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Tussigon Withdrawal Symptoms, Signs, and Detoxification

Tussigon is an antitussive (narcotic cough suppressant) and Schedule II opioid prescribed for cough relief in adults.1 The medication is a combination of hydrocodone, an opioid painkiller, and homatropine, a substance meant to discourage misuse.

In addition to its cough suppressant effects, Tussigon can create a feeling of euphoria for its users (a motivation for recreational use), which can potentially lead to abuse and, later, dependence or addiction.1

Fortunately, there are many treatment options to help you safely detox from Tussigon and recover from opioid addiction.

What Are Dependence and Addiction?

Tussigon is the brand name for an opioid narcotic.Tussigon is an opioid narcotic with a high potential for abuse and dependence and therefore prescribed with caution.1 If used for short-term treatment such as for cough relief, it is unlikely to result in physical dependence or addiction.1 However, because it produces the euphoric high associated with all opioids, some people will abuse it (taking it for longer than prescribed or in ways other than directed, or taking it recreationally solely for the high), all which can significantly heighten the risk of becoming dependent or addicted.

With regular use, a certain level of tolerance will likely develop, after which an increase in the dose may be required to feel the expected effects. Tolerance often develops alongside of physiological dependence, the state where the body needs a consistent dose of the drug to maintain an equilibrium.2

At the point that an individual develops significant levels of tolerance and dependence to Tussigon, they may already be struggling with an opioid addiction, or meet criteria for the diagnosis of what is known as an opioid use disorder (OUD).

Some other signs a person may be struggling with an addiction to Tussigon include the following:3

  1. Taking more or taking it for a longer period of time than first intended.
  2. Wanting to reduce or quit Tussigon, with unsuccessful efforts.
  3. Spending a great deal of time obtaining, using, or recovering from Tussigon.
  4. Craving Tussigon.
  5. Struggling to meet professional or academic responsibilities, or maintain positive relationships with loved ones, due to Tussigon use.
  6. Prioritizing use over important occupational or social activities.
  7. Using the drug in situations that are considered physically hazardous.
  8. Continuing your Tussigon use, knowing that it is damaging your health, your psyche, and/or your social/professional life. 

What Are the Signs of Withdrawal?

How to recognize withdrawal signs.Once a person's body has adapted to a substance and they have become dependent on it to feel normal, they will most likely experience some physical and/or psychological withdrawal symptoms when they try to quit.

Withdrawal usually begins with 6-12 hours after the last dose.Withdrawal signs and symptoms may include:4

  • Anxiety.
  • Agitation.
  • Inability to sleep.
  • Sweating.
  • Tearing of the eyes.
  • Increased yawning.
  • Runny nose.
  • Dilated pupils.
  • Muscle aches.
  • Nausea and vomiting.
  • Abdominal cramping.
  • Diarrhea.

Withdrawal symptoms may extend past the acute stage. Symptoms that persist for weeks or months may be part of what is termed a post-acute withdrawal syndrome (PAWS). It is reported that 90% of opioid users will experience at least some PAWS symptoms.5 These may include:5

  • Anxiety.
  • Panic.
  • Irritability.
  • Depression.
  • Cognitive difficulties, such as problems completing simple tasks.
  • Sleep disturbances.
  • Apathy.
  • Obsessive-compulsive behaviors.
  • Cravings.

Symptoms can fluctuate, disappear, and reappear at any time. Stressful events may cause symptoms to worsen.

Can I Detox Alone?

Though the acute opioid withdrawal syndrome is not considered life-threatening, unlike withdrawal associated with alcohol and some sedative drugs, there is a potential for serious complications, such as:6

  • Aspiration (vomiting and inhaling stomach contents into the lungs). This can result in lung infection or irritation.
  • Dehydration and electrolyte or mineral imbalance from diarrhea or vomiting.
  • Worsening of cardiac conditions due to the elevations in blood pressure and increased pulse common to opioid withdrawal.

Relapse risk may also be higher in an environment where you lack supervision, support, and treatment medications and are subject to the environmental temptations of your everyday life.

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends inpatient detox treatment for clients who may face complicated withdrawal, such as people with cardiac conditions, chronic illnesses like HIV, mental health disorders, and those with chronic pain that will no longer be managed by prescription opioids.6

Withdrawing from Tussigon or other opioids on your own can lead to "needless suffering".6 There's no reason to go through it alone when there are many programs that offer help to ease your experience and protect your physical and mental health.

What Will Detox Be Like?

