Hydrocodone Abuse and Treatment
Hydrocodone is a semisynthetic opioid that doctors typically prescribe to treat pain. Patients who use it to ease short-term pain following surgery or an injury may not be as likely to develop a physical dependence on it as those who use hydrocodone to treat chronic pain, but the risk is always there because it’s a highly addictive substance. According to the National Institute on Drug Abuse (NIDA), Vicodin, which contains a blend of hydrocodone and acetaminophen, is the most commonly abused prescription drug among high school seniors.
Hydrocodone binds to opioid receptors in the central nervous system, weakening pain signals in the brain and producing a feeling of euphoria. It is often combined with acetaminophen or antihistamines to treat specific symptoms, like pain following wisdom tooth removal or a chronic cough. Other opioids include oxycodone, codeine, and morphine. The National Survey on Drug Use and Health administered by the Substance Abuse and Mental Health Services Administration found that 4.3 million Americans were using prescription painkillers for nonmedical purposes in 2014.
Signs of Abuse
Hydrocodone addiction is a chronic medical condition that’s caused by changes in brain chemistry due to regularly using the opioid. In fact, the American Society of Addiction Medicine considers it a chronic brain disease because dysfunction in the brain’s circuits leads to biological and psychological manifestations.
Signs of hydrocodone abuse may not be obvious initially, but they typically become more apparent over time. Opioid addiction can be effectively treated, but it is necessary to recognize the signs that a loved one is abusing it in the first place in order to get help. According to CBS News, signs of hydrocodone abuse include:
- Drowsiness or a lack of energy, which can lead to skipping activities with friends and preferring to stay in and use the drug instead
- An inability to concentrate due to a shortened attention span, which can result in missing work or school more frequently
- A lack of motivation
- Behavioral changes, including the desire to avoid most social situations or to engage more with friends who have similar destructive habits
- Changes in appearance, including pupils that stay constricted even in dim lighting; droopy eyelids; itchy arms, stomach, or legs; head nodding; a flushed face and neck; or slurred speech
- A strong desire for privacy or increased secrecy
Knowledge is power when it comes to helping a loved one fight a hydrocodone addiction, and it can be helpful to know the most popular brands of hydrocodone on the market. They include:
- Vicodin: Vicodin is a blend of hydrocodone and acetaminophen. Every tablet has 300 mg of acetaminophen with either 5, 7.5, or 10 mg of hydrocodone. Doctors generally prescribe Vicodin to patients following surgery, and they instruct those recovering to take one tablet every 4-6 hours.
- Norco: Norco is also a blend of hydrocodone and acetaminophen. Norco contains 325 mg of acetaminophen and either 7.5 or 10 mg of hydrocodone. Before the FDA required prescription painkiller manufacturers to decrease the amount of acetaminophen in their products, Norco had the lowest amount of acetaminophen of all the hydrocodone medications. Now, it has highest amount allowed by the FDA.
- Tussionex: Tussionex is a blend of hydrocodone and chlorpheniramine, which is an antihistamine. Doctors often prescribe Tussionex, an oral solution, to treat congestion and coughs.
- Zohydro: Zohydro is the first purely hydrocodone medication that the FDA has approved, and doctors only prescribe it for severe pain. It is available in pills with either 10, 15, 20, 30, 40, or 50 mg of hydrocodone. Because hydrocodone is so addictive, doctors who prescribe Zohydro monitor their patients closely for signs of dependence.
Treatment Starts with Addressing the Problem
Abusing hydrocodone can have serious repercussions, including physical, emotional, and social consequences; however, it’s never too late to seek help or to offer it to a loved one who is struggling with addiction. In fact, a strong support group can make the recovery process much easier, and confrontational approaches to the problem are rarely successful. The National Council on Alcoholism and Drug Dependence (NCADD) advises families who want to stage an intervention to consult a professional before doing so, especially if there is a chance that the loved one will react self-destructively or violently.
When family and friends rely on someone trained as an interventionist, NCADD reports that more than 90 percent of the people who are confronted make the commitment to get help. Staging an intervention and acknowledging there’s a problem is only the first step toward a better life, but it’s often the most difficult one.
After acknowledging that there is a problem and committing to fixing it, the next step is undergoing medical detox. Both the severity and duration of withdrawal symptoms will vary depending on the extent of the addiction, but symptoms usually start to arise within the first 48 hours without hydrocodone. According to the U.S. National Library of Medicine, early symptoms include muscle aches, sweating, and anxiety.
Withdrawal may not be enjoyable, but it is entirely manageable, especially with a rehab program’s dedicated team of doctors, nurses, and addiction experts by the client’s side. The body will start to adjust to life without hydrocodone between days 3 and 5, and withdrawal symptoms will peak during that time before they start to subside. By day 6, most physical symptoms are gone, and the individual can begin to tackle the psychological symptoms of dependence.
In some instances, medications may be used during hydrocodone detox that act as replacement medications. If medications like methadone or buprenorphine are used, it will prolong the overall detox process, but withdrawal symptoms and cravings are managed, allowing the individual to proceed to therapeutic care.
In addition, medications may be prescribed to address specific symptoms of withdrawal, such as anti-nausea medications to lessen nausea and vomiting, antidepressants to combat feelings of sadness and anxiety during detox, and sleep aids to help those struggling with insomnia. The use of medication is always determined on a case-by-case basis.
Medical detox ensures that clients are supported and supervised during the withdrawal process. This 24-hour assistance ensures that prompt medical attention is available should any complications arise. While relapse is a common outcome of at-home detox attempts, those in medical detox won’t have access to substances of abuse so relapse is not possible. They also receive the support and encouragement needed to make it through the withdrawal process.
Detox is only the beginning of the treatment process; it is not considered addiction treatment in and of itself. It should always be followed by comprehensive therapy that addresses the root causes that led to the substance abuse in the first place.
Once a client has finished going through withdrawal symptoms and received medical clearance, the next stage of recovery is residential treatment. A 2014 study published in JAMA Internal Medicine found that treatment for addiction to heroin, which is an opioid like hydrocodone, was most effective when it included both inpatient and outpatient therapy following medical detox.
Residential treatment is effective because it gives clients a safe, calm environment in which they can focus solely on recovery without the threat of triggers or distractions; however, just as each client’s situation is unique, so is each person’s path to recovery. Residential treatment might include individual and group therapy, family therapy, and Cognitive Behavioral Therapy.
NIDA outlines why various types of therapy are effective in opioid addiction treatment. Though no single treatment works for every client, therapy is the most commonly used form of treatment for hydrocodone addiction. Individual therapy often includes Cognitive Behavioral Therapy, which consists of the client challenging negative thought patterns in order to alter unwanted behaviors. Group therapy is also part of most residential treatments. In group therapy, clients can see that they are not alone in their journey to recovery.
Because a strong support system can be invaluable when it comes to recovery, family therapy is also an effective way to help clients make positive changes in their lives and family units.
Partial Hospitalization Program
Following a residential treatment, clients can enter a partial hospitalization program, during which they attend group therapy sessions daily, as well as one-on-one sessions weekly. A quality PHP program provides structured help at least five days per week for six hours per day and encourages access to external hydrocodone abuse support groups.
Outpatient Programs and the Road to Recovery
When a client has reached a positive, stable place in a partial hospitalization program, an outpatient program typically follows. Outpatients programs are often an effective way for clients to ease back into their daily lives with some semblance of structure, which they may not have had before seeking treatment.
Of course, none of this is possible without taking that first critical step. Seeking help may seem scary initially, but people quickly realize that addiction treatment facilities are some of the most supportive environments they are likely to find, and it may be just what they need to overcome their addiction safely.