Hydrocodone is one of the most-prescribed opioids in the United States (in 2013, 136.7 million prescriptions for hydrocodone were made in the United States). The American Society of Addiction Medicine called hydrocodone “America’s favorite opioid.” The U.N. International Narcotic Control Board reported that in 2010 the global production of hydrocodone was 36.3 tons, of which more than 99% was consumed by the United States.
In 2014, the United States Congress placed restrictions on hydrocodone by designating it as a Schedule II Controlled Substance, reflecting hydrocodone’s growing role in the opioid crisis.
What Is Hydrocodone?
Hydrocodone is a semi-synthetic opioid drug, derived from the opiate codeine. The term “semi-synthetic” means that it is made by chemically altering a naturally occurring substance that comes from the opium poppy; in this case: codeine.
The reason that naturally occurring codeine is changed chemically to make hydrocodone is because hydrocodone is about six times more potent than codeine.
Is hydrocodone an opiate? No, it’s not because it is not a naturally occurring substance. However, regardless of the terminology, the hydrocodone drug class and addictive properties are the same as all the other opium-derived drugs, such as oxycodone, fentanyl and heroin.
What Is Hydrocodone Used For?
What does hydrocodone do? Hydrocodone is a prescription opioid drug with two FDA-approved clinical uses:
- Pain management
- Antitussive (cough suppressant)
When used for pain management, hydrocodone is meant to manage moderate to severe chronic pain after other treatment options are found either inadequate or intolerable (e.g., due to an allergy). Guidelines from the CDC indicate that hydrocodone should be considered for use in three settings:
- Chronic, non-cancer pain (pain lasting more than three months)
- End-of-life care
- Cancer pain
Unfortunately, hydrocodone has been over-used for pain, which contributed to the opioid epidemic.
Hydrocodone is available in various preparations for pain management:
- Combination products with other medications, such as acetaminophen or ibuprofen
- Short-acting, immediate-release tablets
- Long-acting, slow-release tablets and capsules
As a cough suppressant, hydrocodone is used alone or in combination with other medications for non-productive cough (i.e., a cough without phlegm coming up) in adults.
Dosage and Administration
Hydrocodone dosage is based on using the lowest possible amount to achieve reasonable pain control. The drug is taken every four to six hours, and the starting dose in adults is usually 2.5 or 5 mg per dose of the immediate-release drug.
What Do The Different Types of Hydrocodone Look Like?
There are several hundred brand name and generic hydrocodone-containing products available in the United States, most of which are combinations of hydrocodone with other medications.
Hydrocodone comes in tablet, capsule and liquid formulations, and is available in immediate-release and long-acting versions (tablets and capsules only). The hydrocodone brand names for the pain-relief formulations include Vicodin, Lortab, Norco and Zydone.
- What is Vicodin? Vicodin is a brand-name, fixed-dose combination product that comes in various formulations:
- Vicodin 5/300: tablet containing 5mg hydrocodone and 300mg acetaminophen
- Vicodin ES 7.5/300: tablet containing 7.5mg hydrocodone and 300mg acetaminophen
- Vicodin HP 10/300: tablet containing 10mg hydrocodone and 300mg acetaminophen
- What does Vicodin look like? Vicodin comes in an oval white tablet, with “5 300” inscribed on one side and “VICODIN” on the other.
- What is Lortab? Lortab is a brand-name combination product containing hydrocodone and acetaminophen or ASA. It comes in various formulations:
- Oral solution (elixir): 7.5mg hydrocodone, 500mg acetaminophen and 7% alcohol per 15 mL
- Lortab 2.5/500: tablet containing 2.5mg hydrocodone and 500mg acetaminophen
- Lortab 5/500: tablet containing 5mg hydrocodone and 500mg acetaminophen
- Lortab 7.5/500: tablet containing 7.5mg hydrocodone and 500mg acetaminophen
- Lortab 10/500: tablet containing 10mg hydrocodone and 500mg acetaminophen
- Lortab ASA: tablet containing 5mg hydrocodone and 500mg ASA
- What does Lortab look like? The appearance of Lortab tablets depends on the formulation, each having a different appearance. The elixir is a yellow, fruit-punch-flavored liquid.
- What is Norco? Norco is a brand-name combination product containing hydrocodone and acetaminophen. It comes in three formulations:
- Norco 5/325: tablet containing 5mg hydrocodone and 325mg acetaminophen
- Norco 7.5/325: tablet containing 7.5mg hydrocodone and 325mg acetaminophen
- Norco 10/325: tablet containing 10mg hydrocodone and 325mg acetaminophen
- What does Norco look like? Each formulation has a different appearance. All three are oval, scored tablets. Norco 5/325 is white, 7.5/325 is orange and 10/325 is yellow.
