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Hydrocodone Addiction Treatment

In its chronic form, pain negatively affects mood, health and quality of life. More than one-third of Americans live with chronic or recurrent pain and a significant percentage do not receive pain relief due to the intolerable adverse side effects of drugs, development of tolerance or individualized variables leading to inefficacy of pharmacological treatments.1

An opiate drug, hydrocodone is in the same family as morphine and oxycodone. There are several variants available in the U.S., some of which also contain acetaminophen. Zohydro ER and Hysingla ER are extended-release hydrocodone used for 24/7 treatment of severe pain. Like many other opioid substances, hydrocodone has a high potential for physical dependency and addiction if it is abused. It is prescribed for the management of pain not well-controlled by nonsteroidal anti-inflammatory or other non-narcotic analgesic options. The number of prescriptions for opioids (like hydrocodone and oxycodone products) has escalated from around 76 million in 1991 to nearly 207 million in 2013, with the U.S. responsible for nearly 100% of the world consumption of hydrocodone. The recent introduction of extended-release formulations of hydrocodone has fueled controversy about the general safety and need for opioid medications in light of their potential for misuse, abuse, diversion and addiction.1,2

Although opioid dependence is not synonymous with the highly dysfunctional, uncontrolled pattern of substance intake characterizing addiction to other drugs, it can be highly deadly. People addicted to hydrocodone can experience acute withdrawal symptoms. For severe opioid addiction, professionally supervised detox is typically required to gradually and safely rid the body of residual drugs. Medications used to ease withdrawal include buprenorphine, naltrexone and a combination of both called Suboxone. After detox, a range of behavioral therapies help individuals regain control of their lives while incorporating less addictive pain management solutions.3

Hydrocodone Addiction and Abuse

All opioid-based drugs and medications have the ability to produce changes in human brain chemistry. This may result in physical dependence and addiction, especially in individuals who receive no medical oversight from a prescribing physician.2 Potential signs of hydrocodone addiction include:

  • Depending on the drug to function
  • Thinking about hydrocodone numerous times throughout the day
  • Hydrocodone use affects other areas of one’s life
  • A life without hydrocodone is inconceivable

Stats and Facts

  • Healthcare providers wrote nearly a quarter of a billion opioid prescriptions in 2013, enough for every American adult to have their own bottle of pills.4
  • In Alabama, the highest-prescribing state, the number of opioid prescriptions was almost three times as many per person as those in the lowest-prescribing state, Hawaii.4
  • The most common drugs involved in prescription opioid overdose deaths include methadone, oxycodone and hydrocodone.4
  • In 2015, an estimated 276,000 adolescents ages 12 to 17, 829,000 young adults ages 18 to 25 and 2.7 million adults 26 and older misused prescription pain relievers of any kind in the past month.5
  • In 2015, 22,598 overdose deaths were attributed to prescription opioid pain relievers.6
  • Prescription opioid analgesics containing hydrocodone and oxycodone are the most common types of controlled prescriptions drugs diverted and abused.7
  • From 2007 to 2009, data from RADARS poison control centers showed hydrocodone was involved in more intentional exposures by adolescents than any other prescription opioid.8
  • A retrospective review of fatal opioid prescription overdoses revealed 83% were unintentional or accidental. Total prescription opioid overdoses increased from 8,815 hospitalizations in 1999 to 180,106 hospitalizations in 2009.8

Relapse Prevention

Even after successful treatment, few opioid users are able to maintain continuous abstinence during the first year of recovery. The first two weeks after the end of treatment are associated with the highest incidence of overdose, because tolerance is low and new patterns of healthy behavior have not been established. Low doses of the same medications used in detox have shown some benefit in preventing relapse in individuals after they return home. These include naltrexone including a long-acting injectable formulation called Vivitrol, buprenorphine and Suboxone, a combination of buprenorphine and naltrexone. Another option is a small implant called Probuphine, which is placed under the skin and continuously releases buprenorphine for six months at a time.9

  1. Gould HJ, Paul D. Critical appraisal of extended-release hydrocodone for chronic pain: patient considerations. Ther Clin Risk Manag. 2015;11:1635-1640. doi:10.2147/TCRM.S81979.
  2. America’s Addiction to Opioids: Heroin and Prescription Drug Abuse. National Institute on Drug Abuse website. https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse Published May 14, 2014. Accessed January 16, 2017.
  3. How to Help a Hydrocodone Addict. Drug Abuse website. http://drugabuse.com/library/how-to-help-a-hydrocodone-addict/ Accessed January 16, 2017.
  4. Prescription Opioids. