ARTICLE OVERVIEW: Hydrocodone is one of the most widely prescribed drugs in the U.S. It’s highly addictive and known to be habit-forming. In fact, physical dependence and tolerance occur for anyone using hydrocodone for more than a few weeks. What can you expect when you quit using hydrocodone after dependence? This article reviews protocols used during hydrocodone withdrawal and outlines where you can get help.
ESTIMATED READING TIME: 10 minutes.
Table of Contents:
- Is Hydrocodone Withdrawal Hard?
- How Dependence Develops
- Is Hydrocodone Withdrawal Dangerous?
- A List of Withdrawal Symptoms
- Total Duration
- The Basic Timeline
- Medicines that Help
- Natural Remedies that Help
- Where to Go for Help
- Relapse
- Your Questions
Hydrocodone withdrawal is harder when you’ve been taking high doses or when you’ve been using hydrocodone daily for more than a few weeks.
Is Hydrocodone Withdrawal Hard?
Yes. Hydrocodone withdrawal can be hard. The body and brain adapt quickly to hydrocodone. After only a couple of weeks of daily dosing, physical dependence sets in. At the same time, some people experience the brain’s cravings for more, and the tolerance builds…this means that your body requires higher doses or more frequent dosing for initial effect. And when physical dependence is strong, the withdrawal that follows tends to be also.
When you stop taking hydrocodone – even if just for a short period of time – withdrawal symptoms occur because of this physical dependence. The reason for this? The body perceives the chemical structure of hydrocodone as “normal” and it will 7-10 days to reach your original state of non-hydrocodone chemical balance.
This is what makes it so difficult to quit hydrocodone. Due to the body’s imbalance of chemicals, the withdrawal process is highly uncomfortable. Most people will take more of the drug in order to avoid it.
How Dependence Develops
So, how does hydrocodone dependence work?
It starts in the doctor’s office. Hydrocodone is prescribed as a narcotic analgesic (pain reliever) and a cough medicine. Sometimes, it’s combined with paracetamol or ibuprofen. But when it’s prescribed for more than a few weeks at a time, the body has to adjust. The brain and body HAVE TO adapt. Otherwise, the depressant effects of hydrocodone would shut down certain systems and you’d die.
Just like other opioid substances hydrocodone enters the brain and molecules attach to a variety of opioid receptors. From there, neurotransmitters send chemical signals to other areas of the brain and body. The chemistry causes a feeling of euphoria and changes your perception of pain. But it also slows heart rate, breathing, and digestion.
To compensate for hydrodocone’s depressant effects, the brain “speeds” up specific functions.
Take away the hydrocodone, and you get a set of withdrawal symptoms…which are actually the “sped up” stimulant effects the body creates to balance out hydrocodone’s depressant chemistry.
Is Hydrocodone Withdrawal Dangerous?
Not necessarily.
When people ask if hydrocodone withdrawal is dangerous, they’re usually worried about risk of death or fatalities. Though there have been a few reported incidents of people dying from opioid withdrawal, these incidents remain rare.
However, withdrawal can be dangerous because of certain symptoms that come along with it. Many people compare hydrocodone detox to an extremely unpleasant flu. With the flu, you get vomiting and diarrhea. If improperly treated, these can result in dehydration. Plus, relapse is a risk of trying to withdraw on your own…as well as suicidal ideation or thoughts to harm yourself or others.
Please remember: THE SAFEST WAY TO WITHDRAW FROM HYDROCODONE IS WITH MEDICAL SUPERVISION. Most likely, you are NOT a medical professional. Treatment facilities or a detox clinic can address symptoms and make the process more humane. Professionals can also mitigate withdrawal dangers by:
- Alleviating withdrawal symptoms.
- Giving you the opportunity to process thoughts and understand emotions.
- Offering a medically supervised and controlled environment.
These factors are vital for withdrawal, as each case of withdrawal is unique. In fact, you have no idea how your brain and body will react to detox. And when symptoms become too much, you may be tempted to return to use.
A List of Withdrawal Symptoms
Again, the body adapts to hydrocodone’s chemical structure as a means of survival. One of the biggest reasons you might feel as though you can’t stop using hydrocodone is to avoid withdrawal symptoms.
Know that you are not alone!
Once you decide to quit, you need a plan in order to deal with these symptoms. Your brain and body are going to need time to readjust to their original chemical balance, a state known as “homeostasis”. This time of adjustment is what we refer to as withdrawal; withdrawal manifests as a specific set of symptoms.
Have you ever gone a day or two without hydrocodone? Did you notice your body beginning to feel highly uncomfortable?
These were the early stages of withdrawal. The symptoms for this period include:
- Agitation
- Anxiety
- Increased tearing
- Insomnia
- Muscle aches
- Runny nose
- Sweating
- Yawning
As hydrocodone withdrawal progresses, the above symptoms become more severe and the following symptoms kick in:
- Abdominal cramping
- Diarrhea
- Dilated pupils
- Goosebumps
- Nausea
- Vomiting
Symptoms usually begin about 12 hours after your last dose of hydrocodone. They can last for 7-10 days, with most symptoms peaking in intensity about Day 3 after quitting.
