Vicodin is the brand name combination of hydrocodone, a strong semisynthetic opioid painkiller, and acetaminophen, an over-the-counter painkiller used in cold or headache remedies, such as Tylenol. Acetaminophen helps enhance the effects of hydrocodone, and it can also be used to reduce fever.
Vicodin Addiction and Detox
Because hydrocodone is a narcotic painkiller, it can be habit-forming. The Drug Enforcement Administration (DEA) lists hydrocodone as a Schedule II drug, meaning it has medical benefits, but can also be highly addictive. Doctors who prescribe this medication should watch their patients for signs of addiction.
Vicodin is typically prescribed to people who have moderate or severe pain, which should go away over time – for example, pain after an injury or surgery. Vicodin is not intended to be the painkiller of choice for chronic pain, such as from osteoarthritis or cancer, so patients should reach a point where they physically do not need to take it anymore.
Unfortunately, hydrocodone’s potential for addiction means that some people do become addicted to this substance. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2014, 4.3 million Americans used prescription painkillers like Vicodin for nonmedical purposes in the month before the survey, and 1.9 million Americans met the criteria for opioid painkiller use disorder, based on their use of painkillers in the prior year.
When a person becomes addicted, it is important to take steps to end that addiction to avoid wide-reaching effects. The first step is to withdraw from the substance, which clears the substance from the body, lowering the body’s tolerance and ending physical dependence. Although detox is not the same thing as overcoming an addiction, it is a very important first step. As with all opiates, medical detox is needed for Vicodin withdrawal.
What Is Withdrawal, and What Are the Symptoms?
Although not everyone who abuses Vicodin will experience withdrawal symptoms, people who have struggled with addiction to this drug for a long period of time or who have taken doses beyond the recommended prescription are more likely to experience these physical effects. In general, withdrawal symptoms occur because the substance is being processed out of the bloodstream and tissues, and that chemical is not being replaced.
- Agitation and anxiety
- Changes in breathing, such as rapid breathing
- Rapid pulse
- Abdominal cramps
Withdrawal symptoms will peak a few days after the last Vicodin dose has been ingested. The physical effects will begin to decrease after that, although some psychological effects, such as cravings, can linger or reappear years down the line.
Detoxing from opioids like Vicodin is not typically physically dangerous; relapse is typically more dangerous, since it can lead to overdose. Getting help is one of the ways to avoid relapse early in the process. Professional support can help people overcoming an addiction to Vicodin to stay on track.
Vicodin Withdrawal Timeline
Vicodin has a half-life of about four hours, so the drug will most likely be completely out of the body in eight hours. This is typically when withdrawal symptoms begin. However, for people who have taken very large doses of Vicodin for a long time, there might be some of the drug lingering in the body as fat is burned, and it will then be released into the blood. For most people detoxing from Vicodin, however, symptoms will begin 8-12 hours after the final dose.
After the brain realizes that another dose of Vicodin will not be taken, it will begin to compensate until it achieves homeostasis, or normalcy.
For most people who attempt to quit Vicodin “cold turkey,” here is what can be expected over a period of two weeks:
- Days 1-3: Opioid withdrawal symptoms begin to get worse after 36 hours, then peak 2-3 days after the final dose. These symptoms include serious agitation, diarrhea (as constipation reverses itself), nausea, vomiting, insomnia, raised body temperature, and raised blood pressure. There can also be cold or flu-like symptoms. After three days, physical symptoms will begin to taper off.
- Days 4-7: Physical withdrawal symptoms will subside. The individual may experience some tiredness, lingering abdominal cramps or nausea, or other mild physical symptoms. Psychological symptoms, such as mood swings or depression, can linger.
- Days 8-14: Physical symptoms are gone, as are the more serious psychological symptoms. The person may experience cravings, anxiety, or depression, but these will begin to feel milder and start to resolve.
After two weeks, withdrawal symptoms will have subsided for most people who detox from Vicodin. However, addiction is a disease of the brain, and becoming addicted to a substance like hydrocodone can change brain chemistry. People who detox from Vicodin still need to address the addiction with professional help.
