Author: Brittany Tackett

Hydrocodone is a narcotic medication prescribed for the treatment of moderate to severe pain. It is sold under the brand names Loritab, Lorcet, Vicodin, Hycodan, and Vicoprofen. Hydrocodone is the most frequently prescribed opioid in the United States.¹ Therefore, it is also one of the most commonly misused.² People misuse it for its euphoric, relaxing, and pain-relieving effects; however, hydrocodone abuse is dangerous and can lead to many harmful physical and mental health effects, including tolerance, dependence, and addiction. Knowing the hydrocodone abuse signs can help you to seek treatment for yourself or someone you know.

How Do People Abuse Hydrocodone?

Hydrocodone abuse occurs any time someone takes the drug without a prescription or takes it in a way other than prescribed. Some common ways people may misuse hydrocodone include:^4,5

• Taking a higher dose than prescribed
• Consuming hydrocodone more frequently than prescribed
• Taking hydrocodone to get high rather than to relieve pain
• Mixing hydrocodone with alcohol or other drugs
• Crushing and snorting pills
• Injecting hydrocodone intravenously

What are Hydrocodone Abuse Signs?

Because hydrocodone is a prescription medication, many people who were prescribed this opioid legally do not recognize when their use has become a problem. If you are concerned that someone you love may be misusing hydrocodone, watch the person closely for common hydrocodone abuse signs, such as:^3,6,7,8

• Frequent changes in mood
• Appearing sedated
• Pinpoint pupils
• Nodding in and out of consciousness
• Becoming more energetic and talkative than usual
• Sleeping more often or at different times of the day
• Missing medications or seeking refills more often
• Dismissive of non-opioid medications for pain relief
• Loss of interest in activities one used to enjoy
• Spending a significant amount of time alone
• Changes in groups of friends
• Becoming defensive when asked about drug use
• Changes in personal hygiene
• Irritability or nervousness
• Missing work, school, or other commitments
• Unexplained weight loss
• Showing signs of withdrawal when use is stopped, such as nausea, vomiting, muscle and bone pain, and trouble sleeping

Some common signs that a person may be injecting hydrocodone include:⁸

• Track marks—scars or bruises that appear on frequent injection sites (the arm is the most common place, but people also inject in the hands, feet, legs, or groin area)
• Finding needles, syringes, or syringe caps in the person’s belongings
• Spoons or aluminum foil with burn marks on it
• Burn marks on the fingers
• Q-tips, cigarette filters, cotton balls, rubber bands, or straps in the person’s belongings
• Missing shoelaces
• Wearing long sleeves in warm weather

Some common signs that a person may be snorting hydrocodone are:⁸

• Frequent sniffing
• Odd colored nasal discharge
• Constant stuffy or runny nosev
• Frequent nose bleeds
• Crushed pill residue on surfaces
• Cut up straws in the person’s belongings

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What are Potential Long-Term Hydrocodone Abuse Effects?

Hydrocodone abuse can be extremely harmful, especially when abused over a long period of time. It has adverse effects on nearly all of the body’s organ systems. Research has shown the following long-term health risks of opioid abuse:^2,4,9

• Chronic constipation
• Gastrointestinal bleeding
• Bowel obstruction
• Sleep-disordered breathing
• Sleep apnea
• Carbon dioxide retention
• Respiratory depression
• Bradycardia (slowed heart rate)
• Hypotension (low blood pressure)
• Heart attack
• Heart failure
• Frequent falls and bone fractures
• Osteoporosis
• Hormonal issues
• Sexual dysfunction
• Infertility
• Impotence
• Chronic fatigue
• Lowered testosterone levels
• Lowered estrogen levels
• Menstrual cycle changes in women
• Increased incidence of infections
• Weakened immune system
• Depression
• Anxiety
• Clouded thinking
• Hyperalgesia (more sensitive to pain)
• Overdose
• Hypoxia (lack of oxygen to the brain)
• Coma

What Happens When You Overuse Hydrocodone?

Chronic hydrocodone use can lead to tolerance, meaning the effects of hydrocodone over time become less pronounced, and you need more of the drug to achieve the same effect.¹ When tolerance increases, so does the risk of overdose. The higher dosage you take, the higher the risk of overdose becomes. Hydrocodone overdose can be dangerous and potentially even fatal.³ On average, more than 90 Americans die every day from an opioid overdose.⁵

Symptoms of Hydrocodone Overdose

Some potential signs of hydrocodone overdose to watch out for include:³

• Shallow, slow, or labored breathing
• Slowed heart rate
• Muscle weakness
• Clammy skin
• Pinpoint pupils
• Muscle weakness
• Unconscious—completely unable to respond or wake

Hydrocodone overdose is a medical emergency and requires immediate medical attention. Call 911 or take someone to the nearest emergency department.

