Hydrocodone Withdrawal

Posted by Jackson Bentley on Aug 16, 2018 8:00:00 AM
Jackson Bentley
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Hydrocodone is an opioid agonist that is the primary ingredient in many common prescription pain killing medications, the most common being Vicodin. Hydrocodone, similar to Oxycodone, impacts the central nervous system by binding to opioid receptors and flooding the body with pain killing pleasure feelings of euphoria. It is typically taken in the oral form either as a liquid or pill and is primarily prescribed in the U.S., which is where 99% of the world’s supply was consumed in 2007. Some of the most common brand names that Hydrocodone is sold under are:


  • Vicodin
  • Norco
  • Lortab
  • Lorcet
  • Maxidone
  • Zydone
  • Vicoprofen
  • Ibudone
  • Reprexain
  • Zohydro


Because of its high potential for addiction, hydrocodone products are tightly regulated by the Drug Enforcement Administration and Food and Drug Administration as a Schedule II drug. Prescription opioids such as hydrocodone are usually prescribed for the management of chronic pain. Like any opiate medication, Hydrocodone affects dopamine levels in the brain and can lead to a growing tolerance. Abusers of Hydrocodone will gradually need to take more and more hydrocodone to reach the same effects as the ones they initially got.


Hydrocodone Withdrawal

An individual sleeping on the couch trying to overcome withdrawal symptoms from hydrocodone.

The amount of time a withdrawal will take is dependent on the dosage and length of time a person has been abusing hydrocodone. Typically, these drugs are taken orally and have effects that last 4-6 hours, but there are also extended release forms that can last up to 12 hours. The longer this drug is taken, the more likely that a significant physiological dependence will develop. Generally speaking; however, Hydrocodone withdrawal usually peaks within 72 hours and can last from a week for immediate withdrawal to a month or years for Post Acute Withdrawal Symptoms.


The side effects of hydrocodone withdrawal can range from mild to severe and are different depending on the person. The withdrawal timeline is influenced by the level of dependency the person has developed. Opioid drugs bind to receptors throughout the brain and body, depressing the central nervous system and potentially shutting down the lungs, heart rate, blood pressure, and dropping the body temperature. When someone becomes addicted to hydrocodone or any other type of opioid, the sudden removal of that drug can have some pretty devastating effects as the body and brain attempts to recover a sense of equilibrium. Because of the adverse side effects associated with hydrocodone withdrawal, it is not recommended that anyone try withdrawing from hydrocodone cold turkey. Withdrawal symptoms include:


  • Muscle aches
  • Trouble feeling pleasure
  • Depression
  • Agitation
  • Night Sweats
  • Nausea and abdominal cramps
  • Sweating
  • Chills
  • Fatigue
  • High blood pressure
  • Drug cravings
  • Thoughts of suicide
  • Goosebumps
  • Trouble sleeping
  • Yawning
  • A runny nose
  • Excessive tearing
  • Anxiety
  • Irritability
  • A headache
  • Restlessness
  • Mood swings
  • Vomiting
  • Diarrhea
  • Irregular heart rate
  • Difficulties focusing or concentrating


Hydrocodone Withdrawal Timeline

Hydrocodone withdrawal typically starts anywhere from 6-12 hours after the last dosage. You can generally expect some pretty unpleasant side effects to occur in different phases. First is a gradual withdrawal that takes place as the high wears off, followed by the peak withdrawal symptoms, accompanied by post-acute withdrawal symptoms (PAWS).


  • 4-6 hours: After the last dosage, the user’s high gradually starts to wear off. During this time, the user will experience the pleasurable side effects of opioids begin to wear off and reality to set back in.


  • 6-12 hours: This is when the unpleasant side effects first appear. This phase is characterized by mild anxiety, the return of any physical pain, irritability and more. At this point in the withdrawal process, the drug is still within the user's system but is approaching its lowest levels.


  • 72 hours: This is typically when peak withdrawal symptoms occur. During this time users will experience the worst of the symptoms, including sweating, shakes, pain, diarrhea, insomnia, and vomiting. At this point in the withdrawal process, the drug has left the user’s system, and the body is having trouble calibrating to the lack of drugs. This is the stage when most clinical providers will administer some form of medication-assisted treatment to help recovering addicts overcome the pain.


