All about Hydrocodone

Hydrocodone is a potent opioid pain reliever. It is commonly prescribed to manage moderate to severe pain. It works by binding to opioid receptors in the brain and spinal cord, which reduces the sensation of pain.

The drug is often combined with other substances to enhance its effects. You will see it mixed with acetaminophen or ibuprofen, for example.

Since it is highly addictive, in the United States it is classified as a Schedule II controlled substance. This means it is strictly regulated by the government and can only be prescribed by a licensed healthcare provider. The United States is one of the largest consumers of opioids in the world. Hydrocodone is one of their most commonly prescribed opioids. This drug has seen an increase of 20 million more prescriptions per year since 2006.

In the UK, hydrocodone is not generally prescribed. Instead, other opioid medications like codeine and morphine are more commonly administered.

However, like all drugs, hydrocodone can be obtained illegally. Its use outside of its approved medical prescription is illegal in the UK and can result in criminal charges.

What is hydrocodone?

Hydrocodone is a semisynthetic opioid pain medication. It is derived from codeine. Chemically, it is classified as a phenanthrene-derivative and it has the chemical name 4,5α-epoxy-3-methoxy-17-methylmorphinan-6-one.

Being made from codeine, hydrocodone is naturally derived from the opium poppy plant. Codeine is converted into hydrocodone through a chemical reaction that involves adding a hydroxyl group (-OH) to the molecule. The resulting compound is then purified and formulated into tablets or capsules.

Like other opioids, hydrocodone works by binding to opioid receptors in the brain and spinal cord. This reduces pain sensations.

Hydrocodone has a high potential for abuse and addiction. Its use can lead to physical dependence, withdrawal symptoms and overdose. Common side effects of this drug include drowsiness, dizziness, nausea, constipation and respiratory depression.

What is hydrocodone used for?

This potent pain reliever is commonly used to manage moderate to severe levels of pain. It is often prescribed for short-term relief of acute pain, such as postoperative pain, dental pain or pain due to injury. It is also sometimes used to manage chronic pain that is not adequately managed with other pain medications or non-pharmacological interventions.

Some of the medical conditions that may be treated with hydrocodone include:

• Chronic pain: Hydrocodone may be used to manage chronic pain conditions such as fibromyalgia, arthritis or low back pain.
• Postoperative pain: Hydrocodone can be prescribed to manage pain following surgery, such as dental procedures, joint replacement or abdominal surgery.
• Traumatic injuries: Hydrocodone may be used to manage pain from traumatic injuries like fractures, dislocations or sprains.
• Cancer pain: Hydrocodone may be used to manage cancer-related pain, either alone or in combination with other pain medications.
• Neuropathic pain: Hydrocodone may be used to manage neuropathic pain like pain caused by nerve damage or shingles.

Who can take hydrocodone?

Hydrocodone is not recommended for those under the age of 18 due to the risk of serious side effects, including respiratory depression. It is also not recommended to be taken by pregnant women. This is because it can cross the placenta and potentially cause harm to a developing foetus.

Hydrocodone is a regulated substance and can only be obtained with a prescription from a licensed healthcare provider. It is important that people follow the dosage and administration instructions provided by their healthcare provider and only take hydrocodone as prescribed.

Who can’t take hydrocodone?

Hydrocodone is a potent opioid medication that can have serious side effects and interactions with other medications and its use should be carefully evaluated by a healthcare provider. Apart from during childhood and pregnancy, there are other reasons why hydrocodone may not be suitable for everyone. As such, it’s important for patients to inform their healthcare provider of any medical conditions or medications they are taking before starting hydrocodone.

Here are some examples of people who may not be able to take hydrocodone:

• People with a history of opioid addiction or abuse
  Those with a history of opioid addiction or abuse are at an increased risk of addiction, abuse and overdose with hydrocodone. In some cases, alternative pain management strategies may be recommended.
• People with medical conditions affecting their lungs
  People with respiratory problems (asthma, COPD, pulmonary emphysema, etc.) could also be at an increased risk of serious side effects from this drug. This is because hydrocode has respiratory depressant effects, meaning that it slows down breathing. In individuals with pre-existing lung conditions, there is an increased risk of respiratory depression because their lungs are already compromised. The drug can also suppress cough reflexes, which is problematic for people who need to cough to clear mucus and other secretions from their airways, like those with cystic fibrosis.
• People with liver disease
  Hydrocodone is primarily metabolised in the liver and individuals with liver disease may not be able to process the medication effectively. The liver is responsible for breaking down drugs and toxins in the body and if it is damaged or not functioning properly, it might not be able to metabolise it as efficiently. As such, the drug may accumulate in the body, leading to potentially harmful side effects.
• Pregnant or breastfeeding women
  Hydrocodone can cross the placenta and enter breast milk, potentially causing harm to the developing foetus or nursing infant. For breastfeeding mothers, hydrocodone can cause sedation and respiratory depression, which is especially dangerous for newborns and their immature respiratory systems. It could also lead to physical dependence in the infant, which can cause withdrawal symptoms when the medication is stopped.
• Children under the age of 18
  Hydrocodone is not usually prescribed to children because of the risks of them experiencing serious side effects like respiratory depression.
• People taking certain medications
  Hydrocodone can interact with other medications and taking them together could cause significant harm.
  Some of the medications that shouldn’t be taken alongside hydrocodone include:
  – Other opioids: Taking hydrocodone with other opioids puts the patient at risk of severe side effects like respiratory depression.
  – Benzodiazepines: Combining benzodiazepines like diazepam or alprazolam with hydrocodone can cause sedation, respiratory depression, coma or even death.
  – Muscle relaxants: If you take hydrocodone with muscle relaxants like cyclobenzaprine and carisoprodol, it can increase the risk of respiratory depression and sedation.
  – Monoamine oxidase inhibitors (MAOIs): Combining hydrocodone with the likes of selegiline or phenelzine, for example, can cause a condition called serotonin syndrome, which is a potentially life-threatening condition. It causes symptoms like agitation, confusion, seizures and fever.
  – Anticholinergic drugs: Taking anticholinergic drugs like oxybutynin and diphenhydramine can cause blurred vision, dry mouth, constipation and more.
  – Alcohol: When taking hydrocodone with alcohol, you can increase the risk of harmful effects like sedation and respiratory depression.

