The opioid epidemic is so far-reaching that in its two decades of its existence, it has been responsible for a majority of the drug overdose deaths that have occurred since the late 1990s. The U.S. Centers for Disease Control and Prevention (CDC) estimates that between 1999 and 2017, nearly 400,00 people have died from an opioid-involved overdose. In the 1990s, prescription hydrocodone and oxycodone medications are what fueled the first wave of this drug crisis.

However, there is evidence that the use of prescription opioids is down. In 2018, for example, U.S. prescription opioid abuse was down by 17 percent according to this 2019 CNBC report. That same report indicated that since 2011, the height of prescription pain pill consumption, use had declined by 43 percent.

Potent synthetic opioids like fentanyl are driving the latest wave of this drug crisis, but hydrocodone medications are still being abused. Hydrocodone remains habit forming and highly addictive. It is also capable of producing uncomfortable withdrawal symptoms that are enough to cause people to relapse and succumb to overdose, which can be fatal.

What is Hydrocodone?

German scientists developed hydrocodone in the 1920s. The U.S. Food and Drug Administration (FDA) approved it in 1943. Hydrocodone is employed to treat severe pain.

What’s more, hydrocodone is often formulated with acetaminophen and marketed under brand names such as Norco, Lortab, and Vicodin. This particular kind of hydrocodone medicine is available as a tablet, solution, or elixir.

Hydrocodone binds to opioid receptors in the brain and spinal cord. This action results in the blocking of pain signals. But hydrocodone also stimulates the flooding of dopamine in the brain, like other opioids.

Dopamine is a chemical messenger in the brain often associated with feelings of bliss, euphoria, and motivation. When hydrocodone activates this area, users experience a profound euphoric rush. The effect can be so impactful that it will cause people to take hydrocodone and other opioids repeatedly.

Hydrocodone’s ability to spur repeated use is why the drug remains highly addictive.The U.S. Drug Enforcement Administration (DEA) substantiates the drug’s addictive nature by assigning it as a Schedule II controlled substance, which means that use “may lead to severe psychological or physical dependence.”

That DEA classification means that hydrocodone is grouped with other notorious opioids of abuse like fentanyl, oxycodone, and opium.

While hydrocodone is not as potent as say, oxycodone, heroin, or fentanyl, it is still capable of generating flu-like withdrawal symptoms, which is customary of most opioid medications.

Learn what those symptoms are and when they occur during withdrawal.

The Stages of Hydrocodone Withdrawal

When someone reaches the stage of hydrocodone withdrawal, it usually means that the body can only feel normal in the presence of the drug. Once that substance is withdrawn, the system experiences physical disturbances. This occurrence is the hallmark of drug dependence, and hydrocodone is no different.

While hydrocodone withdrawal is not life-threatening like alcohol or benzodiazepines, these uncomfortable symptoms can generally last between seven to 10 days.

Withdrawal timelines can vary from person to person and depend on the severity of use and the health of an individual.

Generally, hydrocodone withdrawal occurs in three stages:

Days 1-2 (Beginning stage): Withdrawal symptoms typically begin about 24 hours after last use. Symptoms can diminish within a week and linger for a month or more. The symptoms of the beginning stage include:

  • Yawning
  • Insomnia
  • Runny nose
  • Anxiety
  • Restlessness
  • Agitation
  • Muscle aches and pains
  • Sweating
  • Tearing

Days 3-5 (Peak stage): It is during this time that the most severe ailments show up, where those flu-like symptoms will be at their worst.

Hydrocodone cravings may also be at their most pronounced, leaving a user prone to relapse.

Intense physical and psychological symptoms that occur in this period are:

  • Depression
  • Anxiety
  • Muscle pain
  • Joint aches
  • Nausea
  • Diarrhea
  • Stomach pain
  • Tiredness
  • Insomnia
  • General malaise

It is crucial that you seek medical attention at this stage due to the severity of the symptoms and the intense cravings, which can cause you to relapse and potentially overdose.

Days 5-7 (Decline stage): The physical and psychological symptoms will continue, but they generally subside at this stage.

During this period, symptoms such as nausea, diarrhea, and muscle aches show up. Cravings, agitation, insomnia and mood swings occur as well, but they take longer to subside.

If you have abused hydrocodone for an extended period or have attempted to quit on your own, you could develop the most severe form of opioid withdrawal, which is post-acute withdrawal syndrome (PAWS). It’s worth noting that people who have not used hydrocodone over a long time are susceptible to PAWS as well.

Post-Acute Withdrawal Syndrome (PAWS)

For some users, the three previous stages of the withdrawal timeline can, for them, precede the first actual withdrawal stage: PAWS or the acute phase.

PAWS can also be a second stage, where withdrawal symptoms endure for weeks or months.

With the onset of PAWS, people in withdrawal can begin to feel bounceback pain, or they can be more sensitive to pain. It may also feel like they are coming down with the flu again, and they may experience feelings of depression, anxiety, and insomnia.

PAWS can ultimately cause people to relapse and succumb to overdose. Hydrocodone and hydrocodone/acetaminophen overdose symptoms can include:

  • Confusion
  • Seizures
  • Dizziness
  • Drowsiness
  • Tiredness
  • Cold, clammy skin
  • Weakness
  • Lightheadedness
  • Low blood pressure
  • Muscle spasms
  • Tiny pupils
  • Stomach and intestine spasms
  • Blue lips and fingernails
  • Nausea and vomiting

The Life-Threatening Symptoms of Hydrocodone and Hydrocodone/Acetaminophen Overdose Include:

  • Breathing complications such as slow, difficult, or shallow breathing, or no breathing.
  • Coma
  • Liver failure and jaundice (from hydrocodone-acetaminophen medications)
  • Weak pulse
  • Loss of consciousness

Why Professional Treatment is Necessary

The threat of PAWS is why professional treatment for hydrocodone abuse and addiction is necessary. Medical detoxification is the first step in professional treatment. A medical staff of doctors, nurses, and other personnel gradually remove the hydrocodone from your system and treat withdrawal symptoms that show up.

Depending on your profile, you can be administered approved medications to treat your opioid addiction and the withdrawal symptoms mentioned above.

Once detox is complete, you may be recommended for residential treatment if your case is deemed severe. Residential treatment offers full-time comprehensive care at a facility where you will reside.

Here you will receive the intensive, multi-level care necessary to treat the most fundamental areas of opioid addiction, the mental and emotional aspects.

The therapy approaches offered in residential treatment include:

  • Behavioral therapy
  • Group therapy
  • Family therapy
  • Mindfulness
  • Life skills training
  • Motivational interviewing

An outpatient program is typically recommended for milder cases of addiction. With outpatient, you will have an opportunity to receive therapy and care on a part-time basis without having to put your life on hold.

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