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January 19, 2019

How Long Does It Take to Get Addicted to Hydrocodone?

First approved by the Food and Drug Administration in 1943, hydrocodone was sold as a short-acting opiate for several decades before the long-acting form became more popular. It is frequently prescribed (usually in pills that also contain acetaminophen) to relieve ongoing severe pain that has failed to respond to less potent medications. Sometimes, hydrocodone is recommended for milder pain or (since it’s synthesized from the classic cough suppressant codeine) chronic cough.

Hydrocodone is also a frequent cause of prescription-opiate addiction and is recognized by the Drug Enforcement Administration (DEA) as having high abuse potential. In 2014, it was the most commonly prescribed opiate in the U.S. Prescription rates have fallen off in subsequent years, partly because of reclassification from a Schedule III drug to the more dangerous Schedule II: 120 million prescriptions were written in 2014, only 93.5 million in 2015, and in late 2016 the DEA announced a 2017 quota of 58.4 million. Nonetheless, hydrocodone is still the country’s most frequently misused opiate.

(It should be noted that fewer prescriptions doesn’t always mean less of the drug being taken. Recent studies indicate that the average number of tablets per prescription has increased.)

Why Do People Become Addicted to Hydrocodone?

Although its medical purpose is to allow people with debilitating pain to function normally in everyday life, hydrocodone also has high potential for inducing euphoria. Many people who start with legitimate painkilling prescriptions are tempted to take extra by the lure of feeling really good. As with most drugs, there are also people who take hydrocodone recreationally, for the sole purpose of getting “high.”

Most people who become addicted, though, simply fall into the trap of relying on a pill to make all their pain go away permanently. If they feel better after the first few doses, they may assume all their pain problems are solved as long as they keep taking the medication. Then, if they start to develop hydrocodone tolerance (the pain no longer disappears after the old dose), their reaction is to add another pill or two to see if that helps. It usually does, so since the problem seems solved once again, they keep on taking extra pills without checking with their doctors. Before long, when they can no longer obtain additional hydrocodone legally, they turn in desperation to illegal sources. And they’re on the slippery slope to a life that revolves around the drug.

It’s also possible to become addicted by pure accident: someone follows all the rules, but proves to be more susceptible to addiction than the prescribing doctor anticipated. (Anyone whose doctor recommends hydrocodone should remember that doctors also have to rely on their own best judgment. Usually that judgment is accurate, but not always: don’t trust any prescription so blindly as to brush off the possibility that it’s hurting you.)

How Long Does It Take to Get Addicted to Hydrocodone?

 How long addiction takes to develop varies from person to person. Under official Schedule II rules, hydrocodone prescriptions are carefully monitored and limited to a 90-day supply—presumably the maximum period that’s considered safe for the average person to stay on the drug without undue risk—though some people take it for years without any problems. On the other hand, even two weeks can be risky if someone has had a previous drug addiction or is genetically vulnerable to addiction.

Other factors that may cause addiction to develop more rapidly include:

  • Taking more of the drug than is prescribed
  • Taking it for the euphoric effect, not just to kill pain
  • Depending on the drug as a quick-fix panacea, and never seriously considering additional or alternate ways of managing pain

If your doctor recommends hydrocodone for pain relief, be sure to mention any past or present addiction issues in your family. Also ask about nondrug pain management techniques and lifestyle changes you can implement in addition to taking the hydrocodone. (Since new hydrocodone restrictions have limited how much can be prescribed—limited it drastically, in some opinions—not becoming too reliant on a prescription is a good idea in any case. Even if hydrocodone works perfectly for you and you never have any addiction symptoms, there’s always the chance that larger-scale addiction concerns may affect everyone’s ability to obtain a drug.)

And for those who do accept a hydrocodone prescription (or a prescription for any potentially addictive drug), the best way to avoid becoming addicted is to judiciously follow two rules:

  1. Take it only according to the official instructions.
  2. Ask the prescribing doctor for advice if the regular dose no longer seems to be doing its job, if you see any symptoms of physical illness after missing (or taking) a dose, or if you find yourself craving extra doses for any reason.

Also, if it seems likely you’ll be returning for a second prescription, plan on scheduling time for a detailed discussion of how well the first prescription worked and how you might test whether you still need hydrocodone (or as much of it). Be careful to avoid the trap of continuing to take it just because you always have.

What Are the Symptoms of Hydrocodone Addiction?

It’s vital to immediately report any unusual symptoms to your doctor, even if you’ve never gone outside official prescription instructions. As noted above, some people do become addicted despite staying within the limits. (It’s also possible that you are allergic, or otherwise vulnerable to side effects such as jaundice or loss of appetite.)

Besides increasing tolerance (getting less effect from the regular dose), the most common sign of an addiction developing is that a missed dose triggers withdrawal symptoms:

  • Nausea, stomach cramps, diarrhea, vomiting
  • Heavy perspiration, sometimes alternating with chills
  • Aching muscles
  • Rising body temperature
  • Feelings of anxiety and agitation
  • Insomnia
  • Dilated pupils

The sooner an addiction is recognized and treated, the better. Even short-term addictions place users at risk of life-threatening overdose. And if someone continues to take the drug indiscriminately to relieve discomfort or induce euphoria, dependence will grow until all of life revolves around hydrocodone. A person who stays addicted for several months or years will develop increasingly serious physical and behavioral symptoms:

  • Chronic drowsiness
  • Breathing difficulties
  • Mood swings
  • Defensiveness when someone else hints that hydrocodone use is becoming a problem
  • Attempts to hide from one’s family, and even one’s doctor, how much hydrocodone is being taken
  • Paranoia or psychosis
  • Loss of interest in old friends and activities
  • Missing work or neglecting other duties
  • Obtaining more hydrocodone through forged prescriptions or black-market channels, or turning to other opiates such as heroin
  • Spending most of one’s money on drugs

If use continues long enough, the drug may do permanent damage to the kidneys or (especially if extra acetaminophen is taken with the hydrocodone) liver.

