The most commonly prescribed opioid narcotic, hydrocodone, is designed to function similarly to morphine, as an analgesic for pain relief. It also works like codeine as a cough suppressant or antitussive. In the United States, hydrocodone is marketed as a combination product, combined with acetaminophen, aspirin, ibuprofen, and antihistamines most often. The most recognizable of these may be Vicodin. Other forms include:
- Lortab ASA
Hydrocodone is a Schedule II drug, meaning that it has some medicinal properties, but also a high potential for abuse and dependency. Drug diversion refers to using prescription medications for recreational purposes, while abuse is defined as the misuse of prescription medications, often leading to dependency. According to the DEA, hydrocodone is the most diverted and abused opioid in America.
Opioids and the Brain and Body
Opioid drugs are derived from the opium poppy plant and include prescription drugs like morphine, codeine, methadone, hydrocodone, and oxycodone as well as the street drug heroin. Opioids bind to receptor sites in the central nervous system (CNS) as well as other parts of the body. Opioids suppress pain sensations and promote a calming and relaxing state. Users also often experience a sense of euphoria while taking opioids. In short, opioids generally make you feel good and affect the reward pathways of the brain, enhancing the potential for abuse.
Over time, a tolerance to the drug can build up, meaning that you will have to take more and more each time to obtain the same effects. This can easily lead to dependence, which manifests with the onset of withdrawal symptoms when the drugs are removed. Opioids suppress parts of the CNS and disrupt the brain’s natural messengers, or neurotransmitters. If you are dependent on opioids, when you stop taking the drug your brain may experience a rebound effect causing the parts of your system that were suppressed before to suddenly become hyperactive. This can make someone feel jumpy, restless, irritable, and anxious; it can also cause you to experience muscle cramps and diarrhea, not to mention drug cravings.
Abuse of Hydrocodone
In 2013, IMS Health reported that 136 million prescriptions for drugs containing hydrocodone were dispensed in America – the most common being the combination of acetaminophen and hydrocodone in the form of Vicodin or Lortab. Hydrocodone most commonly comes in a pill or tablet form to be taken orally, is most often abused by diversion, and is not generally produced on the street. In order to obtain hydrocodone via drug diversion, people call in fake prescriptions, alter prescriptions, doctor shop, steal the drug, or buy it from an illicit source on the Internet.
Hydrocodone is relatively easily accessible, found in medicine cabinets, and prescribed by doctors, giving people a sense of false security.
These factors may contribute to the fact that in the United States in 2013, 24.4 million people over age 11 were reported to have used hydrocodone for nonmedical purposes in their lifetime, according to the National Survey on Drug Use and Health (NSDUH). Perhaps even more disturbing is the number of young adults and children abusing hydrocodone. The 2013 Monitoring the Future Study found that 5.3 percent of 12th graders had abused Vicodin in the past year, for example. Hydrocodone abuse is not just a problem with our youth, however; it spans all economic and ethnic groups as well as genders and age groups.
Hydrocodone is usually abused by taking the pill form when it’s not medically necessary, although some abusers will crush the pills and snort the powder, negating the extended-release format to obtain an almost immediate “high.” This sends a concentrated dose directly into the bloodstream and rapidly across the blood-brain barrier, which can be extremely dangerous or even lead to a potentially life-threatening overdose.
Hydrocodone abuse may cause both physical and psychological side effects. Physical health risks include:
- Trouble urinating
- Respiratory depression
- Slowed heart rate
- Decreased appetite
- Nausea or stomach cramps
- Low blood pressure
For the combination hydrocodone drugs containing acetaminophen, abusers also have the added risk of potential liver damage and liver toxicity. Hydrocodone overdose is characterized by sweating, trouble breathing, lowered blood pressure and heart rate, limp muscles, nausea and/or vomiting, pinpoint pupils, and even seizures leading to coma or death. If you notice any of these symptoms, call 911. The Drug Abuse Warning Network (DAWN) reported that in 2009, there were 104,490 visits to emergency departments (EDs) related to hydrocodone abuse. Additionally, the American Association of Poison Control Centers (AAPCC) reported 36 deaths associated with hydrocodone in 2012 in the United States.
Hydrocodone changes the chemical makeup of your brain and can have lasting psychological affects as well. Chronic abuse may lead to side effects that can include:
- Mood swings
- Hostility or anger
- Negative self-image
Abusing hydrocodone if you already suffer from a mental health disorder can greatly exacerbate your symptoms. Often hydrocodone is mixed with other substances like alcohol, which can also increase the risk for a dangerous interaction or potentially fatal overdose.
Opioid drugs like hydrocodone are highly addictive and can be very difficult to break free from once a dependence has formed. Hydrocodone is prescribed for short-term relief, and due to how quickly your body can become dependent on it, it is not recommended to be taken for long periods of time. Therefore, abusing hydrocodone greatly increases the potential for addiction. If you are worried about you or your loved one suffering from a hydrocodone addiction, some of the warning signs to be aware of include:
- Frequent prescription refill requests
- Seeing more than one doctor to obtain multiple prescriptions
- Financial difficulties
- Increased isolation or social withdrawal
- Mood swings
- Weight loss
- Decreased interest in things that used to be pleasurable
- Pills or pill bottles in easy-to-reach locations
Once your body has become dependent on hydrocodone, physical and psychological withdrawal can be dangerous and even life-threatening in some cases. Side effects of withdrawal often mimic flu symptoms; in addition, they include intense depressive, and even suicidal, thoughts and behaviors. Health care professionals should therefore supervise withdrawal from hydrocodone.
If you, or your loved one, are suffering from dependency or addiction to a drug like hydrocodone, it is important to seek the right kind of help. A substance abuse disorder often co-occurs with a mental health disorder, requiring specialized care. Dual diagnosis treatment involves a team of caregivers treating each disorder simultaneously for the best results.
Withdrawal symptoms often need to be medically managed during the detox process in order to prevent dangerous side effects. You should never attempt to stop taking hydrocodone suddenly, or cold turkey, without direct medical supervision. The changes in your brain and body will take time to safely reverse. Intense drug cravings also often need to be controlled in order to prevent relapse.
In addition to managing the physical side effects, the psychology of addiction or dependence cannot be overlooked either. Behavioral therapies strive to define the underlying social, emotional, or environmental triggers that may lead to drug-seeking or drug-abusing behavior and teach life skills and coping mechanisms to successfully overcome them.
Addiction or dependence all too often leads to a physical and psychological deterioration of the body and soul that needs to be rebuilt in a specialized rehabilitation facility. Here at Axis, we provide a supportive, patient-centered environment with many amenities to help you or your loved one make a full recovery. Our customizable programs ensure that your individual and specific needs will be met. We promote long-term health, working as a team to provide comprehensive care and support. Call us to learn more.