Vicodin Addiction, Withdrawal and Treatment
- Vicodin Addiction
- Signs and Symptoms of Abusing Vicodin
- Vicodin Withdrawal & Detox
- Treatment for Vicodin Dependency
Vicodin is a brand of prescription, narcotic pain reliever. The drug combines the opioid hydrocodone and the over-the-counter (OTC) pain reliever acetaminophen. Generally, doctors prescribe Vicodin to be taken on an as-needed basis in order to control moderate to severe pain related to injury or surgery. Vicodin is most commonly taken orally. The brand name version of this drug is available as a tablet, while the generic version is available as both a tablet and a liquid. Vicodin goes by the street names of fluff, hydros, v-itamin, vic, vike, and Watson-387. Users may chew the pills, crush and snort them, or dissolve them in water and inject the solution in order to elicit the drug’s euphoric effects.
Hydrocodone, the active ingredient in Vicodin, is an opiate similar to morphine and heroin. Like other opioids, hydrocodone works by impacting receptors in the brain and spinal cord to interfere with the brain’s ability to perceive pain. In addition to decreasing a user’s ability to feel pain, the drug may also produce euphoric effects. It is this “high” that people who abuse the drug are seeking.
Due to the drug’s combined legitimate medical uses and high potential for abuse, the Drug Enforcement Administration (DEA) has categorized Vicodin as a Schedule II controlled substance. Like with other powerful opioid pain relievers, patients taking Vicodin should follow dosing instructions exactly to minimize the risk of dependency. Research by the Centers for Disease Control and Prevention (CDC) shows that up to one in four patients using prescription opioids long term struggles with addiction. In 2014, nearly two million people in the US either abused opioid pain medications or were dependent upon them. Moreover, reported deaths from prescription opioids have more than quadrupled since 1999.
Misuse or abuse of any opiate drug can change the way the brain works over time. Users build up a tolerance to the drug, requiring more of the active ingredient in order to experience the same pain relief or euphoric effect. Higher doses increase the potential for addiction and overdose, as well as other dangerous consequences. For example, most prescription pain relievers are expensive. Because they require a prescription, they are also more difficult to obtain. Therefore, dependent users and addicts may resort to unsavory means to acquire the drugs. This can include stealing them from a relative or friend, forging prescriptions, or purchasing them illegally on the street. In cases where addicts are unable to get the drugs, they may turn to cheaper, more dangerous drugs like heroin.
Signs & Symptoms of Abusing Vicodin
Abuse of Vicodin typically occurs in two ways. First, a user who has been prescribed the medication takes it longer, more often, or in higher doses than prescribed. Second, a user takes the drug recreationally, or without a prescription, in order to achieve the euphoric effects.
Users in both of these categories will likely experience some common side effects:
- vomiting, and/or
Vicodin misuse or abuse can also have serious side effects that could indicate a medical emergency:
- skin rash,
- swelling of the face, throat, and mouth, and/or
- trouble breathing.
Liver problems (including liver failure) may also occur, as indicated by the following symptoms:
- yellow skin or eyes,
- stomach pain in the upper right quadrant,
- stomach swelling,
- confusion, and/or
As with other opiate drugs, it is possible to overdose on Vicodin. Without proper medical attention, an overdose could be fatal. A user experiencing an overdose may exhibit
- depressed breathing,
- slow heart rate,
- low blood pressure, and/or
In the event of an overdose, a first responder will likely administer naloxone, an opioid antagonist designed to reverse and block the effects of opioids like Vicodin. Naloxone can be injected or administered as a nasal spray. In some locations, naloxone can be purchased by addicts or people close to them to be used immediately in the event of an overdose. Depending on local laws, a prescription may be required.
Vicodin Withdrawal & Detox
Even when taken as directed by a doctor, users may experience withdrawal symptoms if they stop taking the drug suddenly. Symptoms will vary from mild to moderate to severe based on how much and how long the drug was taken. In all cases of withdrawal, flu-like symptoms, including fever, nausea, and vomiting, are common. A patient may also experience anxiety, panic attacks, and muscle pain or weakness.
