Hydrocodone Withdrawal Timeline, Symptoms & Detox

Hydrocodone is one of the most prescribed and most abused opioids in the United States. Nearly all the world’s hydrocodone is used in the United States, and more than 30 million prescriptions involving hydrocodone were dispensed in 2020 alone.

Hydrocodone is available on its own as a long-acting tablet both as a generic drug and under the brand name Hysingla ER. It is also available as a generic long-acting tablet that was previously sold under the brand name Zohydro ER.

Hydrocodone is also available in its short-acting form as a combination medication with acetaminophen, the active ingredient in Tylenol. Although hydrocodone/acetaminophen tabs are currently only sold as generic drugs, they were previously available under brand names like Lorcet, Lortab, Norco and Vicodin.

People ready to stop their hydrocodone use must first pass through hydrocodone withdrawal as their body undergoes detox. Understanding how hydrocodone withdrawal and detox works can benefit people taking their first step toward long-term sobriety during this crucial process.

Hydrocodone Withdrawal Symptoms

When you take hydrocodone on a regular basis, the brain adapts to its presence. Suddenly stopping the drug can trigger extremely uncomfortable withdrawal symptoms as the brain struggles to adapt. Hydrocodone withdrawal symptoms are similar to withdrawal from other opioids. Withdrawal symptoms involve physical and psychological aspects, including:

• Muscle aches 
• Insomnia
• Runny nose
• Runny eyes
• Sweating
• Goosebumps
• Yawning
• Cravings
• Enlarged pupils
• Abdominal cramps
• Diarrhea
• Nausea and vomiting
• Agitation
• Anxiety

These symptoms can be difficult to overcome without support. Those who struggle through withdrawal on their own without medical help have a higher rate of relapse as their bodies rebel against the drug’s sudden absence. For these reasons, those who want to quit hydrocodone should do so with medical help from their doctor, preferably in a medical detox setting.

Hydrocodone Withdrawal Timeline

Although everyone has a unique hydrocodone withdrawal experience, the withdrawal itself tends to follow a timeline. However, the timeline can differ depending on whether you take short-acting hydrocodone (Vicodin) or long-acting hydrocodone (Hysingla ER). It is important to remember that any withdrawal symptom can occur at any time during the withdrawal process. 

12 Hours to 30 Hours After the Last Dose: Symptom onset

Hydrocodone has an elimination half-life of around four hours for the short-acting version and up to nine hours for the long-acting version. The half-life of a drug is the time it takes the body to metabolize and excrete one-half of that drug. Withdrawal symptoms usually develop after more than one half-life has passed. Generally, this means that symptoms develop within 12 hours for the short-acting versions and within 30 hours for the long-acting versions.

24–48 Hours to 3–8 Days After the Last Dose: Symptoms Peak

After hydrocodone has completely left your body, your brain must learn to adapt to the drug’s absence. This can take a few days and can lead to worsened withdrawal symptoms as your brain tries to recalibrate. These symptoms tend to peak between 24 and 48 hours after the last dose of short-acting hydrocodone and between three and eight days after the last dose of long-acting hydrocodone. 

3–5 Days to 10 Days After the Last Dose: Symptoms Ease

Withdrawal symptoms start to resolve after a few days, as your brain gets used to being without hydrocodone. This can take three to five days after the last dose of short-acting hydrocodone and 10 days after the last dose of long-acting hydrocodone. Although symptoms get better during this period of time, the underlying addiction itself still needs to be treated. Experts recommend at least 90 days of rehab to help keep you off hydrocodone for good.

Some people may develop symptoms that last beyond the acute withdrawal phase. These symptoms are known as protracted withdrawal symptoms and may last for weeks or months. These lingering symptoms tend to include anxiety, depression and insomnia.

Factors Impacting Hydrocodone Withdrawal

Multiple factors can impact the duration of hydrocodone withdrawal. Some people metabolize hydrocodone particularly slowly (for genetic reasons), so the onset and duration of withdrawal symptoms may take longer for them. The severity and duration of symptoms of hydrocodone withdrawal will also 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. 

A co-occurring disorder like depression or anxiety can also prolong and complicate the recovery process if left untreated. For this reason, The Recovery Village offers a dual diagnosis rehab option to treat any underlying mental health problems concurrently with your addiction.