How Long Does It Take to Recover from Hydrocodone Addiction?

Once hydrocodone addiction has taken hold, the only way to prevent worse damage is to detox from hydrocodone and stop taking it for good. As with the question of how long it takes to become addicted, the answer to how long it takes to detox varies from person to person. Factors affecting recovery may include:

  • Overall physical condition
  • Mental health
  • Length of time a person has been addicted
  • How much hydrocodone a person regularly took per dose

Typically, when hydrocodone is stopped cold, withdrawal symptoms (as described above) begin a few hours after the last dose, gradually intensifying for three or four days. When symptoms reach their peak, the person will feel extremely ill, as if with a bad case of the flu. By the fifth day, symptoms will start to lessen, but it may take as long as two weeks before the patient regains normal strength.

During or shortly after detox, a person may receive a temporary prescription for Suboxone or another MAT (medication-assisted treatment) drug to keep opiate cravings from returning during readjustment to everyday life. MAT should always be used with a plan for discontinuing the substitute drug within a set time frame, to keep a new long-term dependence from developing. With or without assisting medication, hydrocodone detox should never be attempted without professional supervision: although opiate withdrawal is rarely life-threatening, it is never risk-free.

In one sense, real recovery from any chemical addiction is rare: the brain never quite forgets how to reactivate cravings if it tastes the drug again. Risk of relapse is particularly high during the first year, but the danger can be reduced by:

  • Getting long-term therapy.
  • Becoming involved in a sobriety support group.
  • Practicing drug-free pain management techniques: yoga, meditation, relaxation exercises, biofeedback, massage.
  • Taking steps to reduce overall life stress. (In some cases, this may mean changing jobs or ending a toxic relationship.)
  • Maintaining good physical health through diet, exercise and sleep.
  • Developing hobbies and interests, or doing volunteer work, to stay busy in mind and body.
  • Staying optimistic and concentrating on the present moment. Recovery is a lifelong journey, but life is manageable one day at a time!

SOURCES

 Anson, Pat (2016, October 4). “DEA Cutting Opioid Supply in 2017.” PainNewsNetwork.org. Retrieved from https://www.painnewsnetwork.org/stories/2016/10/4/dea-cutting-opioid-supply-in-2017

Anson, Pat (2017, May 5). “Hydrocodone Prescriptions Continue Falling.” PainNewsNetwork.org. Retrieved from https://www.painnewsnetwork.org/stories/2017/5/5/hydrocodone-prescriptions-continue-falling

Burke, John (2017, January 16). “Hydrocodone Prescribing and Quotas.” Pharmacy Times, January 2018. Retrieved from https://www.pharmacytimes.com/publications/issue/2017/january2017/hydrocodone-prescribing-and-quotas

Department of Justice, Drug Enforcement Administration (2016, October 4). “DEA Reduces Amount of Opioid Controlled Substances to Be Manufactured in 2017.” Retrieved from https://www.dea.gov/press-releases/2016/10/04/dea-reduces-amount-opioid-controlled-substances-be-manufactured-2017

Department of Justice, Drug Enforcement Administration (2016, October 5). “Established Aggregate Production Quotas for Schedule I and II Controlled Substances and Assessment of Annual Needs for the List I Chemicals Ephedrine, Pseudoephedrine, and Phenylpropanolamine for 2017.” Federal Register. Retrieved from https://www.federalregister.gov/documents/2016/10/05/2016-23988/established-aggregate-production-quotas-for-schedule-i-and-ii-controlled-substances-and-assessment

Freyer, Felice J. (2015, April 18). “Researchers Use Black-Market Drug Website to Gauge Public Health.” Boston Globe. Retrieved from https://www.bostonglobe.com/metro/2015/04/17/crowd-sourcing-website-reveals-black-market-drug-prices-but-its-purpose-public-health/cSMUlc9JrURxckanwygfFN/story.html

Godman, Heidi (2016, December 12). “Understanding Hydrocodone Addiction.” Healthline.com. Retrieved from https://www.healthline.com/health/understanding-hydrocodone-addiction

Holland, Kimberly (2017, December 6). “Oxycodone vs. Hydrocodone for Pain Relief.” Healthline.com. Retrieved from https://www.healthline.com/health/pain-relief/oxycodone-vs-hydrocodone

Krashin, Daniel, Natalia Murinova, and Andrea M. Trescot (2013, January 10). “Extended-Release Hydrocodone: Gift or Curse?” Journal of Pain Research, No. 6, pp. 53–57. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555555/

Lava, Neil, medical reviewer (2018, June 14). “11 Tips for Living With Chronic Pain.” WebMD.com. Retrieved from https://www.webmd.com/pain-management/guide/11-tips-for-living-with-chronic-pain#1

Mundell, E.J. (2018, August 23). “U.S. Opioid Prescribing Limits May Have Backfired.” WebMD.com. Retrieved from https://www.webmd.com/mental-health/addiction/news/20180823/us-opioid-prescribing-limits-may-have-backfired#1

 For related information on hydrocodone and prescription-opiate addiction, see the following articles:

  1. Addiction to Oxycodone, Hydrocodone and Other Opiates: Warning Signs, Effects and Stats
  2.  Do I Need Hydrocodone Rehab?
  3. Hydrocodone Detox Guide—Withdrawal Symptoms and Timeline
  4. Prescription Opiate Detox: What to Expect From Withdrawal and Recovery
  5. What You Need to Know About Painkiller Addiction
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