Vicodin, a combination of hydrocodone and acetaminophen, is frequently prescribed to treat moderate to severe pain. Hydrocodone is the active ingredient in Vicodin and is classified as an opioid. It interacts with opioid receptors in the brain and spinal column to change the perception of pain signals. Acetaminophen also relieves pain and increases the effectiveness of hydrocodone.
Drugs in the opioid class may be derived naturally from the opium poppy plant or may be made synthetically in a lab. Hydrocodone is partially synthetic, as it is synthesized from codeine which occurs naturally in the poppy plant.
The opioid class also includes drugs like oxycodone, codeine, morphine, and fentanyl, which may be legally prescribed, as well as the illegal drug heroin. All opioids contain a risk for abuse, even when they’ve been prescribed. Misuse and illegal use of opioids puts users at a much higher risk for abuse, addiction, and overdose. When used as prescribed and for a short time, Vicodin is generally safe and effective.
According to the Diversion Control Division of the Drug Enforcement Administration (DEA), hydrocodone is both the most frequently prescribed opioid in the U.S. and the most frequently used and diverted. They have found most diversion is taking place “via bogus call-in prescriptions, altered prescriptions, theft, and illicit purchases from Internet sources.” The DEA also reports that hydrocodone is usually used orally and is often accompanied by alcohol.
How Does Vicodin Affect the Body?
The chemicals in Vicodin relax the body, reduce pain, and trigger a heightened sense of well-being and euphoria. As the hydrocodone activates receptors in both the pain and pleasure areas of the brain, its effects are twofold: blocking pain signals and releasing increased levels of dopamine. High levels of dopamine trigger intensely pleasurable feelings, which tend to encourage the user to want to re-experience those feelings. This increases the risk for abuse or addiction.
Even when used on a short-term basis, the National Institute on Drug Abuse (NIDA) warns hydrocodone can cause uncomfortable or dangerous effects, including:
- Slowed Breathing
Slowed breathing can be especially dangerous, as it can result in too little oxygen reaching the brain, a condition called hypoxia. This lack of oxygen can lead to coma, brain damage, or death. Brain damage may be permanent.
The other main component of Vicodin, acetaminophen, also poses serious health risks, especially when high, acute doses are taken. Acetaminophen is known to carry a high risk for liver toxicity. The U.S. Pharmacist cites a Poison Control Survey that found “acetaminophen toxicity is the most common cause of acute liver failure and the second most common cause of liver failure requiring transplantation” in the United States.
In 2014, the Food and Drug Administration notified all drug manufacturers to limit the amount of acetaminophen contained in their products to 325 mg. per dosage. They also require a boxed warning to highlight the potential for severe liver failure from acetaminophen use.
Older adults who use Vicodin are at particularly high risk for adverse effects or abuse. This may be because:
- They tend to have a slower metabolism, which may allow drug toxicity to build up in their bodies
- They are more likely to take multiple prescription medications which can cause an adverse interaction
- They are more likely to be prescribed multiple pain medications which can increase the danger of addiction
- Doctors may overlook the potential for addiction in older patients
MedlinePlus warns that serious side effects from Vicodin use are possible for users of any age. These can include agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea. If any of these side effects occur, speak to a doctor immediately.
In an effort to reduce the prevalence of opioid use disorder, overdose, and death, the Centers for Disease Control and Prevention (CDC) published new guidelines in 2016 for physicians prescribing opioids for chronic pain to patients of all ages. These guidelines provide recommendations for primary care physicians treating non-cancer-related pain lasting more than 3 months or pain lasting longer than the time of normal tissue healing. The goal of the new guidelines is to provide patients with safer, more effective pain treatment while reducing the risk of opioid abuse.
What Does it Mean to Misuse Vicodin?
Medical News Today defines misuse of a drug or alcohol as “the incorrect, excessive, or non-therapeutic use of body- and mind-altering substances.” They also note that misusing a substance doesn’t necessarily mean the person has an addiction.
