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Aftercare & RecoveryHydrocodone Withdrawal Timeline & Symptoms
Written by Thomas Christiansen
& Medically Reviewed by Dr. Andrew Proulx, MD
Medically Reviewed
Up to Date
Updated 12/29/2022
People who wish to stop using hydrocodone must detox from the drug to clear it from their body. Learn how the uncomfortable withdrawal symptoms from detox can be addressed.
Hydrocodone is one of the most prescribed and most abused opioids in the United States. The American Society of Addiction Medicine called hydrocodone, “America’s favorite opioid,” and with good reason: in 2011, 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 Americans.
People ready to stop their hydrocodone use must first pass through hydrocodone withdrawal as their body undergoes hydrocodone detox (detoxification). 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
Hydrocodone withdrawal symptoms are similar to withdrawal from other opioids. Withdrawal symptoms involve physical and psychological aspects, including:
- Nausea and vomiting
- Diarrhea
- Hot and cold flashes
- Excessive sweating
- Insomnia
- Shaking
- Muscle aches
- High blood pressure
- Anxiety
- Intense cravings
- Depression
Hydrocodone Withdrawal Timeline
Hydrocodone has an elimination half-life of four to six hours. 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 one half-life — so about four to six hours after the previous use, in the case of hydrocodone. Withdrawal symptoms tend to peak between 36 to 72 hours after abstinence and last a total duration of 4-10 days.
Acute withdrawal symptoms are the symptoms that occur in the period immediately following the discontinuation or reduction of drug use. Acute withdrawal symptoms typically last 4 to 10 days in most individuals.
Some people may develop symptoms that last beyond the acute withdrawal phase. These symptoms are known as protracted withdrawal symptoms and they may last for weeks or months.
Factors Impacting 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.
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.
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 upon individual factors, but generally, it takes six to seven half-lives for the drug to be completely detoxified from the body. However, the withdrawal symptoms can continue well beyond that range.
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 be living alone and the people at home should be aware of the detox situation
– They should be highly motivated 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 body.
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, high blood pressure 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, and Naltrexone.
Tapering Off Hydrocodone
People using hydrocodone should consult a medical professional to find out how to taper off hydrocodone when the drug is no longer needed or desired. Many people have difficulty self-tapering off hydrocodone or any other addictive substance because these drugs are addictive precisely because they are difficult for people to control using.
People who find themselves unable to taper themselves off of hydrocodone should consider seeking help at a professional detox center. Substance use is progressive and rarely ends well if left untreated. Tapering is challenging, but trying to taper while struggling with addiction and withdrawal symptoms is even more challenging. It is highly beneficial to let medical professionals assist with the tapering process.
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.
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. It gives the body a chance to properly ease away from the drug use and shift back to normal health and function without the shock of sudden withdrawal.
View Sources
American Society of Addiction Medicine. “National practice guideline for the use of medications in the treatment of addiction involving opioid use.” June 1, 2015. Accessed July 17, 2019.
Cardia, Luigi; Calapai, Gioacchino; Quattrone, Domenico. “Preclinical and clinical pharmacology of hydrocodone for chronic pain: A mini review.” Frontiers in Pharmacology, October 1, 2018. Accessed July 17, 2019.
Cofano, S; Yellon, R. “Hydrocodone.” NCBI bookshelf, Updated January 8, 2019. Accessed September 20, 2019.
Coleman, John. “Rescheduling hydrocodone combination products: Addressing the abuse of America’s favorite opioid.” American Society of Addiction Medicine, April 10, 2015. Accessed July 17, 2019.
Drug Enforcement Administration. “Hydrocodone.” October 2018. Accessed July 17, 2019.
National Institute on Drug Abuse. “Opioid Addiction”. January 2018. Accessed September 20, 2019.
Substance Abuse and Mental Health Services Administration. “Protracted withdrawal.” July 2010. Accessed July 17, 2019.
United Nations International Narcotic Control Board. “Narcotic drugs: Estimated world requirements for 2012 and statistics for 2010.” 2012. Accessed July 17, 2019.
Authorship
Editor - Thomas Christiansen
With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read More
Medical Reviewer - Dr. Andrew Proulx, MD
Andrew Proulx holds a Bachelor of Science in Chemistry, an MD from Queen's University, and has completed post-graduate studies in medicine. He practiced as a primary care physician from 2001 to 2016 in general practice and in the ER. Read More