Vicodin is a prescription painkiller made from a semisynthetic opioid, hydrocodone, with acetaminophen, the active ingredient in Tylenol. It is used to dull moderate to severe pain on a short-term basis, typically after surgery. Vicodin is not intended for long-term use, or to treat chronic pain, because it is a short-acting opioid painkiller. Sometimes, a person can develop an addiction to the opioid in the prescription medication, and when the individual attempts to stop taking the medication, they may experience withdrawal symptoms.
The Drug Enforcement Administration (DEA) lists hydrocodone medications, including Vicodin, as Schedule II substances. This means that there is a specific medical use for these substances, but they have a high risk of addiction and abuse. The DEA also noted that, since 2009, hydrocodone substances are the second most frequently found opioid drugs in evidence submitted to forensics labs at the federal, state, and local levels. Vicodin is one of the most abused drugs today, so many people who attempt to withdraw from opioid medications have a history of Vicodin addiction or abuse.
How Is Vicodin Addictive?
The opiate in Vicodin, hydrocodone, is a narcotic analgesic, which depresses the central nervous system. The effects of hydrocodone can lead to a sense of euphoria or ease, which can be addictive for some people.
The other active ingredient in Vicodin is acetaminophen. This medication helps to reduce pain and fever, and it is often in over-the-counter medications like cough syrups or pain relievers. It is not considered addictive, although it can build up in the liver and lead to toxicity and overdose.
Addiction and dependence are different conditions, but they often occur together. Dependence occurs when the brain and body need a specific amount of a substance, such as hydrocodone, to feel normal or good. Addiction is a disease in which the reward centers of the brain need a substance or behavior to release dopamine, serotonin, or other “happy” neurotransmitters. Without a specific level of these neurotransmitters in the brain, the individual can begin to feel intense cravings for the substance or suffer psychological withdrawal symptoms.
Dependence does not always equal addiction. Some people can be dependent on a medication while taking it legitimately, according to a doctor’s instructions. If a person begins abusing the medication, taking it more frequently or in higher doses than prescribed, or altering it in any way, it is likely that addiction has formed.
Physical dependence can induce physical withdrawal symptoms. However, for people who struggle with an addiction to Vicodin, it is very important to detox from this drug with medical assistance.
Symptoms of Addiction and Intoxication
When a person becomes addicted to Vicodin, they may display several symptoms of addiction or intoxication. Some of these symptoms include:
- Loss of coordination
- Slurred speech
- Reduced breathing rate, or shallow breaths
- Small pupils
- Nausea or vomiting
- Nervousness about when the next dose will come
- Irritation or mood swings
- Inability to stop taking the drug
If a person becomes addicted to Vicodin, they are at an increased risk of overdosing on this medication. Many people who become addicted to opioid medications like Vicodin are at a greater risk of switching to heroin as well, because it is less expensive and relatively easy to obtain.
According to the Centers for Disease Control, more people died from drug overdoses in 2014 than any prior year. Six out of 10 of those overdose deaths involved an opioid drug, such as Vicodin or heroin. Use of natural and semisynthetic opioid drugs, including the hydrocodone in Vicodin, often leads to an increase in overdose deaths.
Addiction to opioid drugs like Vicodin can be physically harmful, and many people who struggle with Vicodin will try to stop taking the drug. Without help, however, severe withdrawal symptoms can occur.
- Anxiety and irritability
- Increased breathing rate
- Cold or flulike symptoms, like runny nose, watery eyes, or congestion
- Repeated yawning
- Increased salivation
- Muscle aches
- Nausea or vomiting
- Abdominal cramps
- Confusion or delirium
- Tremors or shakiness
- Changes in appetite, especially loss of appetite
- Cravings for the drug
Withdrawal symptoms typically set in when a person tries to stop taking Vicodin too suddenly. Although the worst of the symptoms are typically over in a week, for many people attempting to detox alone, the discomfort of the first few days can lead to relapse.
Detoxing from Vicodin without Help
Many people who struggle with Vicodin addiction attempt to detox from the drug themselves. This is called cold turkey detox, and it involves suddenly stopping all use of the drug. There are several factors that can change how long cold-turkey withdrawal can take. Some of these factors include:
- How long the person took the drug: If the individual struggled with a Vicodin addiction for many years, their dependence on and tolerance of the medication can lead to longer-lasting withdrawal symptoms. This is in part due to psychological dependence and in part because of buildup of the drug in the body.
