How Long Does Vicodin Withdrawal Last?

The opiate painkiller Vicodin, formulated from acetaminophen and the codeine derivative hydrocodone, has been prescribed for moderate to severe pain since the late 1970s. Its 2014 reclassification as a Schedule II drug highlighted increasing concerns about its addiction potential. (Vicodin had previously been categorized as a Schedule III drug, considered a lower addiction risk than most hydrocodone products.)

The safest way to avoid developing Vicodin addiction is, of course, to take the drug strictly according to prescription. It’s hard to predict how susceptible any one person will be, though, so anyone whose doctor recommends Vicodin should be aware of possible risks. Especially if there is any personal or family history of chemical addiction.

SYMPTOMS OF VICODIN ADDICTION

Anyone who has been taking a Vicodin prescription and develops the following symptoms may already be addicted:

• Frequent nausea or diarrhea
• Perspiring for no obvious reason
• Irregular breathing
• Changes in appetite
• Chronic drowsiness, or changes in sleep patterns
• Return of the pain symptoms Vicodin was originally prescribed for (a sign of increasing physical tolerance)
• Frequent mood swings or anxious feelings
• Difficulty concentrating
• Bouts of paranoia

In addition, any of the following behaviors (or even frequent temptations to engage in them) are signs of trouble:

• Performing poorly at work or in other daily duties
• Losing interest in old friends or favorite activities
• Becoming obsessed with keeping “enough” Vicodin on hand
• Seeking Vicodin through doctors or channels besides the original prescriber
• Overspending, or borrowing money, to pay for additional Vicodin
• Attempting to hide the extent of one’s Vicodin use from others
• Becoming defensive about one’s Vicodin use, and getting into arguments over whether the drug is causing problems
• Taking the drug primarily to induce euphoria rather than relieve pain
• Crushing and injecting tablets to get a faster effect
• Showing symptoms of even a minor overdose: blue-tinged lips or fingernails, pinpoint pupils, obvious difficulty breathing, muscle spasms, intense fatigue (anyone who may be experiencing an overdose should take naloxone—trade name Narcan—and get medical attention immediately)

If you notice these symptoms in yourself or anyone else, talk to (or suggest the other party talk to) the prescribing doctor immediately. If the symptoms are frequent or increasing, consult a detox specialist as well.

PREPARING FOR VICODIN WITHDRAWAL

Once Vicodin addiction is diagnosed, the next step is to check into a detox center for treatment. Attempting to go it alone is never advisable: while opiate withdrawal is rarely life-threatening in itself, it can trigger dangerous behavior, including suicide attempts.

To ensure good care and minimize any possible problems in detox treatment:

• Choose a treatment facility that has been in the same location (preferably one convenient to your home area) for several years. Verify it has a solid reputation, and keeps licensed MDs either on staff or on immediate call. (Your regular doctor or health insurance company may be able to recommend a treatment center.)
• Determine in advance what your health insurance will cover.
• Check the center’s typical client profile, philosophy of treatment and anything else that may affect whether it and you are a good fit.
• Schedule an advance interview and tour of the facilities. Don’t be afraid to ask questions about post-detox daily schedules (if planning on a long-term stay), what the center will do in case of individual or large-scale emergency, and any special concerns such as dietary provisions.
• Make plans to stay in touch with supportive family and friends on the outside.
• If your addiction has been a problem for more than a few months, consider scheduling an advance physical to determine if your overall health has been damaged. (The liver is a particularly vulnerable organ where high doses of acetaminophen-containing drugs are involved.) Or, confirm with the detox clinic that they do include an in-depth physical assessment as part of routine treatment.
• At your admissions interview, be completely honest about the length, extent and nature of your Vicodin use. Be prepared also for questions on any other drugs you have taken, (including alcohol and non-addictive medications), and any chemical addictions in your family.

THE VICODIN WITHDRAWAL EXPERIENCE

Although a professional detox center will do everything possible to keep you comfortable, there’s no way to make withdrawal completely painless, even in medication-assisted treatment. Ask the average patient just completing detox if they know how long it took, and the answer will likely be, “It felt like forever!”

Objectively speaking, how long Vicodin withdrawal lasts can be affected by a person’s overall physical condition, the length of time they had the addiction, and how much Vicodin they were taking regularly. Psychology and state of mind can be additional factors. (People who expect a miserable experience will probably get one: those who focus on “it’ll be over soon” often recover faster.)

