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Vicodin Withdrawal: Timeline, Symptoms, and Detox

The most common reason Americans access the health care system is pain. It impacts more Americans than diabetes, heart disease, and cancer combined, and it’s the most common cause of long-term disability. In 2019, the projected revenue in the U.S. for prescription painkillers is $5.36 billion, according to Statista Market Forecast.

This quest for pain relief has largely driven the ongoing opioid epidemic, which is considered the worst drug crisis in U.S. history. However, that quest can lead users to decline into dependency and addiction. Vicodin is one of the most widely prescribed medications in the U.S., and it has helped fuel this scourge. The drug consists of hydrocodone (a powerful opioid) and acetaminophen (a pain reliever).

This opioid has long been an abused drug, as it’s capable of producing profound euphoria. But its unique formulation of hydrocodone and acetaminophen means that each ingredient can produce its own negative effects. 

When Vicodin is overused or recreationally used, it can quickly create tolerance that can descend into addiction, even when taken as prescribed. In addition, prolonged use can lead to severe liver damage.  Particularly when taken with alcohol and narcotics, Vicodin abuse can cause permanent bodily damage and even death.

What Is Vicodin?

The first medical use of acetaminophen occurred in 1893. Almost 30 years later, a German pharmaceutical company named Knoll synthesized hydrocodone. Then, in 1978, Knoll introduced Vicodin to the U.S., and a generic version of the drug hit the market five years later. Norco and Lortab are other well-known drugs with the same ingredients.

 Vicodin is available as a tablet, capsule, or liquid. In terms of potency, it rivals morphine. Vicodin works by reducing the experience of pain and producing feelings of pleasure. Hydrocodone produces the latter effect, which causes users to become addicted. Furthermore, long-term acetaminophen abuse can cause liver damage.

What Is Physical Dependence?

When the Drug Enforcement Administration (DEA) reclassified Vicodin from Schedule III to Schedule II under the Controlled Substances Act, it served as a testament to the drug’s potential for harm and abuse. The DEA essentially recognized Vicodin’s ability to inflict physical and psychological dependence. This reclassification also served as an assent to the drug’s dangerous effects. 

In addition, a U.S. Food and Drug Administration (FDA) advisory panel suggested that the regulatory body ban medications like Vicodin because the use of it increases the risk of overdose and acute liver injury. As a result, the FDA requested that pharmaceutical companies limit the amount of acetaminophen in their products.

Unfortunately, such efforts haven’t deterred the abuse of Vicodin. When a user exceeds the prescribed dosage, they can quickly develop a mental and physical dependence, which is especially true if it’s abused for recreational purposes.

The National Institute on Drug Abuse (NIDA) defines dependence as a state when the body only functions normally when the drug is present. When a person stops using the drug, they almost immediately experience withdrawal symptoms. This withdrawal can quickly morph into addiction, as users will start compulsively seeking the drug and using it despite adverse consequences. Vicodin is particularly pernicious because it can rewire the brain after repeated use, which profoundly impacts its reward pathways.

Withdrawal Timelines and Symptoms

A standard dose of Vicodin can provide up to eight hours of pain relief. The acetaminophen in Vicodin has a half-life of up to three hours, depending on the health of an individual’s liver.

Most of the drug leaves the body within 24 hours, although traces of it can remain in the body for far longer. For example, a hair follicle test can reveal Vicodin use up to 90 days afterward.   When the drug eventually leaves the body, users can start experiencing withdrawal symptoms.

Vicodin Withdrawal Timeline

For most users, the acute symptoms of Vicodin withdrawal can last up to ten days. The first few days tend to produce the most severe symptoms, which include physical and psychological effects. However, many people feel better within two weeks of the last use.

Still, the length of withdrawal varies greatly. Some users can even develop post-acute withdrawal syndrome (PAWS).

Generally, the withdrawal symptoms associated with Vicodin use include:

  •     Anxiety
  •     Confusion
  •     Constipation
  •     Abnormal happiness or sadness
  •     Drowsiness
  •     Lightheadedness
  •     Difficulty urinating
  •     Rash
  •     Itching
  •     Pinpoint pupils

Treatment for Vicodin Withdrawal

Opioid withdrawal tends to produce flu-like symptoms. While it’s rare for opioid withdrawal to be fatal, the symptoms can be painful and uncomfortable, enough to compel someone to reuse. This impact is especially true if a person has engaged in long-term opioid abuse, as this type of drug use produces intense withdrawal symptoms.

