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Vicodin (the brand name for hydrocodone) is the most prescribed opioid painkiller in the United States, despite its true addictive nature and high potential for abuse. Vicodin addiction is a serious condition that could be a precursor to a deadly overdose or other medical complications. The good news is that treatment programs for Vicodin dependency have a high rate of success for those who are truly committed to recovery, and the odds are more favorable if treatment begins immediately after a diagnosis has been made.
What Is Vicodin Addiction?
Symptoms and Diagnosis of Vicodin Addiction
Diagnosing Vicodin Addiction
Vicodin Overdose
Vicodin Addiction Causes and Risk Factors
Treatment and Prognosis for Vicodin Addiction
Vicodin is the brand name for the opioid medication hydrocodone, a painkiller generally prescribed as a remedy for the symptoms of moderate to moderately severe pain.
In the late 1990s and early 2000s, Vicodin prescriptions were written in high volume by physicians who considered the drug relatively benign. But Vicodin is not as harmless as first believed: like other opioid pain medications it is can be highly addictive when abused, either by people with prescriptions, those self-medicating for pain, or those who use Vicodin recreationally for its euphoric effects.
To more accurately reflect reality, in 2014 the U.S. Drug Enforcement Agency reclassified hydrocodone as a Schedule II drug, meaning it has high potential for abuse and dependency and should only be prescribed with caution.
Hydrocodone is the most prescribed pharmaceutical medication in the United States. In 2013, 136 million prescriptions for hydrocodone-based painkillers were written by American physicians, with Vicodin comprising the lion's share of these orders.
Since 2013, the number of prescriptions given out for opioid painkillers has declined by about 20 percent, to below 200 million annually. Nevertheless, Vicodin remains the opioid of first choice for physicians treating patients with chronic pain, and this brand name specifically accounts for about 46 percent of all opioid prescriptions written in the United States each year.
Despite attempts to reign in runaway opioid abuse, the United States still consumes about 80 percent of the opioids prescribed on a global basis, including an astonishing 99 percent of all hydrocodone products. This explains why U.S. drug overdose death rates have skyrocketed, to more than 72,000 fatalities annually as of 2017. Prescription opioids are responsible for nearly 70 percent of those deaths, with several thousand dying from the effects of a Vicodin overdose.
In 2017, 11.1 million Americans age 12 and over misused opioid painkillers, a behavior that can easily lead to addiction. An estimated 2.1 million Americans had an actual opioid use disorder, and it is this group that are most at risk for serious personal and health complications if they don't receive treatment for their drug dependency.
Some of the distinctive signs and symptoms of Vicodin abuse and addiction include:
Daytime drowsiness
Slowed breathing patterns
Low heart rate
Muscle aches and cramps
Difficulties urinating
Impairments in memory and reasoning
Lethargy when under the influence of the drug
Anxiety and agitation when not under the influence of the drug
Vicodin addiction generally does not develop when the medication is used exclusively as prescribed. But when self-medicating behavior occurs, and people begin using it without a prescription or in larger quantities than recommended, the risk of dependency is dramatically elevated. People who use it recreationally for its euphoric and relaxing effects are always in danger of developing an addiction, especially if they mix Vicodin with alcohol or other drugs that can amplify its impact.
Liver problems are one possible complication of Vicodin abuse, caused primarily by the acetaminophen that is added to the hydrocodone in this medication. Anyone who shows signs of jaundice or other symptoms suggesting liver malfunctioning should seek medical attention immediately, and substance abuse treatment shortly thereafter.
The development of Vicodin addiction will cause a variety of psychological and behavioral symptoms to manifest. To be diagnosed with Vicodin dependency, a person must meet two or more of these criteria:
Vicodin is consumed for longer or in larger quantities than originally intended.
Attempts to stop using Vicodin, or reduce dosages, are unsuccessful.
Using and obtaining Vicodin, and recovering from its use, involves an enormous investment of time.
Vicodin abuse is implicated in repeated failures to successfully manage work, school, home, or personal responsibilities.
Recurrent social and/or interpersonal problems are linked to Vicodin use, yet consumption of the drug continues.
Valued occupational, recreational, or social activities are abandoned or neglected because of Vicodin abuse.
Physical and mental health problems are caused or exacerbated by Vicodin abuse, but the person continues to take the drug.
Vicodin abuse is linked to reckless, impulsive, or dangerous behaviors.
Physical and psychological cravings precede Vicodin usage.
Growing tolerance for the effects of Vicodin, requiring more consumption to achieve the same effects, is experienced.
Withdrawal symptoms accompany attempts to halt drug use.
If six or more of these symptoms is present, a severe substance use disorder will be diagnosed.
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Approximately 49,000 people lost their lives to opioids in 2017, and that number includes several thousand people who took more hydrocodone than their bodies could handle. Acetaminophen is also toxic at high doses, and that only adds to the risks of a Vicodin overdose.