The most typical timeline, though, goes like this:

• Six to 12 hours after last dose of Vicodin: restless and nervous feelings develop, muscle aches begin, perspiration and watery eyes/runny nose may become evident.
• 12–48 hours: increasingly strong flulike symptoms, nausea, difficulty relaxing or sleeping, possible feelings of panic.
• Two to three days: flulike symptoms and mood swings at their worst, dizzy spells, vomiting and diarrhea to the point of possible dehydration (intravenous fluids may be administered), elevated pulse rate, noticeable rise in blood pressure, risk of violent behavior
• Fourth or fifth day: detectable decrease in physical symptoms, which continue to lessen for the next few days
• End of first week: most of physical symptoms have abated, person is physically weak and emotionally numb
• Second or third week and beyond: person slowly regains physical strength, psychological opiate cravings may resurface periodically for two or three months

If less fortunate, a recovering Vicodin addict may develop post-acute withdrawal syndrome (PAWS), or protracted withdrawal. A person with PAWS will experience intense psychological cravings, and often physical symptoms, on a frequent basis for six months or more. Someone with this problem will need extra counseling and support to avoid relapse.

LONG-TERM RECOVERY FROM VICODIN ADDICTION

Even those who escape full-blown PAWS typically have an uphill battle learning to live long-term without Vicodin. You’re at extra risk for relapse if:

• Your addiction lasted long enough that you came to see Vicodin as an all-purpose solution to life’s stresses
• You still have the physical pains that Vicodin was originally prescribed to relieve
• There’s any other drug addiction in your family, especially if anyone you’ve been in regular contact with is still actively using (in which case you may need to be extra diligent about limiting future contact and cultivating a support network elsewhere)
• You encounter a situation, or an anniversary, that reminds you of a former setting where you always took Vicodin
• You fail to get long-term therapy and find an active support network
• You ever take Vicodin, or any other opiate drug, again for any reason

So have an active relapse prevention plan before you ever leave the detox center. And don’t get overconfident even if you don’t see yourself in any of the above points. “It won’t happen to me” thinking is at least as dangerous after being addicted as before.

Some hints for enjoying life long-term without opiates:

• Learn nondrug means of pain management, such as yoga relaxation exercises and maintaining overall good health.
• To further reduce pain risks, maintain a healthy weight and avoid participating in intense physical activity (or even sitting in one spot) for long periods without a break.
• Practice daily affirmations: “I am strong. I can handle whatever comes my way. I have a bright future. I am worthy of love and success.”
• At least once a week, participate in a hobby or activity you really love.
• Set far-reaching life goals, and regularly envision yourself working toward and achieving them.
• Maintain active relationships with friends and family, sharing regular personal attention. Know whom (besides yourself) you’re living for and who deserves your time and attention.
• Do things for others. Consider volunteering for a cause you support.
• Participate in religious activities, and consider what a Higher Power (or Higher Purpose) means to you.

CLOSING THOUGHTS

Ultimately, a more important question than “How long does Vicodin withdrawal last?” is “What do I want from life after Vicodin?” Just getting the physical system clean of opiates isn’t “cure” enough: if a person has no greater purpose in life than minimizing pain, there’s no real reason not to return to addiction as soon as life gets tough.

Some 27 million people worldwide suffer from addiction to opiates, including Vicodin. Fewer than one in ten get effective treatment. As many as 118,000 people a year die from the effects of opiate addiction. Many of these started with a legitimate prescription, or with otherwise seeking a solution to a legitimate problem.

Just as with finding lasting solutions to any problem, recovery from Vicodin addiction doesn’t come from a “quick fix” and quick return to business as usual. It comes from knowing one’s own values and purpose. It comes from being willing to work hard for what matters. It comes from tackling problems proactively.

And, frequently, it comes from setting aside easy, pop-a-pill “solutions” and making major life changes.

SOURCES:

1. American Society of Addiction Medicine (2016). “Opioid Addiction Treatment: A Guide for Patients, Families and Friends.” Retrieved from http://eguideline.guidelinecentral.com/i/706017-asam-opioid-patient-piece/0?
2. Kroll, David (2014, August 22). “New Rules for Hydrocodone: What You Should Know.” Forbes.com. Retrieved from https://www.forbes.com/sites/davidkroll/2014/08/22/what-you-need-to-know-about-new-restrictions-on-hydrocodone-combinations/#428f305055c2
3. National Institute on Drug Abuse (2018, April). “Opioid Overdose Reversal With Naloxone (Narcan, Evzio).” Retrieved from https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio
4. U.S. Department of Health and Human Services, Food and Drug Administration (2011, January 13). “FDA Drug Safety Communication: Prescription Acetaminophen Products to Be Limited to 325 mg Per Dosage Unit; Boxed Warning Will Highlight Potential for Severe Liver Failure.” Retrieved from https://www.fda.gov/drugs/drugsafety/ucm239821.htm
5. World Health Organization (2018, August). “Management of Substance Abuse: Information Sheet on Opioid Overdose.” Retrieved from https://www.who.int/substance_abuse/information-sheet/en/

For related information on detoxing from Vicodin and other opiates, and for general information on opiate addiction, see the following articles:

Addiction to Oxycodone, Hydrocodone and Other Opiates: Warning Signs, Effects and Stats

Do I Need Hydrocodone Rehab?

Prescription Opiate Detox: What to Expect From Withdrawal and Recovery

Vicodin Withdrawal Timeline: Common Symptoms to Expect