- What is Zydone? Zydone is a brand-name combination product containing hydrocodone and acetaminophen. It comes in three formulations:
- Zydone 5/400: tablet containing 5mg hydrocodone and 400mg acetaminophen
- Zydone 7.5/400: tablet containing 7.5mg hydrocodone and 400mg acetaminophen
- Zydone 10/400: tablet containing 10mg hydrocodone and 400mg acetaminophen
- What does Zydone look like? Each formulation has a different appearance. All three are eight-sided, oblong, unscored tablets. Zydone 5/400 is yellow, 7.5/400 is blue and 10/400 is pink.
Other Names and Street Names for Hydrocodone
There are a variety of other names for hydrocodone, including pharmaceutical brand names (as listed in the previous section) and the hydrocodone street names. There are many street names for various opioids, but some that are specific to hydrocodone are:
Side Effects of Hydrocodone
Because most hydrocodone-containing formulations also contain other medications, people must be aware of potential side effects of all the medications present in the particular product that they are taking. Always consult with a medical professional before starting to take a new medication.
The side effects of hydrocodone are the same as many other opioid drugs, and include:
- Respiratory suppression
- Overdose and death
- Confusion, impaired cognition
- Mood changes
- High blood pressure
How Long Does Hydrocodone Stay in Your System?
Hydrocodone reaches peak levels in the blood one hour after taking the drug, and has an elimination half-life of four to six hours, which is the time it takes the body to metabolize and excrete one-half of the drug.
The length of time that the drug can be detected in an individual’s system depends on how the testing is done. Some people metabolize hydrocodone slowly (for genetic reasons) and the drug may be detectable in their body much longer than in other people.
The testing methods in use, and therefore the length of time that the drug can be detected after use, varies between laboratories. However, there are some general guidelines as to how long hydrocodone can be detected in the system:
- Blood: After a single dose of hydrocodone, the drug remains detectable in the blood for 48 hours.
- Urine: Hydrocodone remains detectable in the urine for about 98 hours after the last dose.
- Hair: Hair analysis provides the longest-lasting method of detecting hydrocodone use, but is expensive and depends on the length of the individual’s hair. The length of detection is related to the length of hair: the detection window is about one month per half-inch of hair.
- Breast milk: It is not known if hydrocodone is excreted in human breast milk, but it is excreted in small amounts in animal breast milk.
Is Hydrocodone Addictive?
Hydrocodone is highly addictive and is a major contributor to the opioid epidemic in America. Hydrocodone has the highest level of abuse of any prescription medication.
How do you get addicted to hydrocodone? People become addicted to hydrocodone and other opioids because of their effects on the brain’s reward system. This reward system is how the brain motivates people to do things that are necessary for survival.
When people do something necessary for survival, the brain releases “feel-good” chemicals (neurotransmitters) in the brain, and the result is a feeling of pleasure. This reaction is why people feel good after they eat a good meal, for example.
Opioids release neurotransmitters in huge amounts — about ten times the amount naturally produced. This pleasurable feeling is the start of the addiction. People begin to crave this pleasurable feeling and begin using the drug for that effect rather than for its intended use.
Some people are more likely than others to become addicted to hydrocodone. A combination of genetics and life circumstances come together to make up an individual’s predisposition to addiction. Mental health disorders and addiction are closely tied together. The situation where they occur together is referred to as “comorbidity,” which occurs in more than half of people with addiction.
How long does it take to get addicted to hydrocodone? Not long. Hydrocodone addiction can begin with only one dose, especially in people with a lot of predisposing factors, and people with untreated mental health disorders.
If you or a loved one struggle with a hydrocodone addiction, contact The Recovery Village Palm Beach at Baptist Health to speak with a representative about how professional addiction treatment can help. With individualized treatment programs, The Recovery Village Palm Beach at Baptist Healt ensures that each client receives the addiction treatment that will help them on their path to sobriety. You deserve a healthier future, call today.
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Devarakonda, K; Kostenbader, K; Giuliani M; et al. “Comparison of single-dose and multiple-dose pharmacokinetics between two formulations of hydrocodone bitartrate/acetaminophen: immediate-release versus biphasic immediate- release/extended release.” Journal of Pain Research, September 9, 2015. Accessed July 8, 2019.
Drug Enforcement Agency (DEA). “Hydrocodone.” October 2018. Accessed July 8, 2019.
Dowell, Deborah; Haegerich, Tamara; Chou, Roger. “CDC guideline for prescribing opioids for chronic pain – United States, 2016.” CDC Morbidity and Mortality Weekly Report, March 15, 2016. Accessed July 8, 2019.
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