  • 1 Week: Within a week, if the user has successfully refrained from using any substances, the drug will have left the person’s system entirely. At this point in the withdrawal process, the drug is only detectable in hair tests.


  • Onward: Following hydrocodone withdrawal and detox, the recovering person will typically experience some symptoms for weeks to months to years afterward. These symptoms are milder than the immediate withdrawal symptoms, but some recovering users report feelings of depression, anxiety, and difficulty focusing for a period following their detox. These symptoms are called Post Acute Withdrawal Syndromes and while not officially recognized as a mental disorder, is still a significant barrier to recovery for many.


What to Know About Treatment for Hydrocodone Withdrawal

Quitting Hydrocodone can be a difficult and arduous process, primarily if the task is undertaken cold turkey. That is why clinicians recommend that anyone is attempting to stop hydrocodone first enlist the services of a residential treatment center, detox center, or outpatient program. During this time a medical professional will help the user to detox from the substance in a controlled fashion. Some commonly used medication-assisted treatment options for hydrocodone treatment include:



Suboxone is a prescription medication used for the treatment of opioid addiction. It is a combination of the two drugs buprenorphine and naloxone. Buprenorphine is a partial opioid agonist while naloxone is an opioid antagonist. This drug provides a small opioid high that is capped off by the naloxone.



Vivitrol, generically known as Naltrexone, is also used as an effective treatment for opioid and alcohol withdrawal. It works by blocking the opioid receptors in the brain to reduce cravings while stopping the effects of opioids and some alcohol effects from taking place.



Buprenorphine is used as a part of Suboxone, but the drug can also be administered by itself. Buprenorphine works with the same opioid receptors that opioids and alcohol effects, but it is limited and not nearly as potent. Buprenorphine is effective for withdrawal and cravings



Methadone is more widely known than buprenorphine, but it works in the same fashion by activating opioid receptors in the body and brain. Methadone is controversial because it acts as an agonist, meaning that users can become addicted. However, within the confines of a secure rehabilitation clinic, the danger of abuse is significantly limited.


Hydrocodone Detox

As stated above, users should not attempt to detox from hydrocodone without the assistance of a residential treatment or outpatient center. These types of facilities offer a safe environment for people to manage the uncomfortable symptoms of withdrawal. By having detox be a medically supervised process, patients can reduce their chances of relapse or possible death. During detox, patients are likely to lose bodily fluids through sweat, diarrhea, and vomiting, making it essential for people to replenish with nutrients and electrolytes.


Issues can also arrive when people have any existing mental problems such as anxiety, depression, or schizophrenia. There is also the risk if a patient has an issue with self-harm, which could be exacerbated by the ramifications of withdrawal. Medication is helpful in easing the discomfort of these symptoms, and these types of drugs help trick the body into believing it is achieving a similar high. Once someone has gone through the withdrawal process, then they have overcome the first significant hurdle to recovery. The next phase of recovery comes from your continued sobriety and abstinence from substances.


Residential Treatment

Residential treatment is an ideal environment for someone seeking to overcome an addiction to hydrocodone. In residential treatment, recovering addicts will have a chance to undergo medically supervised detox and entirely withdraw from the substances they have been hooked on. Once the brain is cleared from the fog induced by drug abuse, the patient can begin to see clearly and start to address the underlying psychological conditions that may have lead to addiction in the first place. In residential treatment, patients will get to learn about methods for coping with their home environments and healthy alternatives to drug and alcohol abuse.


Outpatient Treatment

Outpatient treatment is recommended for those who have completed residential treatment or detox and need a continued form of support and structure to maintain their sobriety. Outpatient treatment allows patients to attend therapy and counseling multiple times a week where they can learn relapse prevention techniques and share daily stories of recovery. Outpatient is ideal for low-risk patients who can manage to uphold work and life responsibilities while also attending sessions.


Next Steps

If you or a loved one struggling with an addiction to hydrocodone, there is no reason to face it alone. There are residential and outpatient treatment centers available to assist you in achieving a sober, successful life. At Landmark Recovery, our addiction specialists are here to provide structured support, peer group therapy sessions, medication-assisted treatment, and extensive alumni programs.



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Topics: Drug

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