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. For this reason, a medically supervised detox is important to help you gently wean from hydrocodone, followed by rehab. 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.

Hydrocodone Detox

Hydrocodone is a psychoactive drug, meaning that it changes the brain’s chemistry and disrupts its normal functioning. The brain tries to compensate for the drug’s disruptive effects, making adjustments and attempting to function normally despite the drug’s presence.

When the drug use stops or drastically reduces, the brain must adjust. If the brain is forced to do so abruptly (i.e., without a taper), this causes withdrawal symptoms.

The process of hydrocodone detox can be an uncomfortable experience. Fortunately, this process can be medically assisted to minimize the impact on the brain and body to reduce or eliminate the discomfort.

How Long Does It Take To Detox From Hydrocodone?

As mentioned, the process depends on individual factors, but generally, it takes five half-lives for the drug to be completely eliminated from the body. However, the withdrawal symptoms and detox process can continue well beyond that range—possibly lasting for up to five days for short-acting hydrocodone and up to 10 days for long-acting hydrocodone.

Detoxing at Home

When making the decision to attempt hydrocodone detox at home, individuals should do so in conjunction with their physician or an addiction professional and should be clear about the extent of their drug use. People attempting at-home detox should also involve loved ones in the process and ensure they’re aware of signs indicative of a medical emergency.

People tend to overestimate their ability to stop their drug use on their own, even if they failed attempts to do so in the past. Detoxing from hydrocodone at home may not provide the best opportunity for success, as the hydrocodone cravings may be overwhelming.

At the minimum, people who plan to detox at home should have certain supporting factors in place:

• Consultation with and agreement from their doctor
• A short period of drug use at lower doses 
• A stable and supportive home environment 
• Not living alone and the people at home made aware of the detox situation
• A high motivation to recover 
• A safe, drug-free home away from negative influences such as dealers or drug users 
• A set plan of action for treatment and recovery after detoxing

It should be noted that detox does not constitute treatment for hydrocodone addiction. Recovery from drug use takes much more than simply abstaining from drug use. A return to good health and lasting recovery requires addressing the reasons behind the substance use, whatever they might be. This requirement is the main purpose of addiction treatment programs.

Medically Assisted Detox

Medically assisted detox is the use of proper medical support and supervision—with or without the use of supportive medications—to help people get through detox and withdrawal safely, comfortably and with minimal shock to their bodies.

Medically assisted detox provides the option of using opioid replacement therapy to prevent or reduce withdrawal. It also provides:

• A safe place to detox away from distractions, temptations and triggers 
• Immediate help if any complications arise 
• Proper non-opioid management of side effects, such as insomnia, low mood or diarrhea 
• The ability to connect with other motivated people who are detoxing 
• The ability to connect with counselors and begin working out an individualized plan of success for long-term recovery 
• Access to proper information and facts straight from the professionals, rather than casual advice from the street or the internet

The fear of withdrawal symptoms or the inability to resist the cravings to use again are major barriers to recovery. Medical detox directly addresses these problems and gives the individual a strong opportunity to succeed.

Some of the medications used in medical detox include Suboxone, Methadone, Lofexidine and Clonidine.

Tapering Off Hydrocodone

How Long Does Hydrocodone Stay In Your System?

Hydrocodone is available in both immediate-release and extended-release formulations. Hydrocodone is a short-acting opioid, and the time required to eliminate half of the drug (its half-life) ranges between 4 and 12 hours. The half-life for the immediate-release formulation of hydrocodone is four hours, whereas the half-life for extended-release formulations ranges between 7 and 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.

Finding a Hydrocodone Detox Center

Undergoing medically assisted detox at an accredited facility is the safest and most effective way to rid the body of hydrocodone and transition smoothly into treatment and recovery. At The Recovery Village, we offer a full continuum of care to help you stop hydrocodone and keep you off the drug for good. This means a seamless integration from detox, where we ease you off hydrocodone, to rehab. Our rehab options are tailored to suit your needs and include:

• Intensive inpatient rehab
• Residential rehab
• Partial hospitalization
• Intensive outpatient rehab
• Outpatient rehab

Our goal is to help you overcome hydrocodone, and we are with you every step of the way in your recovery journey. Contact us today to learn more.