OVERVIEW: While rarely life-threatening, hydrocodone withdrawal can be severe. Therefore, the safest way to quit hydrocodone is under medical supervision. Doctors can guide you to gradually reduce daily dose in a drug taper. Detox clinics can provide medicines that treat symptoms as they appear.
TABLE OF CONTENTS
- Physical Effects
- Just Stopping
- Cold Turkey
- Medical Detox
- Medicines that Help
- Detox at Home
- Tapering Guidelines
- Do I Have a Drug Problem?
- What To Do Next?
Are you using hydrocodone daily? You’re not alone. Prescribed to treat moderate to severe pain, hydrocodone is a hugely popular painkiller. In fact, according to Customer Reports January 2014 issue, hydrocodone is the most widely prescribed medication in the U.S. The 2016 National Drug Threat Assessment (NDTA) Summary backs this up; more than 6.7 billion hydrocodone tablets were distributed in the United States in 2015.
Hydrocodone is a semi-synthetic opioid agonist. It works as a pain reliever but comes with enormous addictive potential. Hydrocodone changes the way the brain perceives pain. It can cause euphorica…and alter brain function over time. Drug dependence, for example, begins after using hydrocodone for short period of time. Actually, the National Safety Council reports that opioids such as hydrocodone trigger dependence after only 5-7 days of daily dosing.
Why does drug dependence occur?
Over time, your brain and body body becomes used to the presence of hydrocodone. When you abruptly stop taking hydrocodone, your body has to adjust without the medication, which can cause minor or even severe withdrawal symptoms. Even if you aren’t psychologically dependent (addicted) to the medication, this will still be the case.
Opioid withdrawal syndrome can include a number of side effects, such as:
- Abdominal cramping
- Abnormal skin sensations
- Back aches
- Decreased appetite
- Intense craving
- Mood swings
- Muscle aches & cramps
- Restless legs syndrome
- Sensitivity to pain
Still, each case of withdrawal is unique. You cannot truly predict the severity or the intensity of symptoms. On the other hand, taking hydrocodone long term will cause more severe withdrawal symptoms than if you take it for a few months, or less. Hydrocodone withdrawal syndrome may also be worse if you have abused hydrocodone by taking it in very high doses or in a manner other than prescribed, such as chewing, snorting, or injecting hydrocodone.
Can I Just Stop?
Yes, you can just stop taking hydrocodone… but only if you’ve just started. Many people are given hydrocodone for a week or two for the management of pain from an illness, accident, or operation. If you’re only taking hydrocodone for a short period of time, you can easily stop taking hydrocodone when you no longer need it or your prescription runs out.
Many people, however, will need to stop taking hydrocodone gradually. If you’ve taken hydrocodone to help manage chronic pain, things get a little more complicated. Hydrocodone uses and side effects can include physical dependency. You’ll experience withdrawal symptoms after taking hydrocodone long term, making it difficult to quit using hydrocodone. You may also have developed an addiction to hydrocodone which does not allow you to simply stop taking hydrocodone without intense cravings. How addictive is hydrocodone? Relatively very addictive. And, because of its addictive potential, and high frequency of (ab)use, the Food and Drug Administration (FDA) request a change of hydrocodone classification in 2013. So, Drug Enforcement Administration (DEA) moved this painkiller to more controlled group, Schedule II.
If you’ve only been taking hydrocodone for a short while, you can suddenly stop without ill effects. If you’ve taken hydrocodone longer than a few weeks, this isn’t advisable because the withdrawal symptoms can be incredibly unpleasant. Most doctors will recommend gradually reducing your dose of hydrocodone to make quitting easier.
There are some situations in which it would make sense to quit hydrocodone cold turkey. If you’ve previously had a bad reaction to the medication or it’s causing unpleasant side effects, tapering your dosage may be intolerable or even dangerous. If you suffer from a hydrocodone addiction, it may seem tempting to quit cold turkey, but you need to address the underlying addiction issues with a medical professional as well to help prevent relapse.
The process of medical detox is made safe because doctors, nurses, and clinic staff supervise the procedure. This way, you free your body of the hydrocodone under the watchful eyes of medical professionals. Not only do they offer medical support, but detox staff are also well-versed in providing emotional support. Plus, they use medicactions to address withdrawal symptoms as they occur. The main steps involved in medical detox for hydrocodone include:
STEP 1. Paperwork.
Before you start with a medical detox, you will need to fill out paperwork. This part is important because you can self-report your dosage amounts and frequency of use, an important beginning that helps clinicians to plan your individualized treatment.
STEP 2. Clinical Assessment.
