In the late 1990s, the United States saw an increase in opioid prescribing, leading to widespread misuse of both prescription and non-prescription opioids. In 2017, the U.S. Department of Health and Human Services recognized the ensuing opioid crisis as a public health emergency.
Since then, healthcare practitioners and the general public alike have become more aware of the addictive potential of prescription opioids, like hydrocodone. In fact, some people may be reluctant to take opioids at all, even when they're prescribed appropriately, due to worries about addiction potential.
If you've been prescribed hydrocodone, more commonly known by the brand name Vicodin®, you may be wondering about the risk for addiction. Is hydrocodone addictive and, if so, how can you take it responsibly if you're prescribed it? Below, we cover the essential facts.
Why is hydrocodone prescribed?
Hydrocodone is made from the poppy plant and is classified as a Schedule II drug under U.S. law. It's most commonly sold as Vicodin and in medications mixed with acetaminophen; it's even found in some cough suppressants. Other names hydrocodone may be marketed under include Lortab®️, Norco®️, or ibuprofen formulations (e.g. Vicoprofen®️).
Hydrocodone may be prescribed after surgery or a moderate to severe injury. In addition to having a sedative effect, the medicine blocks pain signals to the brain, alleviating patients' discomfort and allowing them to get the rest they need while recovering.
Hydrocodone's other possible effects include:
- Drowsiness
- Dizziness
- Nausea
- Constipation
- Urinary retention
- Depressed respiration, if taken in higher amounts
Opioids like hydrocodone have addiction potential largely because of the feelings of euphoria they cause. By binding to the brain's opioid receptors, the drug incites a rush of dopamine production, causing the individual to feel happy.
What is the risk for hydrocodone addiction?
The euphoric effect that hydrocodone has contributes to its addiction potential, raising the risk of a possible opioid use disorder (OUD). The brain recognizes the pleasurable effects of the drug and wants to repeat that effect in the future. As a result, people may crave hydrocodone's mental effects even if they don't require it for its physical effects of pain relief.
This is why it's so important to distinguish between dependence and addiction. Dependence is generally understood as having a physical dependence on a substance. This is indicated by the fact that the body goes through withdrawal symptoms when that substance is lacking in the system.
In the case of hydrocodone, withdrawal symptoms may include:
- Insomnia
- Muscle cramps
- Yawning
- Depression
- Irritability
- Anxiety
- Seizures
Meanwhile, addiction refers to the behavioral changes that occur in the case of physical dependence. These changes are brought on by biochemical alterations in the brain following continued misuse of a substance.
While the terms "addiction" and "dependence" are sometimes used interchangeably, most healthcare professionals now differentiate between physiologic dependence and addiction. This differentiation becomes especially important when talking about prescription opioids like hydrocodone, which may have a stigma attached to them in light of the opioid crisis.
Signs of possible hydrocodone addiction
While hydrocodone does have addiction potential, it can still serve a medical purpose and be useful when taken in the appropriate context and with the correct supervision. A patient may develop a short-term medical dependence, in which they feel a physical need for the medication, but that doesn't mean they are facing a lifetime of addiction.
The most important thing when taking any kind of prescription medication, including hydrocodone, is to take it as recommended by your doctor. Beyond this, early recognition of possible signs of hydrocodone addiction can help minimize the risk of OUD.
While symptoms vary between individuals, common indicators include:
- Slowed heartbeat
- Dizziness
- Lightheadedness
- Sleepiness
- Blurred vision
- Slowed breathing
- Nausea
- Vomiting
- Fear
- Depression
- Confusion
- Headaches
- Tinnitus (ringing in the ears)
- Cold, clammy skin
- Muscle weakness
- Seizures
If these symptoms arise, it's critical to consult a medical professional immediately. In case of more severe issues, like seizures, don't wait to see a doctor: Call emergency services immediately.
How healthcare providers and patients can reduce the risk of hydrocodone misuse
The answer to the question "Is hydrocodone addictive?" isn't as straightforward as you might expect. While hydrocodone does have addiction potential, it still has a medical purpose. When taken in the appropriate dosage, in the right context, and under fitting supervision, hydrocodone can be part of a valid medical treatment (for example, following a surgery or injury).
Healthcare providers and patients alike can help minimize the risk of addiction by educating themselves about the potential challenges and learning how to recognize signs of dependence and addiction. Transparent communication between patients and their healthcare providers is critical.
As a patient, you can do your part by taking the medication as prescribed. You may also want to keep a pain journal, recording the impact the medication has on you. As your pain management needs decrease, your doctor can adjust your hydrocodone dosage, lowering it to reduce the risk of dependence. If your pain is under control, they may even recommend stopping the medication sooner than expected.
Most importantly, if you find that you're craving the medication, especially if you're craving it despite not feeling any pain, talk to your doctor as soon as possible. This can be a warning sign of a possible addiction issue. A healthcare professional can help you take the steps you need to stay well and avoid OUD.
Support for hydrocodone misuse and other forms of OUD
If you or someone you know is struggling with hydrocodone addiction, Ophelia can help. We offer medications for addiction treatment (MAT) online, making quality care more accessible. Our virtual care teams develop customized treatment plans, including Suboxone® or another buprenorphine-naloxone medication when appropriate, and provide ongoing support to help patients maintain their progress.
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