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October 24, 2018

Do I Need Hydrocodone Rehab?

woman looking out a window through blindsHydrocodone (trade names include Vicodin, Lortab and Vicoprofin) belongs to the class of long-acting opiate painkillers. Like other opiates, it is responsible for many addiction disorders. This article offers tips for minimizing addiction risks and for deciding whether use has reached the point of needing hydrocodone rehab.

WHAT IS HYDROCODONE?

Hydrocodone is a long-acting opiate painkiller, synthesized from codeine and sold in extended-release pills. Although it can be prescribed for chronic cough and for various types of pain, its most frequent use is for long-term relief of constant severe pain that has failed to respond to other forms of treatment.

Like all opiates, hydrocodone carries significant risk of triggering an addiction disorder. In 2014, hydrocodone was America’s most frequently prescribed opiate and the second most likely pharmaceutical opiate to play a role in drug crimes. That was the year the drug’s DEA status changed from Schedule III (accepted medical value and moderate-to-low potential for abuse/addiction) to Schedule II (accepted medical value and high potential for abuse/addiction). Hydrocodone is banned completely in many countries.

Anyone who receives a hydrocodone prescription can minimize addiction risks by:

  • Taking the drug strictly according to prescription.
  • Abstaining from other drugs (including alcohol) for the duration of the prescription, unless cleared with the prescribing doctor.
  • Being doubly cautious about accepting a prescription that contains acetaminophen. (While this doesn’t seem to increase the risk of addiction, there’s evidence it can lead to ingesting enough acetaminophen to damage the liver.)
  • Immediately talking with a doctor if one notices symptoms of dependence, withdrawal or even increased tolerance.
  • If the drug doesn’t seem to be doing its job, consulting the prescribing doctor rather than making an independent decision to take extra doses.

OVERDOSE DANGERS

The risks of going outside official prescription instructions can’t be overemphasized. Over 100 people a day die from opiate overdose in the United States, accounting for more than half of drug overdose deaths. Act promptly if you or anyone else take hydrocodone and then develop any of the following symptoms:

  • Blue or clammy skin
  • Difficulty breathing
  • Slowed heart rate
  • Extreme drowsiness
  • Severe nausea or vomiting
  • Pinpoint pupils

Don’t waste time debating whether it looks particularly bad or whether someone has actually taken too much hydrocodone: call for emergency medical help immediately. Keep the person sitting up and conscious if possible. Administer emergency naloxone if you have it handy.

Not all overdose victims have actual addiction disorder: some simply took more pills than prescribed, often in misguided attempts to numb pain that didn’t seem to respond to the recommended dose. However, if you have a hydrocodone prescription and feel it’s less effective than it used to be, you may already be developing an addiction: one common sign is increased tolerance for the drug. Don’t try to ignore the problem or solve it on your own: get medical advice immediately.

SIGNS OF HYDROCODONE ADDICTION

Other common signs of addiction include:

  • Reluctance to confide in the prescribing doctor about side effects (frequent dizziness or lightheadedness, headaches, insomnia, difficulty breathing)
  • Obtaining additional prescriptions from additional doctors
  • Spending more money on hydrocodone than fits insurance provisions or overall budget
  • Letting drug effects or consumption habits interfere with regular life activities
  • Mood swings
  • Constant drowsiness or poor concentration
  • Constipation or difficulty urinating
  • Tiny pupils or bloodshot eyes

If you have several of these symptoms on a regular basis, your answer to “Do I need hydrocodone rehab?” is probably “Yes.”

Withdrawal from opiates is rarely fatal, and often manageable without medication. Nonetheless, it’s important to go to a professional detox center as the first step in recovery. Qualified treatment centers provide important services beyond the abilities of any home-detox approach:

  • Quick access to licensed medical care (including prescriptions for medication-assisted treatment, if any)
  • Supervision to guard against suicidal or violent behavior
  • Facilities professionally maintained for maximum comfort and safety
  • Adequate hydration/nutrition (dehydration is the most common dangerous side effect of opiate withdrawal)
  • Aftercare counseling and referrals to long-term resources

WHAT TO EXPECT FROM HYDROCODONE REHAB

All chemical addictions, if diagnosed by a doctor, are considered mental/behavioral illnesses: therefore, treatment is covered by most health insurance plans. Check with your insurance provider to verify what opiate detox centers are in their network and what specifically your plan will pay for. Verify (with the Better Business Bureau, a local medical network, local news sources and/or a personal visit) that the center you choose is reputable and well established. If you have special treatment preferences (a specific religious philosophy, a vegan menu, a program for professionals or women only), ask about those as well.