Examples of misusing or illegally using a prescription drug like Vicodin include:
- Taking a medicine that has not been prescribed for you
- Not taking a prescribed medication in the dose or manner it was prescribed
- Taking someone else’s prescription medication
- Taking a medication for its euphoric effects
While prescription Vicodin is usually taken by mouth in pill or liquid form, those misusing or illegally using it may crush the pills, and either snort the powder, or dissolve it in water and inject the liquid into a vein. Snorting or injecting Vicodin increases health risks.
Combining Opioids with Alcohol or Other Drugs
Taking just one dose of an opioid medication along with even a small amount of alcohol “increases the risk of a potentially life-threatening side effect known as respiratory depression, which causes breathing to become extremely shallow or stop altogether.” This finding was reported in a study published in the Online First edition of Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA). Elderly people who combined opioids and alcohol were found to be at an especially high risk.
Because hydrocodone already depresses the central nervous system and slows breathing, combining it with other substances having similar effects can be fatal. Substances like alcohol, antihistamines, barbiturates, and benzodiazepines also work to depress the central nervous system, slowing breathing, causing drowsiness, and affecting the ability to function. When any of these substances are combined with hydrocodone, the intensified results can lead to serious respiratory depression and may cause death. The combination also increases the risk of a fall, motor vehicle or other accident.
Can Vicodin Use Cause Addiction?
Yes, similar to any prescription or illegal opioid, repeated use of Vicodin can lead to addiction, which is now medically known as substance use disorder (SUD). Continued use of Vicodin can lead to tolerance, which happens when the body adapts to a certain dosage, then needs increasingly higher doses to achieve the desired effect. Tolerance can happen relatively quickly and can lead to a SUD.
If a higher dose than prescribed is taken, or the drug is taken illegally, the drug can cause adverse physical and mental changes. The Mayo Clinic defines SUD as “a disease that affects a person’s brain and behavior and leads to an inability to control the use of a legal or illegal drug or medication… you may continue using the drug despite the harm it causes.”
Withdrawal from Vicodin
Once the body has adjusted to a certain level of an opioid and then drug use is stopped, withdrawal symptoms will likely result. Symptoms can range from mild to severe and can begin within a few hours of the last dose.
According to the NIDA, withdrawal symptoms may include:
- Muscle and bone pain
- Sleep problems
- Diarrhea and vomiting
- Cold flashes with goose bumps
- Uncontrollable leg movements
- Severe cravings
Can a Person Overdose on Vicodin?
Yes, accidental or intentional overdoses can occur with any prescription or illegal opioid. According to the CDC, about 130 Americans die every day from an opioid overdose. Taking too much Vicodin can cause breathing to slow or stop. If breathing is too slow, insufficient oxygen reaches the brain, which can result in coma, brain damage, or death.
Medline lists other potential signs of hydrocodone overdose as:
- Muscle weakness
- Cold, clammy skin
- Narrowed or widened pupils
- Slowed heartbeat
Any overdose is a medical emergency. If you suspect a friend or loved one is experiencing an overdose, call 911. Emergency medical personnel carry a medicine called naloxone, which can block the effects of opioid drugs if administered quickly. Many states also allow pharmacists to dispense naloxone, without a prescription, to the public. This allows families and friends to have the hand-held auto-injector (EVZIO®), or nasal spray (NARCAN® Nasal Spray) versions of naloxone on hand for use in case of overdose. To learn about the laws regarding naloxone in your state, see the Prescription Drug Abuse Policy System website.
Treatment for Vicodin Addiction & Abuse
If you or a loved one is struggling with addiction or wants to stop using Vicodin or another substance, we can help. Solution Based Treatment & Detox offers services enhanced with therapeutic elements designed to help individuals suffering from addiction become empowered and reach their highest potential. We offer an array of customized recovery and treatment programs, including; drug detox, residential treatment, and intensive outpatient treatment programs that can help you break the cycle of alcohol and drug abuse.
Contact us today to help get you or your loved one on the road to recovery. Our expert staff is available 24 hours a day, 7 days a week to answers your questions.
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