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What Is Vicodin Withdrawal Like?

Vicodin is a commonly prescribed opioid pain medication that contains hydrocodone and acetaminophen.10 Used to treat moderate to severe pain, Vicodin can easily lead to dependence and addiction if abused. Sometimes, people who are addicted to Vicodin may be unaware of the problem at hand which can hinder their willingness to seek help.

The withdrawal symptoms that opioid-dependent individuals experience when they stop using can make quitting extremely difficult and might discourage them from seeking help in the first place. Withdrawal symptoms can be unpleasant and uncomfortable and may lead to relapse. The good news is that many treatment options are available to help you through the withdrawal and rehabilitation process.

What Are the Withdrawal Symptoms?

A person struggling with feelings of withdrawalWithdrawal from Vicodin can be unpleasant, but symptoms are not generally life-threatening (though certain complications can arise).1 Vicodin withdrawal symptoms may vary somewhat in intensity and duration from person to person.

Common symptoms of withdrawal from opioids like Vicodin include:1,2,3

  • Dysphoric mood.
  • Fever.
  • Muscle aches.
  • Runny nose.
  • Teary eyes.
  • Dilated pupils.
  • Goosebumps.
  • Sweating.
  • Yawning.
  • Insomnia.
  • Nausea and vomiting.
  • Diarrhea.

Vicodin withdrawal symptoms develop and change in the days to weeks following the last dose taken. People who are dependent on short-acting opioids like Vicodin may experience relatively early onset withdrawal symptoms that start within 6–12 hours of their last dose. Symptoms usually peak after 1–3 days and then resolve over a period of 5–7 days.2

During early opioid withdrawal, you’ll begin feeling some of the less severe flu-like symptoms, which often include sweating, aching, yawning, and inability to sleep. You’ll also likely start to feel anxious or agitated.

As time goes on, you may start feeling the more intense symptoms and may feel as though you’re experiencing the very worst flu you can imagine. You might have stomach cramping, goosebumps, and gastrointestinal upset.1,11

Some symptoms may last beyond the acute phase of withdrawal. These are referred to as “protracted” or “post-acute” withdrawal symptoms.2 These symptoms can include feelings of anxiety, low mood, anhedonia (an inability to feel pleasure), and problems sleeping.2

Risks of Withdrawing Alone

In some cases, medical complications may arise over the course of Vicodin withdrawal: 1, 4

  • You could suffer from aspiration, meaning that you vomit and breathe your stomach contents into your lungs, which could lead to lung inflammation and infection.
  • Vomiting and diarrhea can also cause dehydration and electrolyte depletion.
  • Additionally, if you suffer from an anxiety disorder, pain condition, or underlying cardiac condition, you may experience a worsening of your symptoms during withdrawal.

Person experiencing overdoseOne of the biggest risks of withdrawal is relapse. Vicodin withdrawal symptoms, while not life-threatening, can feel intolerable, and individuals attempting to quit often resume using Vicodin as a way of escaping these symptoms. For someone withdrawing at home without the medical and emotional support and substance-free environment of a professional detox program, the risk of relapse may be especially high.

Vicodin abuse, while always troubling, is especially dangerous after a period of abstinence. Your body adjusts during this period and its tolerance for opioids decreases. When someone quits for a period and then returns using, their body will no longer be able to handle the dose that they previously tolerated. This could result in a serious overdose. Most opioid overdose deaths happen to people who have relapsed after going through withdrawal.1,4

Vicodin Information at a Glance
Medication Name, Costs Class of Medicine
  • Generic Name: Vicodin
  • Generic Name Variations: N/A
  • Chemical Name: Hydrocodone bitartrate and acetaminophen
  • Brand Name: N/A
  • Brand Name Variations: N/A
  • Cost/Price: Roughly $36 per 45 tablets
  • Used to Treat Addiction? No
  • Function or Use: Pain relief
  • System: Narcotic analgesic
  • Duration of Action: 4-6 hours
Form, Intake, and Dosage Interactions and Complications
  • Drug Forms: Tablet
  • Administration Routes: Oral
  • Dosage: Each tablet contains 5mg hydrocodone bitartrate and 500mg acetaminophen
  • Overdose: N/A
  • Alcohol Interaction: Vicodin should not be taken with alcohol.
  • Prescription Medications: Consult your doctor before taking Vicodin with any other prescription medications.
  • Contraindications: Those who have been hypersensitive to other hydrocodone or acetaminophen medications may also be hypersensitive to Vicodin.
Effects and Adverse Reactions Substance Abuse
  • Short-Term: Lightheadedness, dizziness
  • Long-Term: Liver failure, sedation
  • Risk of Substance Abuse: High
Physiological Problem Signs and Symptoms Dependence and Addiction Issues
  • Withdrawal Syndrome Onset: N/A
  • Withdrawal Symptoms: Headaches, fatigue, sleepiness, irritability, dilated pupils, shakes, tremors, insomnia, anxiety, nausea, vomiting, diarrhea, sweating, runny nose, fever
  • Tolerance: Tolerance may develop quickly
  • Cross Dependence: N/A
  • Physical Dependence: Dependence may develop
  • Addiction: Abuse may result in addiction
Legal Schedules and Ratings
  • Controlled Substances Act Rating: Schedule II

What Are the Options for Treatment?