Taking medication to combat the symptoms of withdrawing.Detox generally involves withdrawing under professional supervision and may also involve medication, counseling, and support groups. The safest places to detox are in inpatient detox facilities, or in a hospital, contingent on the severity of your symptoms.

If you're attending an inpatient program that utilizes medication, you may be given one of the following:4

  • Buprenorphine (used alone or in combination with naloxone as Suboxone)—Alleviates withdrawal symptoms and cravings and can be used for long-term recovery maintenance.
  • Methadone—Lessens withdrawal symptoms while detoxing. It can also be used as a long-term maintenance medication. Can only be administered in a methadone clinic.
  • Clonidine—Often used during detox to reduce symptoms like anxiety, sweating, agitation, cramping, and runny nose. Does not help reduce cravings.

Another medication that is only appropriate for use after you've completed withdrawal and are in recovery is naltrexone. As a narcotic antagonist, it blocks the effects of opioids, reducing the temptation to use by eliminating the potential for getting high.7

An important and necessary first step to recovery, detox does little to treat the underlying addiction. Most people require long-term treatment after detox to:

  • Better understand what led to their substance abuse.
  • Develop new and healthier beliefs and patterns.
  • Build relapse prevention strategies.
  • Replace negative coping skills with sobriety-sustaining ones.
  • Begin repairing the damage done to their relationships and other areas of their lives.

Long-term treatment can take place in an inpatient or outpatient environment (or both). As forms of continued support, you will most likely regularly attend mutual support group meetings, such as Narcotics Anonymous or Smart Recovery. These groups are held within and outside of treatment facilities and provide a great source of support for those in recovery.

Detoxing from Tussigon during Pregnancy

Using Tussigon during pregnancy may present some risks to your developing baby, such as growth problems, preterm birth, placental abruption and stillbirth.7 The lack of personal care that often accompanies substance addiction may also harm you or your unborn child. Missing prenatal appointments, not eating well, and neglecting regular tests can put both you and your baby at risk of developing numerous health problems.7

Signs of Neonatal Abstinence Syndrome

Your baby may be born with withdrawal symptoms, or neonatal abstinence syndrome (NAS), if you use Tussigon during your pregnancy. A baby born with NAS may exhibit signs and symptoms such as:8,9

  • Mottled (blotchy) skin.
  • High-pitched or excessive crying.
  • Irritability.
  • Poor feeding and weight gain.
  • Trouble sleeping.
  • Fever.
  • Tremors.
  • Vomiting.

These symptoms may last days to weeks. A pediatrician may prescribe medications to your baby and recommend other measures such as breastfeeding, skin-to-skin contact, and swaddling to comfort your new child. At this time, NAS is not known to cause any lasting intellectual or physical problems.However, a new mother with a high-needs infant who is new to recovery may find caring for a baby with NAS to be stressful enough to send them into relapse.

Detoxing from a substance while pregnant.Pregnant mothers with opioid dependence should seek out the support of medical detox and professional addiction treatment to stop using. Going cold-turkey alone can cause harm to you and the fetus and may raise your risk of relapse. Under medical supervision, you will be closely monitored and prescribed certain medications, such as methadone or buprenorphine, during and possibly even after the baby is born.9 This is called opioid-assisted therapy (OAT) or medication-assisted therapy (MAT). These medications stay in the body for a long time to reduce cravings, helping you to stay abstinent and protect your health and that of your child.

To avoid relapse during or after pregnancy, it is important to seek long-term treatment where you will receive medical care, counseling, and support. You might also look into parenting support groups where you can build a network of people to support you in your transition to motherhood.

Is Detox Enough to Recover?

Once you have been successfully detoxed from Tussigon, you can begin a course of counseling and therapy that identifies the root cause of the addiction. For example, many programs utilize cognitive behavioral therapy to help you learn healthy and constructive ways of dealing with the stresses and pressures that led you to abuse substances.

There are various treatment options for addiction treatment and recovery, many of which incorporate several types of therapy, such as CBT, motivational interviewing, and family therapy. While taking into account any insurance coverage and other means of handling treatment costs, your treatment team will work with you to help design the best course of treatment for your needs. Treatment settings and program types vary, but commonly sought avenues for recovery include:6

  • Inpatient facility – You'll stay in a residential facility while receiving treatment, which may include detox, medication, counseling, therapy, exercise, nutritional meals, mutual-support groups, and complementary or alternative therapies, such as yoga.
  • Intensive outpatient program (IOP) – More intensive than standard outpatient (see below), you'll stay at the facility for several hours throughout the day. These programs often work with hospitals and can link a patient to a higher level of care when needed.
  • Standard outpatient facility – If you opt for outpatient treatment, you will live at home, go to work, and spend time with friends and family. However, you also have clinic visits, either every day to every 3 days, in order to receive addiction treatment. You may also participate in group therapy.