After your entry, you can expect to spend an hour in discussion with detox clinic supervisors, whose job it is to evaluate you, and determine what kind of detox protocol you will follow. They will collect your medical history, and conduct a psychological evaluation. Also, expect a physical examination and drug testing using urine or blood samples. Moreover, if there is a need for medications that will address withdrawal symptoms, medical nurses will get prescriptions from a licensed physician.
STEP 3. Tapering Procedure.
Tapering is a reduced dosage schedule that is administered according to doctor’s orders. So, get prepared and learn what symptoms to expect during hydrocodone withdrawal.
STEP 4. Transition.
The last step in a medical detox is to consider transition to addiction treatment. Medical detox is only the first step of your recovery. It is important to learn how to live without using substances, and rehab programs are made just for that. However, no one can force you to enroll into a program after medical detox. You need to want to attend yourself.
Medicines that Help
Hydrocodone detox can include the use of medications to ease withdrawal symptoms. Some of the most important are:
Antidepressants. People who are over-using hydrocodone need to be examined for depression or other mental illnesses. Antidepressants can be life-savers in those cases.
Buprenorphine. Subutex and Suboxone (brand names) are commonly used during detox. Buprenorphine helps prevent withdrawal symptoms caused by stopping other opioids. It also addresses cravings and can be used in the weeks, months, and years following detox.
Clonidine. This medication is used to reduce symptoms of anxiety, agitation, sweating, runny nose, cramping, and muscle pain.
Dicyclomine hydrochloride. Use primarily to treat abdominal cramps.
Diphenoxylate and Loperamide. These medications can be used to treat diarrhea.
Hydroxyzine and Promethazine. They reduce nausea and vomiting.
Methadone. Being a long-acting opioid, methadone is one of the most commonly used medications in longer term opioid replacement therapy. It is considered safer to dose and easier to taper than hydrocodone. However, methadone is not prescribed for all cases.
Methocarbamol. This medicine is used to treat joint pain and muscle cramps.
Naltrexone. Used in combination with other substances (mostly buprenorphine), naltrexone blunts some of the rewarding effects of opioid drugs like hydrocodone. So, it is used to help prevent relapse.
Trazodone. This medication is used to treat depression and anxiety.
REMINDER: It is possible that you switch one addiction for another when you use some of the medications listed here. Self-report feelings of euphoria, cravings, or obsessive thinking to prevent cross addiction.
Can I Detox at Home?
You may, but it’s not recommended.
Any home detox requires medical supervision which means that you first need to consult with your prescribing doctor to help you plan an individualized tapering schedule. Getting medical permission is very important since withdrawal from hydrocodone may be very uncomfortable and harsh, so people in poor health may not be eligible.
Slowly reducing your dose may be over for several weeks or even months, but its the safest way to stop taking hydrocodone. CDC Guideline for tapering opioids for chronic pain suggests that a decrease of 10% of the original dose per week is a reasonable starting point.
Tapering schedules should be individualized, so they can minimize withdrawal symptoms. If the tapering plan doesn’t work for you, speak with your doctor about making a new dosage plan.
Guidelines for Tapering
Before starting to taper hydrocodone, consult with your doctor and follow their instructions. Some FDA labels of hydrocodone products come with their own tapering schedules. Generally, the opioid taper for hydrocodone includes these suggestions:
1. If you use 20 to 30 mg every 12 hours, reduce by 10 mg on Day 1 and 2. Day 3, stop.
2. If you use 40 mg to 70 mg every 12 hours,
- Take 40 mg every 12 hours on days 1 and 2.
- Take 20 mg on days 3 and 4.
- Take 10 mg on days 5 and 6.
- Day 7, stop.
3. If you use 80mg to 100 mg every 12 hours,
- Take 80mg on days 1 and 2.
- Take 60mg on days 3 and 4.
- Take 40 mg on days 5 and 6.
- Take 20 mg on days 7 and 8.
- Take 10 mg on days 9 and 10.
- Day 11, stop.
The supervising doctor should monitor carefully for signs of withdrawal. If you show significant signs of withdrawal, doctors usually raise the dose to the previous level, and taper more slowly.
How to Stop taking Hydrocodone Safely?
Reducing your dosage over several weeks or months is the safest way to quit hydrocodone. It’s also the best way to ensure that you don’t experience a relapse and start taking hydrocodone again.
The FDA label of ZOHYDRO® ER (a hydrocodone product) states:
When a patient no longer requires therapy with ZOHYDRO ER, taper the dose gradually, according to the schedule while monitoring carefully for signs and symptoms of withdrawal. If the patient develops these sign or symptoms, raise the dose to the previous level and taper more slowly.