- How large the dose was: If the dose of Vicodin was small, withdrawal symptoms will not last very long. However, if the person took large doses of Vicodin, or took Vicodin more often than prescribed, the buildup of the medication in the body could cause withdrawal symptoms to last longer or be more intense.
- Individual factors: Genetics, family history, environment, body weight, gender, and other factors affect an individual’s tolerance for Vicodin, as well as their level of addiction to the substance. This can also influence the severity and length of withdrawal symptoms, particularly psychological symptoms.
Typically, cold-turkey withdrawal lasts up to two weeks. Symptoms begin between 4-8 hours after the last dose, since Vicodin’s half-life is four hours. The most intense physical withdrawal symptoms should clear within one week, and the majority of symptoms should be gone in two weeks. Protracted withdrawal for short-acting opioids is usually 4-10 days, according to the Substance Abuse and Mental Health Services Administration. However, for people who struggle with addiction, psychological symptoms can linger, and these symptoms are often what lead people to relapse.
Although opioid withdrawal symptoms are not physically dangerous, if a person relapses, they may accidentally overdose on the drug, because their body no longer has a high tolerance to Vicodin. In other instances, they may overdose because they take too much of the medication in an attempt to overcome the discomfort of withdrawal.
In some rare cases, a person may develop PAWS, or post-acute withdrawal syndrome. This syndrome is a suite of intense withdrawal symptoms, including:
- Mood swings
- Anhedonia, or the inability to feel pleasure
- Anxiety or panic attacks
- Depression and suicidal ideation
- Reduced cognitive faculties
- Intense cravings for the substance
People who have struggled with addiction to drugs such as Vicodin for a long period of time are more likely to experience PAWS. This syndrome can last for weeks or months. Because of the changes to the brain’s risk/reward system, the ability to deal with stress and release neurotransmitters like dopamine or serotonin has been reduced, and this can lead to relapse. However, with help, the intensity of withdrawal symptoms can be reduced and managed.
Medical Assistance during Detox
When a person decides to end their addiction to Vicodin, it is important to get help. Due to the intensity of withdrawal symptoms and the strong likelihood of relapse, medical detox is recommended for opiate withdrawal. Medical professionals can help people with the withdrawal process in many ways, including by prescribing medications to ease withdrawal symptoms and to reduce physical dependence on the drug.
Tapering is a common method that is used for those who are physically dependent on opioids but not addicted to them. Doctors establish this treatment plan based on how much of the drug the individual took regularly and how long they have been taking it. The tapering process gradually reduces the amount of Vicodin the person ingests, which can reduce or even prevent withdrawal symptoms. Doctors know that, in general, the longer a person has taken Vicodin, the slower the taper should be.
The basic recommended tapering schedule involves reducing the dose by 20-50 percent per week. The doctor will monitor the individual for signs of withdrawal symptoms and may prescribe small doses of antidepressants or anti-anxiety medications to ease psychological symptoms. Over-the-counter painkillers can be used to ease muscle or joint pain as well.
For people who struggle with Vicodin addiction, particularly those who have on a long-term basis, a doctor may prescribe buprenorphine or Suboxone, which is a combination of buprenorphine and naloxone. These medications bind to the opioid receptors in the brain, since buprenorphine is a partial opioid agonist. This drug binds to opioid receptors for a longer period of time than Vicodin does, and it does not induce the same high as stronger opioid medications. This allows the person to work on overcoming their addiction with therapy, while also gradually tapering their use of buprenorphine to prevent withdrawal during detox.
Tapering, either with the original drug, Vicodin, or with buprenorphine, can take much longer than quitting the substance cold turkey. This process typically takes weeks, and sometimes, it takes months. However, when a person works closely with a doctor to detox from an addictive substance, they will have medical monitoring of their condition, which will help to prevent relapse and subsequent overdose.
Detox is an important step in ending addiction, but it is not the same thing as overcoming the addiction. Treatment following detox is needed.
Get Help for Vicodin Addiction
The National Institute on Drug Abuse (NIDA) recommends that people who want to overcome their addiction get help from a rehabilitation program. These programs can be either inpatient or outpatient, and the client and treatment team can decide which option is best for their specific circumstances.
Rehabilitation is most effective when the person stays in the program for at least 90 days. This gives the individual time to safely detox from their substance of abuse, as well as to effectively address the issues related to addiction. Therapy helps the person learn about the root causes of their addiction, develop coping strategies to deal with cravings and triggers, and find social support from others who have struggled with the same concerns.