Hydrocodone is considered a semi-synthetic opioid drug that is utilized orally as an analgesic and antitussive medication. It is derived from codeine and is often combined with acetaminophen in various formulations such as: Vicodin. It is mostly prescribed in the United States where it is considered a “Schedule II” controlled substance; indicating a high potential for abuse and dependence.
This is a drug that does a great job at providing relief from moderate to severe pain as well as coughing. In comparison to the opiate oxycodone, it has been found equally effective at providing pain relief; there is little practical difference between the two drugs. Hydrocodone works by binding to opioid receptors in the central nervous system, acting primarily on the mu-opioid receptors.
Research has shown that hydrocodone is more potent than its derivative codeine. Most people take hydrocodone to cope with pain that they are experiencing. For pain relief, this drug works very well. In addition to taking it for its intended purpose of pain relief, many individuals take it recreationally to “get high.”
In these cases, people may become addicted to the mood enhancement and reductions in anxiety associated with initial consumption. Over time though, most consistent users of hydrocodone end up developing tolerance to its effects. Other individuals simply want to get off of the drug because they don’t like the side effects. If you are planning on going through withdrawal, you may want to read below so that you are familiar with some common withdrawal symptoms.
Factors that influence Hydrocodone withdrawal
When it comes to withdrawal from any opioid, there are factors that play a role in determining intensity and length of symptoms. These factors include things like: how long you were on the drug, your dosage, whether you became tolerant, whether you are addicted, how quickly you withdrew, and other individual factors such as whether you are on any other drugs.
1. Time Span
How long have you taken hydrocodone? In most cases, the longer you were on the drug, the more difficult withdrawal symptoms will be. This is due to the fact that when the drug is taken over an extended period of time, your body becomes reliant on the effects of the hydrocodone for daily functioning.
People on this drug for a long period of time are typically those who needed it for chronic pain and/or addicts. Those who took the drug for a short duration typically will exhibit quicker recovery and less symptoms.
2. Dosage / Tolerance
What dose of hydrocodone did you take? Those that took higher doses tend to have a tougher time dealing with withdrawal effects because their body became used to that particular high dose. When a person takes a higher dose, it is easier to become tolerant, which in turn makes it significantly more difficult to cope with discontinuation symptoms.
Most people take the drug in formulations of 5 mg, 7.5 mg, and 10 mg of hydrocodone. Maximum doses for the drug are 8 tablets daily for the 5 mg, and 6 tablets daily for the 7.5 mg and 10 mg. The greater the dosage that you’ve been taking and greater the frequency at which you’ve been taking it, the more difficulty you may have coping with withdrawals.
Individuals that haven’t become tolerant to the effects of the drug are thought to have the easiest time coping with discontinuation symptoms. Those who have become tolerant to the highest doses may have a difficult time discontinuing.
Are you addicted to hydrocodone? This is a powerful opioid that many people take for pain relief, but become addicted to the effects of the drug. Most people that become addicted don’t ever plan on developing an addiction. People that are using this drug for a long period of time to manage their pain can become dependent and addicted.
There are individuals that take the drug recreationally to cope with stressors who also can develop addictions. People that are taking it to deal with depression and/or to get high and escape life’s stressors can have a tough time kicking their habit as well. Most people that are addicted are going to need some outside support from a professional to help get through withdrawal symptoms.
If you know that you are addicted, it may be very helpful to consult a psychotherapist and/or a psychiatrist to help deal with the effects of withdrawal. If you have a high tolerance to the drug, you may want to consider something like “opioid replacement therapy” to help with the addiction.
4. Cold Turkey vs. Tapering
How quickly did you quit taking hydrocodone? Those who quit “cold turkey” without tapering are thought to have more difficult withdrawal symptoms because the nervous system is given no time to adapt to changes. If you quit “cold turkey” from a high dosage, it can sometimes serve as a shock to the nervous system, making the acute phase of withdrawal more intense as well as increasing the chance for protracted symptoms.
It is typically recommended to conduct a gradual taper if you were on a high dose of the drug. You may want to consider working with your doctor and/or a professional to come up with a tapering protocol. Although you can quit cold turkey usually without any severe danger, to minimize withdrawal symptoms, tapering is always recommended.
A third option to quitting cold turkey and/ or tapering is that of “opioid replacement therapy.” This involves transitioning to a less powerful opioid such as suboxone or methadone. This allows the individual to stop taking hydrocodone, and then gradually reduce their dosage of the less powerful replacement drug. The goal with this is to smoothly transition off of opioids.