The safest way to stop taking hydrocodone is by consulting a doctor and following his or her instructions. There may be medical treatments available to help you deal with withdrawal symptoms, but it’s usually preferable to stop taking hydrocodone without taking other opioid medications for withdrawals.
Currently, there are several effective medical treatments that include medically assessed therapy to ease the hydrocodone withdrawal symptoms. The most common medications used in treating withdrawal include:
- Diphenoxylate and Loperamide
- Hydroxyzine and Promethazine
- Dicyclomine hydrochloride
However, the safest way to stop taking hydrocodone is under medical supervision, where trained staff can help you overcome physical as well as psychological issues.
Do I Have a Problem?
First of all, you need to be honest about your use of hydrocodone. Also, symptoms of substance abuse problems are different among individuals, but generally speaking, hydrocodone problem can be recognized if you display several of the following statements:
- Continue to use the drug despite all negative consequences.
- Find illegal ways to get the medication (doctor shopping, stealing, Internet)
- Feel cravings to use it again and again.
- Losing control over the doses and frequency of use.
- Unable to stop taking hydrocodone regardless many attempts to do it.
- Changed or lost interest in hobbies.
- Obsessed over getting and using the medication.
If many of these statements are ‘YES’, you may have a serious problem. But, if you are not sure that you may have problem with hydrocodone, download our free guide How To Quit Opioid Painkillers to find brief self-screening questions to assess opioid drug use.
What To Do Next?
STEP 1: Admit that you have a problem. Are you worried that you have a problem? Then, you probably do. Get real with yourself, and be honest. The first (and hardest) step to recovery is admitting that there is an issue. Once you do, treatment is possible.
STEP 2: Find reasons to change. If you want to break the cycle of addiction, you need to find reasons to quit. Your motivation for sobriety can bring you a completely new life. So, make a list of 10+ reasons you want to be drug-free.
STEP 3: Reach out for help. Nowadays, addiction is not considered as a moral issue, it’s a brain disease. So, don’t be ashamed to reach out for help. There are people who can help you…and who are trained in working with the physical and mental aspects of addiction. The medically specialized places that can provide you with appropriate services include:
- Addiction rehabs
- Licensed psychologists
- Licensed psychiatrists
- Medical detox clinics
- Medical doctors
Not everyone who is diagnosed with addiction can afford a rehab. But rehabs can truly help you push the “restart” button. They give you the time to get physically and mentally balanced. Plus, you begin healthy, lifelong habits in rehab that can continue with you for years afterwards. You eat at normal times. You sleep at normal times. And you exercise and socialize!
When you look for a rehab program, you will need to make a choice between two main options: inpatient or outpatient program.
Inpatient rehabs provide 24-hour medical care and supervision of their patients. Actually, patients live in the facility during the recovery program. Most inpatient programs last for 1-3 months…up to 6 months. During the program, specialists provide constant care that will prepare you for life after rehab. Some of the most common services that inpatient rehab includes are:
- Individual therapy sessions.
- Group therapy sessions.
- Health education about the brain, addiction, and recovery.
Outpatient rehabs provide similar therapies as inpatient programs, but there is no constant care since the patients come and go for a few hours, several days per week. These weekly programs include visits with a counselor, who supervise your care. Outpatient rehabs are good options for people with a good support system at home and low severity of drug addiction.
Ready To Quit?
Are you interested in stopping hydrocodone?
Keep in mind that it can be difficult to quit hydrocodone without a doctor’s assistance, because how hydrocodone works is related to the brain. There are a variety of reasons why you might have trouble managing hydrocodone dependence or addiction.
If you are ready to quit hydrocodone for good, be sure that you have these three supports:
- Personal motivation. Find reasons to quit by making a pros-and-cons list where you will write all positive reasons to stop using, and all negative effects that addiction could do to you.
- Medical resources. Educate yourself about the dangers of long-term hydrocodone use. Consult with your doctor, and/or a pharmacist. You may also consider enrolling into medical detox.
- Emotional support. Make sure that you’ll have all support of your friends and family to quit. If your environment is not supportive, your recovery path will be more difficult.
Got Any Questions?
Do you still have questions about hydrocodone?
Please leave us your questions here. We do our best to answer you personally and promptly.
Reference Sources: Medline Plus: Hydrocodone
NCBI: The Relative Abuse Liability of Oral Oxycodone, Hydrocodone and Hydromorphone Assessed in Prescription Opioid Abusers
DEA Drug Fact Sheet: Hydrocodone
DEA: National Drug Threat Assessment 2016
NCBI:Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction.
All of the information on this page has been reviewed and verified by a licensed medical professional.