Total Duration
Withdrawal from painkillers generally lasts around 7-10 days. Onset begins between 6 to 12 hours after your last dose of hydrocodone. For the following 1 to 3 days, your withdrawal symptoms will peak. Then, over the course of 5 to 7 days, they’ll gradually die down. However, some symptoms can persist for weeks or months after this acute withdrawal.
Here’s the main difference:
- Acute Withdrawal begins with feelings of anxiety and cravings, climaxes around 36 to 72 hours, and decreases heavily within the following 5 days.
- Protracted Withdrawal Symptoms (PAWS) follow acute withdrawals and can last up to months.
However, the TOTAL AMOUNT OF TIME you’ll spend in hydrocodone withdrawal depends on your level of dependence. Physical dependence is very personal and works differently for everyone. Therefore, not everyone will experience withdrawal the same. You can get some clues as to how long your case of withdrawal might last by answering the following questions:
- How long have you been using?
- How much of a dose do you take?
- What’s your age?
- What’s your family’s history with health and/or addiction?
- What’s your overall health state?
For example, someone who’s used hydrocodone for a long period of time and takes bigger doses will most likely see more time in withdrawal in comparison to someone who’s only been using for a few weeks at lower doses.
The Basic Timeline
With this knowledge, let’s get into the timeline of what to expect day by day while you undergo withdrawals.
24 to 72 Hours After Your Last Hydrocodone Dose: This is the peak of withdrawal symptoms and, for the majority of people, the most uncomfortable. You can expect the following symptoms to be at their most intense during this period:
- Abdominal cramping
- Abnormal skin sensations
- Alternating chills and sweating
- Diarrhea
- Drowsiness
- Mood swings
- Restlessness or anxiety
- Sweating
3 to 7 Days After the Last Hydrocodone Dose: Your symptoms will begin peak and then gradually to die down. In terms of physical withdrawal, the worst is over and your body is starting to adjust back into its normal chemical balance. However, the brain has just entered the beginning stages of readjustment. The following symptoms will persist:
- Alternating chills and sweating
- Decreased appetite
- Exhaustion
- Irritability
- Intense cravings
- Muscle and bone aches
- Problems sleeping
- Sensitivity to pain
- Tears or tearing from the eyes
Week 2 of Hydrocodone Withdrawal: You can expect to feel minor physical withdrawal symptoms still. These may actually be overpowered by the mental symptoms. In particular, you will continue to crave hydrocodone. For this reason, it’s important that you seek out talk therapy in order to reduce cravings and adjust your emotional state/behavioral patterns. The following symptoms may persist during this week:
- Back aches
- Cravings
- Depression
- Irritability
- Fatigue
- Mood swings
- Muscle cramps
- Restless leg syndrome
- Tremors
Week 3 of Hydrocodone Withdrawal: Your cravings are starting to dissipate. However, your brain still needs much time to readjust. During this period, it’s important to be in a trusted therapeutic relationship with a counselor, social worker, or pscyhotherapist… as the following symptoms all have to do with your mental state:
- Anxiety
- Depression
- Mood swings
- Restlessness
- Sleep disorders
Week 4 of Hydrocodone Withdrawal: During this time, you’ll be feeling better, but not 100% better. Psychotherapy is still a must and you’ll start to realize the path of recovery goes beyond this timeline. It’s a lifelong mission to stay sober. The following symptoms may persist, but you know you can handle them:
- Anxiety
- Irritability
- Mood swings
Medicines that Help
Recently, the Federal Drug Administration approved of the first medication to help with opioid withdrawals; lofexidine. The medication is known to greatly reduce withdrawal symptoms as well as reduce cravings. It should be noted that it doesn’t treat drug addiction itself.
Generally, you may be offered one or more of the following medications from a prescribing doctor. These medications are used primarily for the sake of opioid withdrawals:
Buprenorphine. A partial opioid agonist, this medication binds itself to opioid receptors, just not to the full extent of an opioid agonist. In turn, this reduces withdrawal symptoms and cravings, giving individuals a better chance to prevent relapse.
Methadone. Since the 1960’s, methadone has had great success in reducing withdrawal symptoms and, in some cases, even delaying them. Methadone attaches itself to opioid receptors, similar to the way other opiate drugs do. This effectively makes the user crave less and gives them a better chance at preventing relapse. It should be noted, most people are only on methadone for a short period of time, as it can be addictive medication if misused.
Naltrexone. This medicine contains a blocking action against opioids which isn’t addictive nor sedative. However, the medicine can precipitate intense symptoms and should only be administered under medical prescription.
Experts find that medication in combo with psychotherapy is the most beneficial form of treatment. The idea is that you stabilize your physical state and then address your mental state. Reducing compulsive urges helps you focus on the deeper aspects of healing.
Natural Remedies that Help
Just as with the flu, there are natural remedies out there to ease hydrocodone withdrawal symptoms. Medical News Today wrote an article covering home remedies you can find in your household that can help. If we take a look at individual symptoms, it’s easier to understand how these remedies work.
