Hydrocodone Detox Guide: Symptoms, Timeline, and Effects

According to the Drug Enforcement Administration (DEA), hydrocodone is the most frequently prescribed opioid in the U.S ¹. Like many prescription opioid painkillers, hydrocodone is used for its ability to treat moderate-to-severe pain ^1,2. The medication is available alone (i.e., monotherapy), but hydrocodone is most commonly found in combination with other pain relievers like acetaminophen ¹. Examples of brand name hydrocodone products include ^1,2,3:

• Norco.
• Vicodin.
• Vicoprofen.
• Anexsia.

Though effective when used as prescribed, hydrocodone, like other opioid drugs, is problematic due to its abuse potential. The DEA currently lists all hydrocodone products as Schedule II controlled substances ¹. Adults and teens regularly abuse hydrocodone. The DEA reports ¹:

• More than 24 million people 12 and over have abused hydrocodone.
• More than 5% of 12^th graders have abused hydrocodone.

Hydrocodone abuse often leads to addiction and dependence ^1,3. People seeking to quit using hydrocodone should be cautious, since a series of uncomfortable and distressing effects can arise when use stops or is reduced drastically ³. Known as hydrocodone withdrawal symptoms, these challenging and erratic signs add discomfort and stress and, furthermore, can complicate recovery.

Hydrocodone Addiction

Using hydrocodone as prescribed by a doctor can be beneficial in relieving pain, but many people abuse the opioid for nonmedical reasons, such as to get high. Chronic abuse of hydrocodone can lead to addiction.

What Are the Effects?

Although hydrocodone is safe when taken at therapeutic doses, it can cause harmful effects when abused or misused. The longer someone abuses hydrocodone the higher their risk is of experiencing psychological and physical complications related to use. Some include ⁵:

• Dry mouth and nose.
• Vision problems resulting from pupil constriction.
• Severe constipation.
• Profound drowsiness or coma.
• Irregular menses in women.
• Difficulties in sexual functioning.
• Insomnia or disturbed sleep patterns.
• Increased risk of overdose due to tolerance.

Someone who uses hydrocodone intravenously may experience the following unique consequences ⁵:

• Cellulitis
• Abscesses
• Track lines and puncture marks
• Lesions and scars
• HIV
• Hepatitis
• Tuberculosis
• Tetanus
• Infection of the heart lining

A person who abuses hydrocodone intranasally may experience the following effects ⁵:

• Perforation of nasal septum
• Nosebleeds
• Irritation of nasal mucosa

Do I Need Hydrocodone Detox?

It may not be clear whether you or a loved one has an addiction to hydrocodone or not. Thankfully, there are many signs and symptoms that can indicate that a person may benefit from entering a professional detox program that can provide them with support and care during this trying time. If you have experienced at least 2 of the following symptoms within the past year, hydrocodone detox may be an appropriate option ⁵:

• You use higher or more frequent doses than intended.
• You have attempted to quit or cut down on use but have failed to do so.
• You experience problems at school, home, or work due to hydrocodone use.
• You experience interpersonal or social problems resulting from hydrocodone use.
• You frequently use the drug in hazardous situations.
• You continue to use despite psychological or physical consequences caused by or exacerbated by use.
• You have cravings for hydrocodone.
• You spend a large portion of time obtaining the drug, using it, and recovering from its effects.
• You require increasingly larger doses to get the same effect (known as tolerance).
• You experience withdrawal symptoms with abrupt discontinuation of or reduction in use.

It can be challenging to quit using hydrocodone on your own due to the emergence of painful withdrawal symptoms. You may want to consider seeking a hydrocodone detox program that can ensure your comfort and safety throughout the process.

What Are the Withdrawal Symptoms?

A person that quits abusing hydrocodone will likely experience unpleasant or uncomfortable withdrawal symptoms. The specific symptoms and their intensities will depend on various individual factors, but the most common symptoms of hydrocodone withdrawal are ^5,6,7:

• Cramps, nausea, vomiting, diarrhea.
• Increased anxiety.
• Depression or dysphoria.
• Anhedonia, or an inability to feel pleasure.
• Fast pulse, high blood pressure, increased body temperature.
• Rapid breathing.
• Insomnia or disturbed sleep patterns.
• Dilated pupils.
• Excessive sweating and runny nose.
• Goose bumps.
• Muscle twitches.