Over-the-counter medications for pain, nausea, and diarrhea may help a patient manage mild symptoms. In most cases, doctors recommend tapering a user’s dosage under the direction of a physician rather than stopping it abruptly on his or her own. In addition to being uncomfortable, severe withdrawal symptoms can cause life-threatening complications, including dehydration, high blood pressure, seizures, or liver damage.
Treatment for Vicodin Dependency
Studies have shown that people who follow detoxification with additional treatment are more likely to achieve long-term recovery and less likely to relapse. Because of this, it is recommended that opioid addicts participate in long-term management programs. The maintenance treatment protocol for Vicodin and other opioids includes both medication-assisted treatment and behavioral therapy.
Medication-Assisted Treatment (MAT)
Currently, there are three medications approved for use in opioid maintenance programs: methadone, buprenorphine, and naltrexone. Each of these medications must be prescribed by a physician or mental health professional.
Methadone works by binding to opioid receptors in the brain much like heroin does, but weaker. The recovering addict will experience reduced cravings and fewer withdrawal symptoms. Side effects may include:
- difficulty breathing,
- chest pain,
- increased heart rate,
- hallucinations, and/or
Methadone is available as a liquid, pill, or wafer. Patients must take the drug under a doctor’s supervision as part of a certified opioid treatment program (OTP). Doses are typically administered daily at a treatment clinic.
Buprenorphine, like methadone, mimics heroin on a lesser scale. This drug is used to lower the risk of misuse, dependency, and side effects when a recovering addict stops using Vicodin and other opiates. Patients taking buprenorphine will experience side effects similar to those of opioids:
- muscle soreness,
- trouble sleeping,
- irritability, and/or
Unlike methadone, buprenorphine is a long-acting drug. Patients do not necessarily need to take the medication every day, and it can be prescribed and dispensed in a physician’s office. For these reasons, buprenorphine treatment is more accessible for many patients.
Naltrexone works differently in that it blocks opioid receptors in order to prevent the patient from feeling high. The abuse potential of naltrexone is lower due to the fact it does not mimic opioids or produce euphoria. It does, however, increase sensitivity to opioids and makes relapse more dangerous. If a patient relapses during or after treatment, using Vicodin at or below previous dosage rates may result in overdose.
Naltrexone is available as a pill or as an injection. It can be prescribed by a physician or mental health professional. Patients should see a doctor immediately if they experience symptoms of liver injury, injection site reactions, and/or allergic pneumonia. Other side effects of this medication include:
- upset stomach,
- fatigue, and/or
- joint and muscle pain.
Behavioral therapy can include cognitive-behavioral therapy, contingency management programs, or a combination of the two. These therapeutic sessions can take place in individual or group sessions.
Cognitive-behavioral therapy (CBT) helps addicts in recovery identify and correct behaviors that correspond to their drug use. Through therapy, patients develop the ability to anticipate triggers, learn to cope, and maintain self control. Patients with co-existing mental health conditions may benefit by using skills learned in CBT in the management of those conditions.
Contingency management (CM) focuses on providing motivational incentives for continued sobriety. Voucher-based reinforcement (VBR) gives recovering addicts a voucher for each negative drug screen, attendance at a program session, and completion of assigned activities. Vouchers can be exchanged for a variety of goods or services. Typically, vouchers increase in value over time. Another type of CM awards cash in place of vouchers. In both cases, a positive drug screen resets the patient’s progress in the program and accompanying incentives.
- Acetaminophen-Hydrocodone, Oral Tablet – Healthline.com
- Understanding Hydrocodone Addiction – Healthline.com
- Opioid Overdose – Centers for Disease Control and Prevention (CDC)
- Prescription Opioids and Heroin Research Report – National Institute on Drug Abuse (NIDA)
- Opioid Overdose Reversal with Naloxone – National Institute on Drug Abuse (NIDA)
- Symptoms of Vicodin Withdrawal – Healthline.com
- Medications to Treat Opioid Addiction Research Report – National Institute on Drug Abuse (NIDA)
- Medication and Counseling Treatment – Substance Abuse and Mental Health Services Administration (SAMHSA)
- Principles of Drug Addiction Treatment: A Research-Based Guide – National Institute on Drug Abuse (NIDA)