Hydrocodone is a prescription opiate used for long-term pain management with potency identical to medical grade morphine. This drug is also used as an effective cough suppressant arguably less harmful than codeine. Hydrocodone is the most prescribed opioid pain reliever in the United States.
Hydrocodone is semi-synthetic; the drug is derived from the opium poppy but is chemically altered in a laboratory setting. Hydrocodone is frequently prescribed in tandem with other opiates such as acetaminophen for enhanced pain relief.
Hydrocodone Drug Type
Hydrocodone falls under the opioid family of drugs. Opioids can be natural or synthetic and are also the base of many prescription drugs used for post-surgical recovery and pain management. Opioids like hydrocodone are extremely habit-forming, causing addiction in just a matter of days in some cases.
Hydrocodone DEA Drug Class
As a Schedule II substance, Hydrocodone:
- acceptable for medical use in the U.S. (with restrictions)
- has a high potential for abuse
- may lead to severe psychological or physical dependence
The DEA imposes restrictions on hydrocodone production and distribution. Illicit trafficking of Schedule II substances leads to increased fines and jail time.
Forms and Routes of Administration
Hydrocodone in all its available in pure form, but is more commonly prescribed in combination with other drugs like acetaminophen, ibuprofen, and aspirin. Hydrocodone can be administered via tablet or liquid. Non-oral forms of hydrocodone are rarely prescribed by medical professionals. Oral administration remains the predominant route of abuse; however, a small percentage of immediate-release hydrocodone abusers either snorted, smoked or injected the drug.
Historical Timeline for Hydrocodone
Hydrocodone was first synthesized by Knoll Pharmaceuticals in Germany in 1920. Scientists were looking to alter the molecular structure of codeine to create a less harmful version of the drug. In 1929, a safety assessment of over 300 prescription drugs ranked hydrocodone as one of the most effective painkillers with euphoric side effects consistent with more harmful opioids. When compared to morphine, less hydrocodone was needed to produce the same side effects.
By 1955, liquid Tylenol (Acetaminophen) containing hydrocodone was introduced in the U.S as a children’s medicine. Fifteen years later, pure hydrocodone was listed as a Schedule II substance by the DEA. Use of the drug continued to proliferate throughout the country, leading to the development of Vicodin (acetaminophen combined with hydrocodone) in 1978.
At the turn of the millennium, emergency room visits caused by hydrocodone increased by 500% over a decade. Liver damage was cited as the main consequence of hydrocodone use, particularly when used with acetaminophen. Despite this statistic, a total of 130 million prescriptions were written for hydrocodone-containing drugs. In 2004, hydrocodone and oxycodone were implicated in 14,800 overdose deaths.
In 2008, an extended-release Vicodin failed to obtain FDA approval leading to the loss of 200 jobs. A year later, a ban on Vicodin and Percocet-based medications was proposed; however, more than 42 tons of pure hydrocodone were dispersed across the United States in the following year.
Hydrocodone is only one of the hundreds of prescription opiates responsible for the sweeping opioid epidemic in the country. Due to the high likelihood of abuse and existing danger, hydrocodone was rescheduled as a Schedule II substance by the DEA in 2014.
Brand Names for Hydrocodone
- Zohydro ER
Street Names Hydrocodone
Hydrocodone, Pregnancy & Breastfeeding
Few studies have evaluated the effects of hydrocodone while pregnant, but it is never advisable to use any drugs, including hydrocodone while breastfeeding since metabolites will appear in breast milk and harm young infants.
Hydrocodone Effects and Addiction Potential
While hydrocodone is admittedly effective, it exudes a high potential for abuse like any other opioid. Desireable side effects which can lead to addiction include:
- Increased confidence
- Reduced stress
Tolerance to hydrocodone is difficult to assess because long-term users become well-acquainted to the positive side effects at such minute doses of the drug. Hydrocodone abuse is not specific to any particular age group, ethnic or educational background. Approximately 24.4 million people over 12 years old have admitted to recreational hydrocodone use. This drug is especially dangerous because of the ease of access via medicine cabinets at home. Other common ways hydrocodone is obtained:
- Doctor shopping/pill milling
- Illicit trafficking from people with prescriptions
- Forging prescriptions
- Circulation through the healthcare system (i.e. from doctors themselves)
- Raiding medicine cabinets
Hydrocodone Short-Term Side Effects
Mild to moderate side effects usually appear within one hour of administration. If serious side effects occur as a result of hydrocodone’s depressant properties, contact 911 or your local Poison Control center.
|Constipation||Irregular or slowed heartbeat|
|Fatigue||Severe allergic reaction (hives, rash, itching, swelling)|
|Diffuse (widespread) muscle weakness|
Hydrocodone Long-term Side Effects
Long-term hydrocodone use can inevitably lead to irreversible physical, mental, and social consequences:
- Liver damage
- Acetaminophen toxicity
- Sensorineural hearing loss
- Relationship problems
- Negative work performance
- Development of mental health disorders
Signs of Hydrocodone Dependence
Hydrocodone dependence indicates the user cannot function, or lacks the motivation to engage in activities, without administering the drug on a consistent basis. Signs of hydrocodone dependency include:
- Exceeding the prescribed dosage amount and frequency
- Using hydrocodone beyond the prescribed timeframe
- Taking hydrocodone in tandem with alcohol or other CNS depressants
- Falsifying prescriptions and doctor shopping
Symptoms of Hydrocodone Withdrawal
Hydrocodone withdrawal symptoms vary in degree depending on factors such as a patient’s existing physical conditions, duration of hydrocodone use, concentration or dosage, etc.
- Body aches
- Constant shivering
- Difficulty sleeping
- Intense sweating
- Irregular heartbeat
Hydrocodone Addiction Treatment
Long-term hydrocodone use can result in severe withdrawal symptoms particularly in the detoxification phase of rehabilitation. For this reason, if you or a loved one is seeking therapy for an opioid abuse problem, it is not recommended to use detox products outside of medical supervision. Seek professional help through an inpatient treatment center where a qualified counselor can handle hydrocodone withdrawal.
Medication-assisted therapy programs sometimes employ opioids to wean patients from more lethal addictions; MAT must be strictly monitored by addiction treatment professionals, where periodic clinical drug testing is used to measure compliance and effectiveness of therapy.
Testing for Hydrocodone
The initial effects of hydrocodone use peaks around 30-60 minutes after administration and lasts 4-8 hours. Hydrocodone-dependent users usually experience withdrawal symptom as soon as 6-12 hours after their last dose, factoring in personal metabolic rate.
Testing for hydrocodone may be done for a number of reasons:
- Workplace drug testing – Many companies implement a drug testing policy, some of which may consequence the use of hydrocodone.
- Insurance purposes – Many life insurance policies demand urine testing for a comprehensive overview of a person’s health. Premiums vary based on the health of the insurance applicant.
- Addiction treatment – Clinical drug testing is used in most drug treatment centers to monitor patients for adherence to their rehab program.
It is possible to detect hydrocodone use via saliva, hair, and urine drug testing, all of which provide an affordable and accurate method of detecting hydrocodone use within any setting.
Hydrocodone Cut-off Level and Detection Time in Urine
|Specimen||Concentration Cut-off Level||Detection Time|
|Urine||10 ng/ml||Up to 3 days|