Detox typically takes about a week. Possible withdrawal symptoms include:

  • Restlessness, irritability or anxiety
  • Watery eyes and nose
  • Dilated pupils
  • Chills or heavy perspiration
  • Aching muscles
  • Loss of appetite
  • Stomach cramps, nausea, diarrhea or vomiting
  • Insomnia
  • Fast breathing or pulse

In most cases, the experience is extremely unpleasant but not really dangerous. If you start to get panicky or have difficulty breathing, however, don’t hesitate to request help. Staff will be on hand to make sure your needs are cared for throughout the detox.

Full rehab, including post-detox counseling and relapse-prevention coaching, frequently requires around 90 days of inpatient care, although many people opt for intensive outpatient rehab (or 30 to 60 days of inpatient care followed by outpatient rehab).

Since hydrocodone is normally prescribed for intense chronic pain, learning alternate pain management techniques will be a vital part of your rehab. Having developed an addiction disorder means you will have little chance of being able to take hydrocodone—or any other opiate painkiller—normally again.

Some effective non-drug means of pain relief are:

  • Yoga
  • Deep breathing
  • Relaxing visualization
  • Acupuncture or acupressure
  • Limiting consumption of sweets and caffeine, and eating more fruit, fish and legumes
  • Cognitive behavioral therapy to learn additional techniques

If you do need hydrocodone rehab, don’t despair. Help is available, and it is possible to live a life free of pain and addiction!

For related information on hydrocodone and other opiate prescription drugs, see the following articles:

SOURCES

Bowers, Elizabeth Shimer. “Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach.” WebMD.com. Retrieved from https://www.webmd.com/pain-management/features/cognitive-behavioral#1

Centers for Disease Control and Prevention (2017, August 30). “Opioid Overdose: Understanding the Epidemic.” Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html

Chen, Michelle (2018, September 25). “The Opioid Crisis Is Part of a Decades-Long Overdose Epidemic. Fixing It Requires Rethinking Everything.” NBCNews.com. Retrieved from https://www.nbcnews.com/think/opinion/opioid-crisis-part-decades-long-overdose-epidemic-fixing-it-requires-ncna912706

Drug Enforcement Administration, Diversion Control Division (2014, August 22). “Final Rule: Rescheduling of Hydrocodone Combination Products From Schedule III to Schedule II.” U.S. Department of Justice. Retrieved from https://www.deadiversion.usdoj.gov/fed_regs/rules/2014/fr0822.htm

Drug Enforcement Administration, Office of Diversion Control, Drug & Chemical Evaluation Section (2014, October). “Hydrocodone.” U.S. Department of Justice. Retrieved from https://www.deadiversion.usdoj.gov/drug_chem_info/hydrocodone.pdf

Health Resources & Services Administration (2018, September). “Opioid Crisis.” Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html

National Institute on Drug Abuse (2018, March). “Opioid Overdose Crisis.” Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis

National Institutes of Health (2018, March 15). “Hydrocodone.” U.S. National Library of Medicine. Retrieved from https://medlineplus.gov/druginfo/meds/a614045.html

National Institutes of Health (2018, July 5). “Drug Record: Hydrocodone.” Retrieved from https://livertox.nih.gov/Hydrocodone.htm

Patterson, Eric. “Hydrocodone History and Statistics.” American Addiction Centers. Retrieved from https://drugabuse.com/library/hydrocodone-history-and-statistics/

Spera, Rebecca (2014, November 12). “Drug-Free Ways to Fight Pain.” ABC13.com. Retrieved from https://abc13.com/health/drug-free-ways-to-fight-pain/390339/

U.S. Department of Health and Human Services (2018, September 19). “What Is the U.S. Opioid Epidemic?” Retrieved from https://www.hhs.gov/opioids/about-the-epidemic/index.html

WebMD.com (2018, April 22). “Treating a Drug Overdose With Naloxone.” Retrieved from https://www.webmd.com/mental-health/addiction/drug-overdose-naloxone#1

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