Hydrocodone is a generic opioid drug sold under a number of brand names, often in combination with other drugs like acetaminophen. Like other opioids, hydrocodone is a potent painkiller and cough suppressant. It has brought relief for many people struggling with chronic pain, but it also comes with a serious downside and potential risks, like withdrawal, addiction, and death from overdose. There is a high potential for abuse with hydrocodone, which is why it should be prescribed carefully and taken only under the strict direction of a physician. Patients who become addicted face a long struggle to recovery.
What is Hydrocodone?
Hydrocodone is an opioid drug, meaning it is derived from the natural components found in the opium poppy. These natural opioid alkaloids include morphine and codeine. Hydrocodone is based on the latter. This is not a new drug; it was first synthesized in a laboratory in 1920 in Germany. The U.S. Food and Drug Administration (FDA) first approved hydrocodone in 1943 and it was initially sold by a company called Knoll under the drug name Dicodid.
When it became clear that hydrocodone use led to tolerance, and eventually dependence, the Drug Enforcement Administration (DEA) classified the drug as a Schedule II substance. Only Schedule I drugs are more highly regulated and considered more prone to abuse and addiction. Combination products with hydrocodone were classified in Schedule III until 2014 when the DEA moved them into Schedule II.
Until very recently with the FDA approval of Zohydro in 2014 and Hysingla in 2016, all prescription drugs containing hydrocodone were combination products. These two are pure hydrocodone. All other hydrocodone products include at least one other substance and are sold under various names. Some are indicated for treating pain, like Norco, Vicodin, Lortab, Lorcet, which include acetaminophen and Lortab ASA, Damason-P, and Azdone, which have aspirin. Other hydrocodone combination drugs include a number of other compounds and are used to treat coughs and cold symptoms.
How it Works
Like other opioid drugs, hydrocodone works by binding to opioid receptors in the central nervous system. The effects are that it blocks or interferes with pain signals, and has a generally calming effect. It also reduces activity in the parts of the brain that are related to coughing. This gives hydrocodone the dual use as an analgesic and antitussive medication.
The binding to the opioid receptors also has the effect of giving the user a euphoric feeling. It causes a release of dopamine, the neurotransmitter, or brain chemical, associated with the sensation of pleasure. Any time you experience something pleasurable, dopamine is released naturally. Opioids like hydrocodone provide this same feeling, but sometimes more intensely depending on the dose.
The most common side effects of hydrocodone are dizziness and lightheadedness, constipation, nausea, vomiting, and drowsiness. It may also cause mood swings and euphoria, anxiety, difficulty urinating, a dry throat, itching, narrowed pupils, and rash. More rarely, hydrocodone may cause slow breathing, irregular breathing and tightness in the chest. These symptoms require emergency medical treatment.
Because of the euphoria that may accompany hydrocodone, this drug has a high potential for abuse. With a potential for abuse comes a potential for overdosing. It is easy to build up a tolerance to the pleasurable effects, so someone abusing hydrocodone may take more and more to get the same feelings and may accidentally overdose. This requires emergency treatment and can be fatal. The signs of opioid overdose include narrowed or widened pupils, cold and clammy skin, slowed heartbeat, sleepiness, loss of consciousness, and seizures.
Addiction and Withdrawal
The combination of a pleasurable sensation and the development of tolerance that occurs with hydrocodone makes it susceptible to abuse by users, which means that patients taking this drug may become addicted. One sign of dependence on hydrocodone is experiencing withdrawal symptoms. If you have been abusing the drug and then stop taking it, you may feel restless, have pain, experience vomiting and diarrhea, feel irritable, and be unable to sleep. This is withdrawal and it makes it hard to stop abusing a drug.
Addiction is a disorder of the brain. Abusing a drug like hydrocodone causes changes to the brain that make it very difficult to stop using. You may be addicted if you take more of a drug than you have been prescribed; if you try to stop using it, but can’t; if your use of the drug is interfering with the rest of your life; and if your loved ones believe you have a problem.
Hydrocodone Addiction Treatment
Treatment of any opioid drug, including hydrocodone, involves a combination of therapy and medication. Therapy may take place in a residential facility, with one-on-one outpatient counseling, or in a group setting. Medications for treating hydrocodone addiction include naltrexone, methadone, and buprenorphine. These drugs help minimize withdrawal symptoms or minimize the effects of hydrocodone.
Single-Entity Hydrocodone Products
Until just a few years ago, all hydrocodone products on the marketplace were combinations. In 2014 and 2016 the FDA approved two single-entity products, those drugs with only hydrocodone: Zohydro and Hysingla. These products were created to help treat people with severe and chronic pain, but there is also a lot of concern that they may make the problem of prescription drug abuse and addiction worse. These medications are much more potent than the combination products and have raised some valid concerns.
One major concern with Zohydro is that it is an extended release medication. It contains up to 50-milligram doses in one pill, designed to be released in the body slowly so that patients get steady pain relief for 12 hours. The dosage, though, is five times higher than in a combination product. Some people are worried that those who want to abuse it could alter the drug to get the full dose at once. This very high dose is extremely dangerous. Hysingla was developed to also be a potent, extended release drug, but it is supposed to be tamper-proof so that it cannot be abused. Whether that will be true remains to be seen.
If you or someone you care about has suffered because of taking hydrocodone medications, you may be facing a long, uphill battle against addiction. You should know that there are ways to get help and that it is possible to recover from addiction to hydrocodone. It takes time and work, but it is possible.