Hydrocodone is an opioid that is used to suppress cough and for the treatment of severe pain. Long-term use of hydrocodone pills for pain relief, like other opioid drugs, can lead to the development of physical dependence on the drug. Using hydrocodone in a fashion other than prescribed can also lead to dependence.
Hydrocodone may also be abused recreationally due to its ability to produce a euphoric high. Dependence on hydrocodone can be severe enough to result in addiction. Addiction to hydrocodone involves an inability to control drug use and has a negative impact on social functioning.
How Long Does Hydrocodone Stay In Your System?
Hydrocodone is available in both immediate-release and extended-release formulations. It is primarily metabolized by the liver into its active metabolite, hydromorphone. Hydrocodone and its metabolites are excreted through urine.
Hydrocodone is a short-acting opioid and the time required to eliminate half of the drug (i.e. the half-life) ranges between 4-12 hours. The half-life for the immediate-release formulation of hydrocodone is four hours, whereas that of the extended-release formulations ranges between 7-12 hours. Relative to opioids with a longer half-life, like methadone, the symptoms of hydrocodone withdrawal are more severe and last a shorter duration.
Hydrocodone Withdrawal Symptoms
Some of the symptoms of hydrocodone withdrawal include:
- Symptoms of Hydrocodone Withdrawal
Gastrointestinal symptoms such as diarrhea, abdominal pain, vomiting
Watery discharge from eyes and nose
Increased sensitivity to pain
Hot and cold flashes
Hydrocodone Withdrawal Timeline
Hydrocodone is a short-acting opioid and the onset of withdrawal symptoms occurs within 8-24 hours of discontinuation of drug use. The symptoms of hydrocodone withdrawal tend to peak between 36 to 72 hours after abstinence and last a total duration of 4-10 days. Some symptoms of hydrocodone withdrawal may persist beyond this acute withdrawal phase. These symptoms constitute the protracted or prolonged withdrawal phase and may last for weeks and even months after discontinuation of hydrocodone use. Symptoms during the protracted withdrawal phase include mostly psychological symptoms like anxiety, sleep disturbances, and depression.
Factors Impacting Hydrocodone Withdrawal
The severity and duration of symptoms of hydrocodone withdrawal depend on the history of hydrocodone use (length and frequency of use, and dose taken), and specific individual characteristics such as metabolic rate. Hydrocodone abuse is often accompanied by the co-use of alcohol and other substances. Such polydrug use can result in more severe withdrawal symptoms that may involve complications.
How To Cope With Hydrocodone Withdrawal
Although the symptoms of hydrocodone withdrawal are not life-threatening, they can be extremely uncomfortable. These symptoms resemble that of a bad flu and can cause a relapse. Treatment at an inpatient medical detox in a drug-free environment can reduce the chances of a relapse.
The use of hydrocodone should not be abruptly discontinued as this can result in severe withdrawal symptoms. Instead, the dose of hydrocodone should be gradually reduced or tapered. This involves following a taper schedule whereby the dose of hydrocodone is reduced by a specific amount at predefined intervals. The taper schedule adopted may depend on the severity of dependence and the psychological and metabolic characteristics of the individual.
Another alternative is the use of opioid replacement therapy. Opioid replacement therapy involves the use of medications like methadone or buprenorphine. These drugs also bind to opioid receptors but do not produce the same effects as hydrocodone due to their gradual mode of action. These drugs can help reduce the symptoms of hydrocodone withdrawal.
Medications like clonidine and lofexidine that reduce blood pressure can help alleviate some withdrawal symptoms such as insomnia, diarrhea, nausea, anxiety, and tremors. Other medications may also be used to treat specific symptoms that arise during hydrocodone withdrawal. These include loperamide to treat diarrhea and vomiting and non-steroidal anti-inflammatory drugs for muscle pain.
Detoxing Off Hydrocodone
Detoxification involves the elimination of the drug from the body and helping the individual cope with the withdrawal symptoms that arise due to discontinuation of the drug. Undertaking detoxification at an inpatient medical detox or outpatient detox can avail the individual of the necessary medical supervision to help cope with the withdrawal symptoms. Treatment at an inpatient detox allows for a more rapid taper schedule than outpatient detox due to the round-the-clock medical supervision available at a medical detox.
In the case of detoxing at home, the hydrocodone dosage should be tapered very slowly. Detoxification must be undertaken in a calm and supportive environment. Advice from a physician must be sought before detoxification to help decide the taper schedule. A physician can also prescribe medications for specific withdrawal symptoms. Drinking plenty of water can help replace the loss of fluids due to diarrhea and vomiting. Moderate exercise and relaxation techniques such as yoga and meditation can help individuals to relax.
When to Find Help: Hydrocodone Rehab in Florida
Misuse of hydrocodone involves the use of the drug at higher doses or for a longer duration than prescribed. Such misuse of hydrocodone or its abuse for recreational purposes can lead to the development of physical dependence on the drug. Physical dependence involves adaptations to neurons in the brain that make hydrocodone use necessary to function normally. Severe dependence on hydrocodone can lead to an addiction that is characterized by an inability to control drug use despite negative consequences on social life.
In cases of severe dependence on hydrocodone, it is advisable to seek treatment at an inpatient detox due to the possibility of severe withdrawal symptoms. Detoxification only involves the elimination of the drug from the body and treatment at rehab is necessary to address the issues underlying the hydrocodone addiction.
If you or a loved one are addicted to hydrocodone, The Recovery Village Palm Beach at Baptist Health can help. The Recovery Village Palm Beach at Baptist Health provides quality care and treatment for substance use disorders delivered by experienced and accredited medical professionals. Reach out today to explore treatment options available to you.
Cofano, S; Yellon, R. “Hydrocodone.” NCBI bookshelf, Updated January 8, 2019. Accessed September 20, 2019.
Substance Abuse and Mental Health Services Administration.” Protracted Withdrawal. “July 2010. Accessed September 20, 2019.
National Institute on Drug Abuse. “Opioid Addiction”. January 2018. Accessed September 20, 2019.
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