Doctor and patient having a conversation about treatmentWhen opioid withdrawal is uncomplicated, it is not particularly dangerous; however, issues can arise that may require immediate medical intervention. For this reason and because opioid withdrawal is so intensely uncomfortable, the Substance Abuse and Mental Health Services Administration (SAMHSA) recommends some form of 24-hour care and supervision for opioid withdrawal. Additionally, SAMHSA does not advise opioid withdrawal without pharmaceutical intervention and states that “management of this syndrome without medication can produce needless suffering.” Withdrawal medications can help mitigate painful symptoms and alleviate cravings.4

Some of the medications that are used for Vicodin withdrawal include:4

  • Methadone. This long-acting opioid agonist is one of the most commonly used medications for opioid withdrawal and can help to reduce withdrawal symptoms and cravings. Because it is a full opioid agonist and does have some potential for abuse, you must receive it from a doctor in a SAMHSA-certified methadone clinic or at the hospital.
  • Buprenorphine. Unlike methadone, buprenorphine is a partial opioid agonist, so it has a “ceiling effect” which helps to prevent abuse. This medication can be dispensed in a physician’s office. NOTE: Not all physicians are qualified to prescribe this drug. You can find prescribers here.
  • Clonidine. Also used to combat withdrawal symptoms, clonidine is not an opioid agonist so allows for detoxification without the use of other opioids, which may be important for people who want to stop using these substances completely. Clonidine is not approved by the FDA for opioid withdrawal but is often used “off-label” for this purpose.

Other medications may also be used to treat specific symptoms. For example, diphenhydramine (Benadryl) or trazodone may be used to help with insomnia; acetaminophen or ibuprofen may be given for headaches and muscle pain; Mylanta or Maalox may be used to treat acid reflux.4

Once you have decided to undergo detoxification, you should discuss possible Vicodin withdrawal treatment methods with a doctor. Once you’ve decided it’s time to quit, you should discuss your Vicodin withdrawal treatment options with a doctor. Individuals considering Vicodin detox could benefit from inpatient services for at least the first few days after the onset of withdrawal:4 p.13

  • Social detox. This is a nonmedical form of residential detox that involves peer and social support and is mainly intended for people who require 24-hour supervision and support but do not wish to use medication during withdrawal.
  • Medical detox. This is an inpatient form of detox that provides both round-the-clock monitoring and supervision from treatment center staff as well as the administration of medications to improve comfort and prevent complications.

While inpatient detox is recommended for Vicodin withdrawal by SAMHSA, it is not the only option. Outpatient detox may also be appropriate for those whose addictions are less severe and who feel they have a supportive home environment that minimizes the chance of relapse. Outpatient detox allows you to live at home while regularly visiting a detox facility or your physician’s office on to receive monitoring, support, and any medications indicated for treatment. 

Once you have successfully completed withdrawal, you may continue to take maintenance medications, such as methadone, buprenorphine, or naltrexone, to help keep cravings at bay and prevent relapse.5 Depending on which medication you use for recovery maintenance, you may be able to get an injection on a monthly or even bi-annual basis.

Is Ultrarapid Detox Safe?

Doctor with patientUltrarapid detoxification involves placing the person under general anesthesia prior to the induction of withdrawal in an attempt to accelerate the detoxification process. Many ultrarapid detoxification protocols can be completed in several hours. Providers of this kind of detox claim that the procedure helps people avoid much of the discomfort associated with the detoxification process. However, this procedure is controversial, risky due to the involvement of general anesthesia, and can cause serious harm for people with underlying medical conditions such as diabetes, pneumonia, or hepatitis.4,12

Always discuss your Vicodin consumption, medical history, and other applicable factors with your doctor before making a decision about your treatment.4

How Can I Ensure a Successful Recovery?

Doctor comforting patientDetox is often the first step in the recovery process. It is a set of interventions to help you as the substance is eliminated from your body. Alone, detoxification programs are not a substitute for comprehensive substance abuse treatment because they don’t address the underlying issues that led to substance abuse. Detox helps to best prepare you for your continued recovery efforts by helping you stabilize physically and mentally. Ideally, after the successful completion of a detox program, further addiction treatment should continue. Addiction treatment focuses on addressing the root causes of drug addiction and helps the person learn new skills, develop healthier beliefs and ways of thinking, and helps begin the process of healing key relationships. All of these are integral parts of staying sober in the long run.