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How to Help Someone Who Has Overdosed

If you think someone may have overdosed on hydrocodone, it is important to call 911 immediately. Attempt to get the person to respond. If you do get a response, do everything you can to keep the person awake. If you get little to no response, take the following actions:⁶

• If you have naloxone (a life-saving medication that can reverse the effects of opioid overdose), administer it immediately, following the instructions on the package carefully.
• If the person’s breathing is inconsistent or shallow or if they have turned blue, perform mouth-to-mouth rescue breathing. First, clear the airway by tilting the head back and lifting up the chin until the mouth opens. Start with two breaths and then give a strong breath every five seconds.
• If the person is not breathing or does not have a pulse, perform CPR. Push down on the chest repeatedly at a rate of 100 times each minute. After every 30 compressions, deliver two rescue breaths.
• Stay with the person until emergency medical professionals arrive.
• If you have to leave the person, place them in a recovery position—lying on their side, with the opposite hand supporting the head, mouth turned down and facing the side, and the top leg on the floor to keep them from rolling onto their stomach.

Hydrocodone Withdrawal Symptoms

Chronic use of hydrocodone can also lead to physiological dependence. When your body becomes dependent on hydrocodone, you will experience withdrawal symptoms when you suddenly stop using it. Hydrocodone withdrawal symptoms can start as soon as a few hours after the last use.⁴ They generally last three to five days but may last up to 10 days in some cases.⁵ Common opioid withdrawal symptoms include:^4,5,6

• Watery eyes
• Runny nose
• Sweating
• Flushing
• Excessive yawning
• Irritability
• Restlessness
• Loss of appetite
• Increased heart rate
• Increased blood pressure
• Vomiting
• Diarrhea
• Abdominal pain
• Tremors
• Cold flashes
• Goosebumps
• Muscle and bone pains
• Difficulty sleeping
• Uncontrollable leg movements
• Severe drug cravings
• Severe depression

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When is Professional Treatment Needed for Hydrocodone Addiction?

In addition to physical dependence, chronic use of hydrocodone often leads to addiction, meaning that a person may struggle to discontinue use even when it is having negative and harmful effects on their physical and mental health, personal relationships, and professional life.

Hydrocodone addiction can be difficult to overcome without formal substance abuse treatment. Hydrocodone addiction treatment programs may include therapies and interventions, such as:^4,5,6

• Individual counseling
• Group therapy
• Family therapy
• Peer support programs
• Medication maintenance

Some signs that you or a person you love may need professional treatment for hydrocodone abuse include:⁷

• Loss of control of drug use (calling for early refills, seeking opioids illegally, and having withdrawal symptoms between doctor appointments)
• Intense cravings
• Preoccupation with drug use
• Neglecting self-care, personal relationships, and professional commitments because of your drug use
• Continuing to use hydrocodone despite negative consequences

Since opioid withdrawal symptoms can be serious, you should not attempt to quit cold turkey. Medical detox programs are the safest option. They help reduce the severity of withdrawal symptoms and make people feel more comfortable throughout the withdrawal process.^4,5,6,7

If you or a loved one are struggling with hydrocodone abuse signs and effects and would like information on detox and treatment options, call 800-934-1582(Who Answers?) to speak with an addiction treatment specialist.

Resources

1. Drug Enforcement Administration (October 2019). Hydrocodone.
2. Habibi, M., & Kim, P. (July 2021). Hydrocodone and Acetaminophen. StatPearls Publishing.
3. S. National Library of Medicine. (January 2021). Hydrocodone.
4. National Institute on Drug Abuse. (June 2021). Prescription Opioids Drug Facts: What are Prescription Opioids?
5. S. Department of Justice: Drug Enforcement Administration. (2017). Drugs of Abuse: A DEA Resource Guide.
6. American Society of Anesthesiologists. Opioid Abuse.
7. National Institute on Drug Abuse. (2008). Recognizing Opioid Abuse.
8. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)
9. Baldini, A., Von Korff, M., & Lin, E. (2012). A Review of Potential Adverse Effects of Long-Term Opioid Therapy: A Practitioner’s Guide. The Primary Care Companion for CNS Disorders, 14(3).