Chills. A flu-like symptom many people experience during detox are chills and cold-sweats. Constant shivering is usually a major factor of this. In order to warm yourself up, it’s suggested you wear extra layers such as sweatshirts or cardigans. Hot pads and warm, longs showers or baths can also help.
General discomfort. No matter what withdrawal symptoms you experience, a distraction can make a major difference. Some people turn to the arts (such as writing, painting, or playing music) while others develop new hobbies (such as gardening or cooking). Regardless, a distraction can help modify your pain.
Lack of dopamine. One of the goals of psychotherapy is to refuel your dopamine/serotonin levels which were once fueled by hydrocodone. One of the best natural remedies for this is exercise, as it promotes a natural dopamine within us; endorphins. Cardio-based workouts might help. Some people report lessened symptoms from warm/hot baths or showers. Finally, other forms of exercise which have helped people boost dopamine levels include yoga and meditation.
Nausea. Since symptoms of nausea have much to do with the food and liquids you intake, you can eat and drink certain things as a means of reducing the discomfort. These include, but aren’t limited to:
- Bland foods, such as bananas, rice, or toast.
- Eating several small portions of food throughout the day rather than a few large meals.
- Avoiding foods that are high in fat and grease.
- Taking small sips of water often. As mentioned, dehydration can be a dangerous aspect of withdrawals and it’s vital you intake lots of water. Instead of drinking a large amount all at once, it’s suggested you take a little at a time.
Shaking. In a study done by Pharmaceutical Biology, rats were tested on to see if the herb Hypericum perforatum (or St. John’s wort) could reduce the shaking involved in opiate withdrawal. Not only did the shaking cease but researchers also found the rats’ diarrhea to reduce. Another way people reduce shaking is by quitting caffeine when they quit hydrocodone. Caffeinated drinks are known to aggravate shaking and trembling tendencies.
Trouble Sleeping. Though it’ll be difficult to hop right back into a healthy sleep schedule, you want your body to eventually have a clock of its own. This means you’ll want to develop a schedule for when you fall asleep and when you wake up. So, lying in bed at the same time every night helps.
Furthermore, you might want to consider where you’re sleeping. Many people enter an inpatient program, where sleep environments are controlled by others. This has its pros and cons for some individuals. However, you can make requests. For example, if you sleep better in a cooler or warmer environment, this is something you can ask for.
Where to Go for Help
In order to find help, you must fully admit you want it. By admitting you’re defeated, you’re allowing something new to happen. Then, you can seek medical help.
But where can you look?
- Addiction doctors (Find an ABAM specialist)
- Psychotherapists or counselors (Find an APA psychologist member near you)
- Psychiatrists (Find an ABA psychiatrist near you)
- Social workers (Your state’s Department of Health and Social Services)
- Substance Abuse and Mental Health Services Association’s (SAMHSA) National Hotline – 1-800-622-HELP (4357)
- SAMHSA Opioid Treatment Program Directory
- Your family physician
With opioid prescriptions use reaching epidemic numbers, more and more people are falling into this cycle of addiction. If you’re one of those trying to break the cycle and seek help through withdrawal… consult your doctor about your hydrocodone prescription. From there, you’ll get some answers for the safest means of withdrawal.
Or, when you want to find the right treatment facility, give us a call. We’re happy to help. Plus, you can leave us a question or comment in the section at the end. We do our best to respond to all questions personally and promptly.
You’ll also want to talk to your family and friends. The reason for this is throughout your journey to recovery, they’re going to be your support system. The people you can always turn back to when things get too difficult. Furthermore, they can guide you along the rest of the recovery process. If you’re a family member or friend of someone who’s a hydrocodone addict, there are a variety of options for you to seek help for your loved one.
Relapse
Remember, hydrocodone is a very addictive drug. Therefore, most people seek out “a fix” as a means of avoiding withdrawal symptoms. So, while you might assume you can quit on your own, once those withdrawal symptoms come into play, the most likely outcome is you’ll seek out “your fix” too.
Plus, most people usually aren’t surrounded by a supportive environment when they try to detox at home. It becomes a natural tendency for relapse to occur. When those around you are using drugs, you’re more likely to feel comfortable taking the drug rather than discovering a recovery path. In fact, studies show between 40% and 60% of people who get addicted to drugs such as hydrocodone end up relapsing.
The reason for this statistic has to do with hydrocodone’s high addictive liability. It’s very good at getting you high. And even if you were to beat the physical withdrawals, there’s still a danger that lies in the mental withdrawal. You should expect to be craving hydrocodone for weeks after you’ve physically withdrawn.
With all this being said, you can assure the safest way forward is to consider medical detox. Give yourself the gift of a successful recovery and go to treatment. Most people who successfully complete withdrawals do so under medical supervision.
Your Questions
If you have any further questions pertaining to hydrocodone withdrawal, we invite you to ask them in the comments section below. If you have any advice to give for people currently withdrawing, we’d also love to hear from you. We try to provide a personal response to each comment and get back to you promptly.
Additional Reference Sources: Addiction Blog: The Hydrocodone Withdrawal Timeline Chart
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