5. Individual Factors
It should also be noted that everyone recovers at an individual rate based on personal factors. Things such as individual physiology, genetics, environment, social support, and habits all can play a role towards impacting withdrawal. People who are naturally less sensitive to drug withdrawal may feel almost fully recovered after a week off of the drug.
Other individuals that are highly sensitive to withdrawal may have protracted symptoms lasting for weeks or months after the acute phase. It is thought that things such as whether you are taking any other drugs, whether you work out, eat healthy, etc. can influence how quickly you recover.
Hydrocodone Withdrawal Symptoms: List of Possibilities
Below are a list of symptoms that you may experience upon facing hydrocodone withdrawal. Understand that what you experience will vary based on individual circumstances. You may not experience every symptom listed below. Intensity and duration of symptoms will vary depending on the person.
- Abdominal cramping: Many people report feeling extreme cramps in their abdominal area when they stop hydrocodone. This symptom can be very uncomfortable, but should start to improve after a week or two off of the drug.
- Anxiety: You may notice feelings of intense anxiety upon discontinuation. The drug acts as a depressant, reducing activity in the central nervous system – which leads to feelings of relaxation. When you stop taking the drug, you may experience a resurgence of anxiety until your nervous system heals.
- Appetite changes: During the first few days after your last dose, you may experience significant reductions in appetite. You may not want to eat any food because you don’t feel hungry and/or are sick. Do your best to keep your body nourished with healthy foods, it may expedite recovery.
- Chills: Some people feel notice chills throughout their body when they stop hydro. This is a common opiate withdrawal symptom. These chills should significantly improve after the first week of discontinuation.
- Cravings: Many people have intense cravings for the drug after they’ve quit. Cravings tend to be most intense a few days after a person has withdrawn. You may crave hydrocodone weeks or months after your last dose – this is common among addicts. In general, the longer you’ve been off of the drug, the easier these are to resist.
- Depersonalization: Do you feel unlike your normal self? Many people report feeling disoriented as well as depersonalized when they come off of hydro. Your endorphin levels and neurotransmitters will need time to readjust and are usually part of the reason you may feel abnormal during withdrawal.
- Depression: It is common to feel depressed when you quit this drug. The depression that you experience may be mild, but it could be severe. Usually people that withdrew from high doses and/or quit cold turkey will have more powerful depression. This is a very normal withdrawal symptom that takes time to heal.
- Diarrhea: While taking hydrocodone, you likely experienced some degree of constipation. When you stop taking the drug, you will likely experience some diarrhea. If the diarrhea gets bad, be sure to consider getting some Imodium (available over-the-counter).
- Dilated pupils: Taking this drug (or any opioid) will likely constrict the pupils. Upon discontinuation, you may notice that your pupils become dilated. This isn’t usually a symptom that bothers most people, just something to note.
- Dizziness: Do you all of a sudden feel dizzy after you stopped taking hydrocodone? The dizziness is due to the fact that your body is expecting the drug, but doesn’t receive it. As it scrambles to readjust itself, a person may feel dizzy and/or vertigo.
- Fatigue: Excessive tiredness and lethargy are common initial withdrawal symptoms. The low energy levels that you experience may make it difficult to perform normal functions such as: get out of bed, go to work, prepare meals, etc. You should regain some energy after the first week and it should continue to improve over time.
- Fever: You may notice that you have a fever when you quit. Low-grade fevers are most commonly reported, but you could have a higher fever too. This is more of an acute symptom and shouldn’t last longer than several days.
- Flu-like: A combination of symptoms lead people to describe the withdrawal experience as being “flu-like.” Meaning, many people exhibit similar withdrawal symptoms from hydrocodone as they do when they have the flu. These can include things like: nausea, vomiting, fatigue, aches, and dizziness.
- Goosebumps: You may have “goose bumps” across your skin as a symptom. These are caused by tiny muscle contractions at the base of each hair follicle and are influenced by the sympathetic nervous system.
- Headaches: Many individuals report light or moderate headaches when they face withdrawal. These headaches can be intense to the point of migraines in more severe cases. The hydrocodone tends to provide headache relief, so when a person quits, the headaches may temporarily be more severe.
- Hot flashes: These refer to sudden feelings of feverish heat that come out of nowhere. You may be doing something and notice that you feel very hot. Although you may also have a fever during withdrawal, hot flashes are very common. Some people also experience cold flashes as well.
- Insomnia: Some people may be unable to fall asleep at night after they’ve quit this drug. Hydrocodone tends to have a relaxing effect that leads some people to nod off to sleep while taking it. During withdrawal, a combination of anxiety, restlessness, and an array of physical symptoms can set the stage for insomnia.