The signs of a Vicodin overdose include:
Severe drowsiness and unresponsiveness
Mental confusion
Weakness accompanied by dizziness
Bluish lips and fingernails
Dangerously low heart rate
Respiratory distress
Whenever an opioid overdose is suspected, rapid action is required. Emergency responders may be able to reverse the effects of opioid intoxication by administering a drug called Narcan (naloxone) , but this is only possible if they arrive before the overdose progresses too far.
Severe, chronic pain can leave those who have it desperate to find a remedy, and too often people who experience initial relief from painkillers will increase dosages or prolong use on their own, without a doctor's guidance. In other situations, people without a prescription may attempt to self-medicate for pain, if they have access to supplies of narcotic painkillers through friends or family members.
These behaviors, along with the recreational use of a drug clearly not intended for that purpose, are the most immediate causes of Vicodin and opioid addiction. But there are other risk factors that can increase a person's chances of developing a Vicodin addiction.
Family history. Among those who develop opioid dependency, genetic influences account for 60-70 percent of their vulnerability, according to one analysis of multiple medical studies.
Past history of substance use issues. Anyone with a history of addiction must proceed carefully when taking prescription drugs, especially those (like Vicodin) that can cause mind-altering effects.
Mental health disorders. Overall, about half of all people who develop a mental health disorder will also struggle with chemical dependency, which largely reflects a desire to self-medicate when troublesome symptoms make daily functioning difficult.
Exposure to childhood abuse. Up to two-thirds of people in treatment for substance use disorders report experiencing physical, sexual, or emotional abuse, or severe neglect, during childhood.
Withdrawal and Detox
Opioid addiction inevitably produces a range of withdrawal symptoms when opioid use stops. These symptoms are highly stressful and unpleasant and can easily undermine attempts to embrace sobriety.
Withdrawal symptoms caused by the cessation of Vicodin use may include:
Heavy sweating
Anxiety and agitation
Sleep disruptions
Chills and other flu-like symptoms
Powerful cravings for the drug
Fortunately, medically-supervised detox services are available that can ease the difficulties associated with opioid withdrawal. Detox programs at drug and alcohol treatment facilities include round-the-clock care and supervision, with appropriate medical treatment provided by a team of nurses, physicians, addiction specialists, and mental health professionals.
Medications are sometimes administered during detox, including lofexidine, a non-opioid medication that can reduce the severity of opioid detox, and buprenorphine, an opioid that causes less traumatic withdrawal symptoms than prescription painkillers.
The ultimate goal of detox and treatment is to wean patients off of opioids altogether. Consequently, Vicodin and/or buprenorphine dosages will be progressively reduced over a period of weeks or months to facilitate this process.
Most detox programs take from seven-to-10 days to finish, in either an inpatient or outpatient format, although they can be extended if the addiction is severe and medical troubles preclude an immediate transition to treatment.
Many people have mental disorders that precede their Vicodin use, and this helps make them vulnerable to addiction. The list of conditions most often diagnosed in people with Vicodin dependency include:
Other substance use disorders
When such conditions are left untreated, attempts at self-medication are common and may involve prescription painkillers. Vague yet painful physical symptoms often accompany mood and anxiety disorders, leading many people with such conditions to seek out prescriptions for medications like Vicodin.
Inpatient and outpatient treatment programs for Vicodin dependency are comprehensive and multilayered, and specifically designed to meet the needs of each individual patient. Mental health disorders are frequently a factor for those who enter drug and alcohol rehab, and when such conditions are present dual diagnosis plans will be provided that simultaneously treat all symptoms experienced.
Treatment plans for opioid dependency will include a combination of individual, group, and family therapy, with individual therapy forming the core of the long-term recovery regimen. Daily therapy sessions will be offered throughout the duration of a 30-90-day treatment program, and aftercare programs will also provide regular opportunities for healing interactions with addiction specialists, mental health professionals, and peers in recovery who share the person's history of substance abuse.
Medications that can replace opioids, like buprenorphine, may be included in treatment and aftercare, along with a drug called naltrexone, which reduces the risk of relapse by preventing Vicodin from binding with opioid receptors in the brain.
In addition to therapy and medication, life skills and coping skills classes may be included in treatment regimens, along with holistic mind-body healing methods such as meditation, yoga, massage therapy, arts and music therapy, biofeedback, and acupuncture. These complementary treatments promote wellness as both a lifestyle and a mindset, which can work wonders for those who need to change the way they think and behave before they can truly embrace sobriety.
If left unacknowledged and untreated, Vicodin addiction can be a life-threatening condition. Treatment cannot reverse any health or personal damage that may have already been done, but it can give people in recovery a real chance at finding peace and happiness, away from the debilitating influence of drugs and alcohol.
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