Hydrocodone Detox Timeline

Detoxification (detox) refers to the body’s natural ability to process and remove unwanted substances. Detox can also refer to professional interventions used to promote comfort and safety during withdrawal. Any drug detox experience will be tremendously variable based on the interaction of several influences, such as ⁶:

• The exact substance/ formulation being abused.
• Route of administration (e.g. snorting vs. injecting).
• Dose and frequency of use.
• Other substances being consumed.
• Established mental or physical health conditions.

With hydrocodone detox, withdrawal symptoms may begin anywhere from 6 to 12 hours after last use ^5,6. The acute detox period for opioids like hydrocodone can last between 4 and 10 days ⁷. The acute withdrawal symptoms are commonly followed by several protracted withdrawal symptoms ⁸. Sometimes referred to as post-acute withdrawal syndrome (PAWS), extended withdrawal can last for 6 months displaying symptoms like ^7,8:

• Anxiety.
• Depression.
• Emotional blunting.
• Insomnia.
• Irritability.
• Fatigue.

Risks of Quitting On Your Own

More than 82,000 emergency room visits were linked to hydrocodone abuse and overdose in 2011.

In most situations, hydrocodone withdrawal is not life-threatening, but it can lead to many unwanted physical health and mental health effects ^6,7.

The significant health complications associated with acute hydrocodone withdrawal include ^6,7:

• Dehydration: Poor self-care (e.g., adequate food and water intake) during detox paired with vomiting, diarrhea, and increased sweating can result in dehydration and electrolyte problems.
• Heart issues: Especially problematic for those with long-standing cardiac and related issues, the effects of withdrawal on the cardiovascular system can create or worsen heart problems.
• Higher stress: The increased mental stress of hydrocodone detox can spark anxiety and panic, which is more prevalent in people with pre-existing conditions.
• Intense pain: With hydrocodone withdrawal, a person’s pain threshold will be lower and result in increased perceptions of pain.

Cravings are another dangerous complication of hydrocodone detox because they can increase the danger of relapse and hydrocodone overdose. According to the DEA, more than 82,000 emergency room visits were linked to hydrocodone abuse and overdose in 2011 ¹.

Detox Treatment Settings

Recovery from hydrocodone dependence and addiction may be facilitated with medically-assisted or medically-supervised detox. Detox treatment will focus on gradually reducing the dose and frequency of hydrocodone or administering specific medication-assisted treatment (MAT) drugs (e.g., Suboxone) to manage withdrawal and treat cravings ^6,9.

Hydrocodone detox is conducted at different locations based on the needs and supports of the individual ⁶. Detox options include ^6,9:

• Inpatient/residential detox programs are the best choice for people with more severe addictions, a history of complicated withdrawal, or limited supports in their home environment. Inpatient/residential programs allow the individual to live and receive detox services at the facility with staff and other residents for support.
• Outpatient detox programs are a better fit for people with less severe addictions, lower risk of serious withdrawal symptoms, and established family or community supports. With a number of program varieties and time requirements, outpatient treatment generally involves the individual attending detox treatment during the day and returning to home or work following the appointment. This treatment can take place at community health facilities, doctor’s offices, and other detox treatment centers.

Detox can help people take the first step, but lasting recovery from hydrocodone addiction usually requires a long-term commitment to addiction treatment ⁹. Seeking substance abuse treatment following detox is valuable, since people who engage in a comprehensive recovery program tend to be more successful in their abstinence ⁹.

Sources

1. Drug Enforcement Administration. (2014). Hydrocodone.
2. U.S. National Library of Medicine: Medline Plus. (2016). Hydrocodone Combination Products.
3. National Institute on Drug Abuse for Teens. (2016). Prescription Pain Medications: Opioids.
4. Medscape. (2016). Withdrawal Syndromes.
5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
6. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.
7. World Health Organization. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Setting.
8. Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal.
9. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.