Some of the treatment options for Vicodin addiction include:

  • Inpatient treatment. Like inpatient detox, you will reside at the facility but for a longer duration of time. Many inpatient programs last for approximately 30-90 days, though durations will vary. During your stay, you’ll participate in a range of treatments, such as individual and group counseling, and will have 24-7 access to care and support.
  • Outpatient treatment. You can choose from different outpatient options depending on your specific needs. These include:
    • Standard outpatient programs. You live at home and travel to a treatment center on a regular basis, often a few times per week. This form of treatment usually accommodates evening and weekend appointments for those who have other obligations during the day.
    • Partial hospitalization programs (PHP). This is a more intensive form of outpatient treatment that is often used as a step-down from inpatient programs. It is also beneficial for those who require a higher level of support but cannot commit to inpatient treatment. You attend treatment (mostly during the week during daytime hours), usually for 6 hours per day, at a minimum of 5 days per week.13
    • Intensive outpatient programs (IOP). This is more intensive than standard outpatient treatment but less intensive than PHP. You usually attend treatment 3 hours per day, with frequency decreasing as time goes on.14

Most people recovering from Vicodin addiction view the rehabilitation process as a lifelong effort. Beyond completion of any detox and rehabilitation programs, you will need to maintain a focus on your recovery via various aftercare efforts.

Groups like Narcotics Anonymous (NA) or other recovery support groups can help to provide a foundation for long-term abstinence through regular meetings and a supportive circle of people going through similar struggles.

12-step fellowships like NA or other, secular groups can offer daily encouragement for those who have recently left a rehabilitation facility. Regular meetings with a substance abuse counselor or psychologist are also commonly recommended to help reinforce the lessons learned during treatment and to maintain your enthusiasm for sobriety.

If you or someone you know needs help, you can call for confidential information about rehabilitation facilities and treatment options at any time, day or night.

Commonly Asked Questions and Answers

Can I Go through Withdrawal if I’m not Addicted?

Yes. You can still be physically dependent on Vicodin even if you aren’t addicted. You might develop some physiological dependence even if you’ve been taking Vicodin as prescribed by your doctor. Dependence simply means that your body has adapted to the presence of the drug, and you may experience some withdrawal without it.6Is relapsing dangerous?

Yes, and in some cases, the timing of a relapse can even increase your risk of a potentially deadly overdose. This is because, when enough time has passed since your last use, you won’t have the same amount of opioid tolerance you once did and you your body might not be able to handle the same dose you previously took. If you resume taking the amount to which you’re accustomed, you can overdose.7Does every detox center offer medication?

Not every detox center offers medication, although medication can be very helpful during withdrawal. SAMHSA advises medical detox for opioids. One study found that up to 80% of all detox facilities used medications.8 Nonmedical approaches to detox could be viable options for some groups—young, healthy people at low risk of complicated withdrawal, for example. However, in even in nonmedical detox settings, staff members must be properly trained to identify life-threatening situations and to know when to call in emergency medical assistance.4Does using medication mean I’m not sober?

Using treatment medication does not mean that you are not sober. Addiction is a chronic disease. As with any other chronic disease, such as high blood pressure or diabetes, recovery is a lifelong process that often requires medication to manage symptoms and decrease the likelihood of relapse. If you were diabetic, you wouldn’t avoid taking medication. Addiction is no different.9

References:

  1. U.S. National Library of Medicine. (2016). Opiate and Opioid Withdrawal.
  2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Arlington, VA: American Psychiatric Publishing.
  3. New Zealand Drug Foundation. Opiates.
  4. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 13­4131. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  5. Bart, G. (2012). Maintenance Medication for Opiate Addiction: The Foundation of RecoveryJournal of Addictive Diseases31(3), 207–225.
  6. National Alliance of Advocates for Buprenorphine Treatment. (2016). Physical Dependence and Addiction.
  7. National Institute on Drug Abuse. (2016). What Science Tells Us About Opioid Abuse and Addiction.
  8. National Institute on Drug Abuse. (2018). Treatment Approaches for Drug Addiction.
  9. University of Pennsylvania Health System. Can Addiction Be Cured?
  10. U.S. National Library of Medicine. (n.d.). Hydrocodone and Acetaminophen (Oral route).
  11. Wesson, D. R., & Ling, W. (2003). The Clinical Opiate Withdrawal Scale (COWS). J Psychoactive Drugs, 35(2), 253–9.
  12. National Institute on Drug Abuse. (2006). Study Finds Withdrawal No Easier With Ultrarapid Opiate Detox.
  13. Nebraska Department of Health and Human Services. (n.d.). Partial Hospitalization - MH - Adult (Managed Medicaid only Service).
  14. Center for Substance Abuse Treatment. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 47.) Chapter 4. Services in Intensive Outpatient Treatment Programs.
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