However, a professional treatment program can safely and comfortably address the worst of those withdrawal symptoms. If your Vicodin dependence has caused you to experience intense symptoms, a professional treatment program can effectively alleviate those effects while equipping you with the tools to remain sober.

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A professional program begins with medical detoxification. In this program, Vicodin and other toxins are safely and comfortably removed from your body. Patients are usually given medications such as Suboxone or Subutex to block withdrawal symptoms. This process typically lasts up to seven days.

In this phase, medical care will be administered round-the-clock, and you will be monitored for any potentially dangerous medical issues. Due to the risks involved with opioid addiction, the medical staff will slowly and comfortably wean you off it, in order to alleviate your worst symptoms. Residential treatment is one of the most critical stages in the continuum of care. It will give you access to an array of evidence-based therapies that are tailored to treat the root causes of Vicodin abuse.

Here are the most commonly used therapy models:

  •     You’ll receive personalized treatment to address the emotional issues that contribute to addiction.
  •     In cognitive behavioral therapy (CBT), treatment addresses the negative thoughts and actions associated with addiction. In this stage, you’ll learn practical strategies and skills to combat old habits.
  •     Through dialectical behavioral therapy, you’ll learn about the triggers that lead to substance abuse.
  •     In motivational interviewing, you’ll identify key issues, learn how to think positively, and embrace changes that can improve your life.
  •     You’ll learn how to incorporate meditation and mindfulness into your daily life.
  •     Since addiction is often described as a family disease, family therapy will help you heal some of those wounds.
  •     To ensure your post-treatment success, you’ll go through aftercare planning, which helps to prevent relapse.

In addition, residential treatment can ultimately determine whether your recovery will be successful. Research indicates that the longer you stay in residential care, the more likely you’ll be to have long-term sobriety.

Outpatient treatment is the stage after residential. It will provide additional recovery services to help address any concerns about Vicodin abuse. It’s less intensive than residential, but it possesses many of the same evidence-based therapies that have consistently treated substance abuse issues.

Naloxone/Narcan

Naloxone, also known as Narcan, has seen its role over the years grow amid the opioid crisis. Many states have passed laws that allow emergency room doctors and first responders to administer Narcan to those going through an opioid overdose. Prescription painkiller abuse has declined over the years, but it still exists and leads to overdoses. 

Narcan stops the brain, for a short time, from soaking up opioids and binding to the receptors faster than the drug the person consumed. Narcan is a temporary solution that stops the symptoms of an overdose for a period that allows the person to get to a hospital. 

In some cases, Narcan will not prevent an overdose because the medicine will exit the body faster than opioids do. If a person overdoses on Vicodin, Narcan will be administered to stop the overdose while the person is rushed to a hospital.

Narcan is not used in a clinical setting to address symptoms of withdrawal. Narcan, however, has been considered because it does not show any side effects and is not addictive. 

Sources

Statista Market Forecast. (n.d.). Analgesics: United States. Retrieved from https://www.statista.com/outlook/18010000/109/analgesics/united-states

Fogoros, R. N. (n.d.). Is Withdrawing from Vicodin Dangerous for You? Retrieved from https://www.verywellmind.com/vicodin-withdrawal-symptoms-67822

Fogoros, R. N. (n.d.). How Long Does Vicodin Remain in Your System? Retrieved from https://www.verywellmind.com/how-long-does-vicodin-stay-in-your-system-80346

MedlinePlus Drug Information. (n.d.). Hydrocodone Combination Products. Retrieved from https://medlineplus.gov/druginfo/meds/a601006.html

National Institutes of Health (n.d.). Fact Sheets: Pain Management. Retrieved from https://uspainfoundation.org/wp-content/uploads/2018/09/Chronic-pain-facts-infographic.pdf

Mental Health Daily. (2014, August 04). Vicodin Withdrawal Symptoms Duration. Retrieved from https://mentalhealthdaily.com/2014/08/04/vicodin-withdrawal-symptoms-duration/

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