hydrocodone in any other form or method than as prescribed
Symptoms of Hydrocodone Misuse and Abuse
As state above, hydrocodone (also known by the brand names Vicodin®, Norco®, Lortab®, and others) is a powerfully addictive painkiller that has a high potential for misuse, abuse, and addiction. Using hydrocodone for even 5 days can lead to physical dependence; many who take them for a month are still using them a year later. Below are the symptoms of opioid use to recognize when someone is abusing hydrocodone.
Signs of hydrocodone abuse include:
- Diarrhea or upset stomach
- Dry mouth
- Nodding in and out of consciousness
- Pinpoint pupils
- Rash or itchy skin
- Slowed or shallow breathing
- Flushed, warm skin
- Nausea or vomiting
- Slurred speech
- Withdrawal from social activities
- Changed mood
- Sexual dysfunction in men
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Dangers of Hydrocodone: Side Effects of Short- and Long-term Abuse
The effects of hydrocodone are similar to those of morphine and heroin because all three opioid drugs interact with the same parts of the brain. Hydrocodone also interacts with the brain’s reward system, which reinforces continued use by allowing the body to adjust to the drug’s presence and, in a short time, come to depend on it. Continued abuse of hydrocodone can cause short- and long-term damage to the user’s body and mental health.
Long-term addiction to hydrocodone can lead to severe health consequences. Often, chronic health problems develop because the individual cannot feel pain signals that let them know when they are experiencing illness or injury. Many times, the individual will not become aware of health issues until they detox. Some health concerns include:
Chronic constipation due to addiction to hydrocodone causes damage to the bowels. This may lead to hemorrhoids, tearing of the skin in and around the anus, fecal impaction, or even cause rectal prolapse. There is also risk of damage to the nerves around the anus, and an increased risk of ulcers. Moreover, gastrointestinal bleeding is associated with addiction to hydrocodone drugs containing acetaminophen (also known as Tylenol®).
Using large amounts of hydrocodone long-term reduces an individual’s breathing rate, which in turn reduces how much oxygen their body takes in. This can cause damage to various organ systems, including the brain. It can also increase the risk of sudden death for individuals who suffer from sleep apnea or lung diseases. People who crush and smoke hydrocodone can also damage their lungs by smoking the harsh chemicals.
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Endocrine System Damage
Chronic, heavy use of hydrocodone decreases hormone levels in the body. Some of these hormones include estrogen and testosterone, which can lead to fertility damage, making it more difficult to conceive for some men and women. Low hormone levels can also result in increased risk of depression, anxiety, chronic fatigue syndrome, osteoporosis due to loss of muscle mass, and increased risk of bone fractures. A study found that hormone levels in women who were addicted to hydrocodone were between 30 to 70% lower in estrogen levels than normal.
Hyperalgesia (Increased Pain Responses)
Individuals with hydrocodone use disorders are at high risk of damaging opioid receptors in the brain, which affect how the brain manages responses to pain. Numerous studies have reported that individuals who have a history of long-term opioid use are much more likely to experience intense pain. After years of Opioid abuse, many people have a heightened sensitivity to pain. This results in needing longer periods of time to recover from an injury or surgery and experiencing intense cravings to use hydrocodone to relieve pain.
Significant abuse of hydrocodone can alter how chemicals are released and absorbed in the brain, especially mood-regulating neurotransmitters (such as serotonin and dopamine). Taking high doses of hydrocodone for long periods of time can cause large doses of feel-good neurotransmitters to flood the brain. Over time, this will change the structures associated with emotional control, rational thinking, memory, and learning.
Long-term oxygen deprivation will also result in damage to brain structures. Some damage is reversable but may take years to adjust. Some symptoms, however, may not be completely reversible. There is also risk of irreversible brain damage due to lack of blood flow after an overdose from hydrocodone due to respiratory failure. Strokes, for instance, fall in this category.
Loss of Limbs
The loss of blood flow that occurs during a hydrocodone overdose may necessitate the amputation of one or more limbs.
Variants of hydrocodone containing acetaminophen also pose a high-risk of liver damage or failure. Studies show that consuming more than 4,000 mg of acetaminophen in one day can cause acute or chronic liver injury – including cirrhosis and possibly liver failure. For this reason, the Food and Drug Administration (FDA) reduced the acceptable level of acetaminophen to no more than 325 mg in hydrocodone-based medications. Prior to these new regulations, Hydrocodone once contained more than double that amount.
Hydrocodone Withdrawal Symptoms, Treatment, and the Next Steps
Regular use of hydrocodone may result in a physical dependence and addiction. Opioid dependence and addition produce painful withdrawal symptoms when a person tries to stop taking the drug or reducing the amount they use.
Addiction is a chronic, neurobiological disease that is characterized by behaviors such as inability to control drug use, continuing use despite negative consequences, and persistent cravings.
Essentially, hydrocodone withdrawal symptoms produce the opposite effects that the drug’s high produces. For instance, while hydrocodone abuse produces effects of euphoria, withdrawal induces depression. Likewise, misusing any Opioid can cause excessive fatigue, while withdrawal causes insomnia. Some withdrawal symptoms can be life-threatening (such as vomiting and diarrhea) if not monitored by a medical professional. As such, detox and rehab at a qualified addiction treatment facility is vital.
Alongside addiction treatment and therapy, it is important for a recovering hydrocodone addict to find support through local groups, therapists or counselors, and family and friends. Rehab programs can help people focus on recovery and establish new ways to handle pain and stress without using hydrocodone. Other benefits of rehab include:
- Teaching relapse prevention skills, healthy boundaries, and communication skills
- Providing healthy recreational activities as alternatives to drug use
- Help rebuilding relationships
- Providing education on the chronic disease of addiction
- Help building and developing healthy coping and stress-reduction skills
- Providing patients with a strong foundation in early recovery to assist them as they transition to living in the real world, drug-free
If you or someone you care about is struggling, get in touch with a treatment provider to discuss treatment options.