Physical Complications of Vicodin Withdrawal
There are two sets of physical symptoms that can occur during opioid withdrawal, including Vicodin detox. The first is a set of symptoms that mimic a cold or flu. These withdrawal symptoms are unique to opiates and include:
- Runny nose
- Watery eyes
- Excessive yawning
- Chills or goosebumps
A more serious and physically dangerous set of symptoms is called PAWS, or post-acute withdrawal syndrome. This condition is more likely to occur among individuals who are detoxing from alcohol or benzodiazepines, but occasionally, it appears in people detoxing from opioids as well. Symptoms of PAWS include:
- Mood swings that can resemble affective disorder
- Anhedonia, or lack of feeling pleasure from anything except the substance of abuse
- Extreme insomnia
- Extreme cravings for the drug, leading to obsession about the next potential dose
- Anxiety and panic attacks
- Serious depression, including suicidal ideation
- Cognitive impairment
Some of the symptoms, like suicidal thoughts and seizures, are dangerous. Medical detox can help to offset the intensity of these symptoms.
Is Medical Detox Better than At-home Detox?
Detoxing at home, or without help, from an opioid medication like Vicodin is not often physically dangerous; however, the risk of relapse is high, and that is dangerous. In order to counteract the discomfort of withdrawal symptoms, many people simply return to abusing Vicodin.
Medical detox, in general, offers medical oversight for the entire detox process. A doctor will work with a person to develop a plan to manage the withdrawal process, such as tapering use or using medications like Suboxone to replace the opioid in the brain. Oftentimes, doctors may prescribe antidepressants, painkillers, or other mood-stabilizing medications to ease symptoms of withdrawal.
For people trying to overcome an addiction to an opioid drug, such as Vicodin, there are various options a medical professional might pursue.
- Tapering: This process is sometimes called managed withdrawal. A doctor will work with the person to develop a timeline to slowly lower the amount of Vicodin the individual takes, which helps to end the body’s dependence on the medication while also easing the worst physical withdrawal symptoms by introducing a smaller amount of the drug into the blood and brain. Typically, the longer a person has taken Vicodin, the longer the taper should last; generally, this will involve a 20-50 percent reduction in dose each week until the individual no longer physically needs the drug. Tapering works well for some people, but most individuals need to end their access to the medication entirely as part of the overall addiction treatment.
- Buprenorphine or Suboxone: Buprenorphine is a partial opioid agonist, meaning it binds to the same opioid receptors as drugs like heroin or hydrocodone, without creating the same euphoric high. Suboxone is the brand name for a combination of buprenorphine and naloxone. When taken properly, buprenorphine binds to the opioid receptors, but if the individual attempts to bypass the safety aspects of the medication to abuse it, the naloxone will bind to the opioid receptors instead, leading to withdrawal symptoms. When a person receives a prescription for buprenorphine or Suboxone, their doctor should also have a tapering plan for these medications. Ultimately, the point of buprenorphine is to ease the person off an addiction to opioids with replacement therapy and then wean them off the replacement medication as well.
- Other medications: A physician might prescribe small doses of other medications, like antidepressants or anti-anxiety medications, to ease psychological symptoms that can lead to relapse.
How Long Does Medical Detox Take?
Medical detox will take longer than “cold turkey” detox. The specific timeline can be very individual. For some, this means a few extra days or weeks, but for others, this can mean months or even years on a replacement therapy like buprenorphine. The difference is due mostly to how long a person has struggled with Vicodin addiction. Brain chemistry changes and physical dependence on a drug can take time to overcome.
Getting help to overcome Vicodin addiction through medical detox helps more people remain sober for longer. It is also important to pair detox with a rehabilitation program, which offers both individual and group therapy. Therapy groups offer social support, better coping strategies for cravings and life stress, and help understanding the roots of addiction. Detox and rehabilitation together can help people to overcome their addictions and stay sober for life.