The generic opioid drug called hydrocodone is used to treat chronic, moderate, and severe pain. It is a medication that has been around for nearly 100 years and is sold under several different brand names, both alone and in combination with other types of painkillers. As an opioid, hydrocodone is a potent painkiller that has brought relief to many people, but it also has its downsides.
Hydrocodone addiction is very serious and it is easy for patients to become dependent on this powerful medication. It has a very high potential for abuse and is considered a schedule II controlled substance for this reason. Doctors are expected to take care when prescribing hydrocodone products because there is such a high potential for addiction. Treating hydrocodone addiction is tough and may involve both therapy and medical treatment.
An Opioid Painkiller
The opioid drug class contains substances, like hydrocodone, that were synthesized from the natural compounds found in the opium poppy. Opium is a mixture of chemical substances and has long been a drug of abuse, but also one with medicinal properties. Once chemists were able to isolate the active compounds in opium, like codeine and morphine, they could then create new, similar compounds that might work well as medicines.
One of those was hydrocodone, which was first synthesized back in 1920 in Germany. The U.S. Food and Drug Administration (FDA) first approved hydrocodone in 1943 when it was sold under the brand name Dicodid. Since it was first approved, hydrocodone has largely been used for the treatment of pain, but it also acts as an antitussive, which means it can be used for a chronic cough or coughing that doesn’t respond to other treatments.
Today there are multiple brand names under which hydrocodone is sold. Many of these are actually combination drugs, including hydrocodone and a less potent painkiller like acetaminophen or ibuprofen. Some of these include Vicodin, Norco, Lortab and Lorcet. Most recently, some drug companies have come up with extended relief forms of hydrocodone for more severe pain that needs 24-hour treatment. These are Zohydro made by Pernix Therapeutics and Hysingla, made by Purdue Pharma. All hydrocodone products have the potential to be addictive, but there is special concern about the two extended release forms.
High Potential for Abuse
The Drug Enforcement Administration moved up the classification of hydrocodone in 2014. It shifted the drug from a schedule III controlled substance to a schedule II substance. Only the drugs in schedule I are considered to have a higher potential for abuse. Opioids like hydrocodone block pain signals, and a part of that action includes a release of dopamine in the brain.
The chemical called dopamine is a natural neurotransmitter that is associated with mood and a sensation of pleasure. The flood of dopamine that is released from hydrocodone is what makes it potentially addictive. A patient may take more of the medication or take it more often or for longer than is necessary just to chase that high. That is called abuse, and it can quickly lead to addiction.
When someone starts to abuse an addictive drug like hydrocodone, several things start to happen in the body and brain. The first is that the person starts to develop a tolerance to it. He or she begins to need more and more hydrocodone just to get that high. If the behavior continues then the brain and body become physically dependent on the drug. The person then keeps taking hydrocodone in larger and larger doses just to feel normal.
The consequence of not using the drug at this point is to start detoxing and experiencing withdrawal symptoms. Actual changes have occurred in the brain that make stopping using the drug next to impossible and now the person is addicted. Withdrawal from hydrocodone is uncomfortable and can even be dangerous. Symptoms include insomnia, irritability, anger, nausea, vomiting, diarrhea, pain, and restlessness.
Complications of Addiction
Addiction is a disease of the brain, whether it is hydrocodone or some other drug that is being abused. Chronic abuse of hydrocodone changes the brain and makes a person dependent on it. There are many possible complications of hydrocodone addiction, both for physical and mental health and for all areas of life, like relationships and work.
One of the most serious potential complications is an overdose. When someone is abusing a drug like this, it can be easy to accidentally take too much and experience an overdose. If not treated immediately, this can quickly be deadly. Signs of a hydrocodone overdose include dilated pupils, clammy, cold skin, sleepiness, a slow heartbeat, seizures, and loss of consciousness.
Another consequence of abusing hydrocodone is experiencing more of the potential side effects of the drug. Because the person is taking larger doses, side effects become more likely and more severe. They may include dizziness, vomiting, seizures, loss of consciousness, and slowed breathing. Side effects that may not be immediately obvious include liver damage and liver failure.
Over time, hydrocodone addiction can cause a number of other problems in someone’s life. An addict to this drug, for instance, may lose relationships with loved ones because of their constant need to feed the addiction. They may lose their job over poor work performance, and in extreme cases, addicts may lose access to their children.
Hydrocodone Addiction Treatment
Treating any kind of addiction is difficult. Overcoming addiction requires professional assistance. For hydrocodone, the first step is to detox, or stop using it long enough for all traces of the drug to leave the body. This can be done with medical supervision to help control the withdrawal symptoms. Then a patient must go through different kinds of treatment, both behavioral and medical, to find a system that works best.
While therapy and counseling are the traditional ways to treat addiction, and still often used by many people struggling with this disease, there are now medications available to supplement treatment. Medications have been developed to treat opioid, and hydrocodone, addiction in several ways. For instance, naltrexone can be used to limit the effect of an opioid in the brain and buprenorphine can be used to reduce cravings for the drug.
Addiction to any drug is a terrible disease. People’s lives have been ruined by addiction. Although hydrocodone has been an effective painkiller for many people who struggle with pain, it has also caused countless cases of addiction requiring years of treatment. The newer extended release forms of hydrocodone are causing concern that addiction cases will increase. If the extended release formula can be broken somehow, an abuser can get a huge dose of hydrocodone from one pill and be at risk of overdosing. Although experts urged the FDA not to approve these extended release pills, the agency did just that in 2013. Time will tell what damage this will cause.