- Irritability: You may feel more irritable than normal as you come off of this drug. The irritability is probably due to changes in endorphin and neurotransmitter function post-drug. As time passes, your degree of irritability should fade. In the meantime, whenever something minor upsets you, try to take a deep breath and realize that this feeling will eventually improve.
- Itching: It is thought that feeling itchy may be a reaction some people have when they stop this drug. The itching is likely related to increased sensitivity of nerve endings underneath the skin. Many people believe they have developed a rash, when in reality it is a withdrawal reaction from the nerve endings.
- Joint pain: During withdrawal it is common to feel muscle aches and joint pains. These aches and pains can be influenced by the body’s lack of endorphin production. When you take a drug like hydrocodone, your natural endorphins will lower as a result of the drug. It takes time to build these back up.
- Mood swings: You may feel like an emotional wreck when coping with withdrawal symptoms. Your moods may be erratic and difficult to control. As time continues to pass, your emotions should begin to stabilize.
- Nausea: The initial nausea associated with discontinuation can be overwhelming. If it becomes severe enough, it may lead a person to vomit. Fortunately the nausea will likely decline significantly after the first week.
- Palpitations: These refer to sensations that your heart is racing or beating abnormally loud. These can be further influenced by increases in anxiety. If you are dealing with heart palpitations, realize that it’s just a symptom, and focus on relaxation.
- Panic attacks: Some people may develop panic attacks when they quit hydrocodone. These are caused by intense surges in anxiety and inability to lower arousal. Although these may be more common in people with a history of anxiety, anyone could experience them if withdrawal is bad enough.
- Restlessness: Many people feel internally restless and/or unable to sit still. In many cases this is influenced by anxiety levels and mood. You may have restless legs and/or feel as though you cannot stay in one place. To cope with this symptom, consider doing some deep breathing to calm yourself down. If relaxation doesn’t work, go for a walk until it improves.
- Runny nose: When coming off of any opiate, it is possible to develop a runny nose. There is no controlling when the nasal drainage will stop, but be sure to keep some extra tissue handy.
- Sleep changes: Your sleep patterns may become erratic and random during withdrawal. Some days you may feel excessively tired, while others you may not be able to sleep. Some people may not be able to get restful sleep as they may wake up in the middle of the night. Understand that your sleep pattern will fluctuate, but stabilize over time.
- Suicidal thinking: It is important to realize that during withdrawal, your endorphins and neurotransmitters are imbalanced and will eventually correct themselves. However, you may feel suicidal before normative functioning is restored. If you feel suicidal, realize that this is a stage that will pass. If you are unable to cope with this feeling, seek immediate professional help.
- Sweats: Most people end up experiencing profuse sweating during the initial few days of quitting the drug. These sweats may be heavy and constant. You may find yourself waking up in the middle of the night soaked. The sweating is a natural response from your body and should subside after a week or two.
- Vomiting: You may get sick when you initially come off of the drug. Some people feel incredibly nauseous and end up vomiting. This symptom doesn’t usually last longer than a week.
- Yawning: Do you find yourself yawning even when you’re not tired? If you are going through withdrawals, you may be prone to excessive yawning. It will take time for your physiology to readjust and the yawns to subside.
Hydrocodone Withdrawal Length: How long does it last?
There’s no exact science stating that withdrawal will last a specific number of days. The drug itself has a half life of 4 to 6 hours, meaning that hydrocodone stays in your system for less than 24 hours after your last dose. However, just because the drug is clear from your system does not mean that withdrawal is over. Once the drug has finished clearing your system is typically when withdrawal begins.
The initial phase of withdrawal, often referred to as the “acute phase” can last anywhere from 7 to 10 days. This is characterized by the most extreme physical symptoms, including sickness, as well as various psychological symptoms. The most difficulty people tend to have facing hydrocodone withdrawal tends to be in the acute phase. Following approximately 10 days, most people notice significant strides towards feeling better.
It should be noted though that some individuals still exhibit difficult symptoms following the initial couple weeks after discontinuation. This is often referred to as “PAWS” or post-acute withdrawal syndrome. During this time, a person may experience symptoms lasting for weeks (or in some cases months) following their last dose. For most individuals, these symptoms tend to continue fading as more time passes.
To speed up withdrawal, it is recommended to eat healthy, consider useful vitamins and/or supplements, get some mild exercise, socialize, and attempt to stay as productive as possible. If you are having a really tough time coping with symptoms, take things one day at a time. Realize that with each passing day, you are one step closer to full recovery. If you have gone through hydrocodone withdrawal and/or are currently dealing with symptoms, feel free to share your experience in the comments section below.