Patients should always consult with a healthcare provider before taking hydrocodone to determine if it is appropriate for them to use. A doctor will evaluate medical history, current medications and other factors before prescribing any drug in order to determine the safest and most effective pain management strategy.

In what form is hydrocodone taken?

Hydrocodone is available in several forms. This includes tablets, capsules and liquid form. It is typically taken orally. The dosage and administration instructions will depend on the specific formulation of the medication and the severity of the pain being treated.

This drug is sometimes combined with other pain relievers like acetaminophen or ibuprofen in order to enhance its pain-relieving effects. These combination products are available in tablet or capsule form and are usually taken every 4 to 6 hours as needed.

Liquid hydrocodone solutions are also available and may be prescribed for individuals who have difficulty swallowing tablets or capsules. These solutions are usually measured using a special dosing cup or spoon to ensure accurate dosing.

It is important for patients to follow the dosage and administration instructions provided by their healthcare provider when taking hydrocodone. Taking too much hydrocodone or taking it more frequently than prescribed can lead to serious side effects, including respiratory depression, addiction and overdose.

Can hydrocodone be addictive?

Yes, hydrocodone can be addictive. It is a potent opioid medication that works by binding to the opioid receptors in the brain and spinal cord to reduce pain perception. This action can also produce feelings of euphoria, relaxation and well-being, which can be pleasurable and reinforcing for some individuals.

Repeated use of hydrocodone can lead to physical dependence, which means that the body adapts to the presence of the drug and experiences withdrawal symptoms when it is discontinued. Common withdrawal symptoms include anxiety, restlessness, insomnia, nausea, vomiting, diarrhoea, sweating and muscle aches.

As well as becoming physically dependent, repeated use of hydrocodone can also lead to psychological dependence. This means that the individual experiences intense cravings and a compulsive need to use the drug, despite any negative consequences of taking it. This can lead to addiction, which is a chronic, relapsing brain disease characterised by compulsive drug-seeking behaviour and continued use despite harmful consequences.

To minimise the risk of addiction, hydrocodone should only be used under the supervision of a licensed healthcare provider and for the shortest duration possible to manage pain. If a patient has a history of substance abuse or addiction, they should inform their doctor before they take hydrocodone. The doctor can then evaluate a person’s medical history and other factors to determine the safest and most effective pain management strategy for them.

What are the effects of hydrocodone use?

Hydrocodone use can have various effects on the body and mind, both positive and negative.

Here are some of the effects of hydrocodone use:

Positive effects:

• Pain relief: Hydrocodone is primarily used to manage pain, and it can be effective at reducing moderate to severe pain for a range of conditions and problems.
• Euphoria and relaxation: Hydrocodone can produce feelings of euphoria, relaxation and well-being, which can be pleasurable for some individuals. This is, of course, a reason this drug is addictive, and it should never be taken for these positive effects.

Negative effects:

• Drowsiness and sedation: Hydrocodone can cause drowsiness and sedation and can impair cognitive and motor function, making it dangerous to operate machinery or drive a car.
• Nausea and vomiting: Hydrocodone can cause nausea and vomiting, which can be especially problematic for individuals with pre-existing gastrointestinal conditions.
• Respiratory depression: It can slow down breathing, leading to respiratory depression and potentially fatal respiratory arrest in high doses.
• Constipation: Hydrocodone can cause constipation, which can be uncomfortable and require additional treatment.
• Lowered fertility: In males, long-term use of opioids such as hydrocodone can lower testosterone levels and reduce fertility.
• Addiction and withdrawal: Repeated use of hydrocodone can lead to physical and psychological dependence and addiction, and withdrawal symptoms upon discontinuation.

Abuse of hydrocodone, including taking it in higher doses or more frequently than prescribed or crushing, snorting or injecting it, can significantly increase the risk of adverse effects and addiction. It can also lead to serious health consequences, including overdose and death.

Long-term use and its effects

If hydrocodone is used on a long-term basis, it can cause several side effects, including confusion. Over time, individuals taking the drug often develop a tolerance to it, meaning they require higher doses to achieve the same level of pain relief.

Besides a tolerance, long-term use can also cause physical dependence. This means that the body becomes accustomed to the presence of the drug and if it is stopped suddenly, withdrawal symptoms can occur. Finally, long-term use can cause cognitive impairment, including problems with memory, attention and decision-making.

Hydrocodone withdrawal symptoms

If someone takes this drug for a long time, they may experience withdrawal symptoms when they stop taking the medication.

 Possible symptoms include:

• Anxiety.
• Agitation.
• Insomnia.
• Restlessness.
• Sweating.
• Dilated pupils.
• Runny nose and watery eyes.
• Muscle aches and pains.
• Nausea, vomiting and diarrhoea.
• Abdominal cramps.
• Increased heart rate and blood pressure.
• Depression.
• Goosebumps.
• Tremors.
• Yawning.

Withdrawal symptoms can last for a few days to a few weeks, depending on the person and the severity of their hydrocodone dependence.

Final thoughts

In conclusion, hydrocodone is a powerful medication that’s useful for managing moderate and severe pain. However, users can also become dependent and even addicted to the drug and so it is important that it is prescribed carefully and used only as directed for the shortest duration possible.