Maintaining a focus on sobriety by continuing your care in various forms can help you avoid relapse. For example, a sober living home can help to ease you back into your daily life by providing you with a sober and supportive environment to serve as your home base, allowing you to come and go as you need. Many sober living homes have rules, such as a requirement to work and/or contribute to house chores, in order to help instill a sense of responsibility and positive contribution to the community in and outside the home. Peer support groups can also provide additional encouragement during the recovery process and often help you to focus on giving back and helping others new to recovery.

If you or a loved one is suffering from Tussigon dependence or addiction, you are not alone. With the right treatments, including professional detox, therapy, and support through peer-mentor groups, recovery and sobriety are both possible.  

Tussigon Information at a Glance1,3
Medication Name, Costs Class of Medicine
  • Generic Name: Hydrocodone bitartrate and homatropine methylbromide
  • Brand Name: Tussigon
  • Used to Treat Addiction? No
  • Function or Use: Cough suppressant
  • Chemical Makeup: C18H21NO3
  • System: Combination of opioid agonist & anticholinergic/antimuscarinic agent
  • Duration of Action: 6 to 10 hours
Form, Intake and Dosage Interactions and Complications
  • Drug Forms: Tablets, syrup
  • Administration Routes: Oral
  • Dosage: 1 tablet or 5 mL (1 teaspoonful) every 4 to 6 hours
  • Overdose: Exceeding 6 tablets or 30 mL within 24 hours
  • Alcohol Interaction: Sedation, respiratory depression, coma, and death.
  • Prescription Medications: Benzodiazepines, opioids, antipsychotics, antihistamines, anti-anxiety agents (sedation, respiratory depression, coma and death)
  • Contraindications: Hypersensitivity to hydrocodone or homatropine methylbromide, children under the age of 6
Effects and Adverse Reactions Substance Abuse
  • Short-Term: Sedation, dizziness, dry mouth, headache, constipation, nausea, vomiting, respiratory depression, overdose
  • Long-Term: Impaired physical or mental performance, dependence, addiction
  • Risk of Substance Abuse: High
  • Signs of Abuse: Misusing prescription, increasing dosage, using past recommended time period, taking without prescription
Physiological Problem Signs and Symptoms Dependence and Addiction Issues
  • Withdrawal Syndrome Onset: 6-12 hours after last dose
  • Withdrawal Symptoms: Cold or flu-like symptoms, anxiety, cold sweats
  • Tolerance: Users may develop tolerance
  • Physical Dependence: Users may develop dependence
  • Potential for addiction: Misuse may lead to addiction
Legal Schedules and Ratings
  • Controlled Substances Act Rating: Schedule II

Other Commonly Asked Questions

How Long Does Tussigon Withdrawal Last?

While acute withdrawal usually resolves with a week, protracted symptoms may last weeks to months.3 The timeline will differ slightly between individuals and may be dependent upon factors like how long and how much they’ve been abusing the drug.

How Can I Get Off Tussigon at Home?

While it is important to have a healthy diet and get plenty of rest while detoxing from Tussigon, there is no approved home remedy or alternative treatment for withdrawal symptoms. For relief from these symptoms, it is best to seek out a detox program. These programs have proven methods to help alleviate withdrawal symptoms and put patients on the best road to recovery.

How Long Will I Need to Be in Detox? 

The length of recovery from Tussigon depends on each your medical history and severity of dependence.

References

  1. U.S. National Library of Medicine. (2018). Tussigon - hydrocodone bitartrate and homatropine methylbromide tablet.
  2. The National Alliance of Advocates on Buprenorphine Treatment (NAABT), 2018. Physical Dependence and Addiction.
  3. Diagnostic and Statistical Manual of Mental Disorders 2000 and updated to: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  4. MedlinePlus, 2016. Opiate and Opioid Withdrawal.
  5. Semel Institute for Neuroscience and Human Behavior, 2018. Post-Acute Withdrawal Syndrome (PAWS).
  6. Substance Abuse and Mental Health Services Administration (SAMHSA), 2013. Detoxification and Substance Abuse Treatment.
  7. U.S. National Library of Medicine, Medline Plus. (2017). Naltrexone.
  8. U.S. National Library of Medicine, Medline Plus. (2015). Neonatal abstinence syndrome.
  9. The American College of Obstetricians and Gynecologists (ACOG), 2016. Important Information About Opioid Use Disorder and Pregnancy.
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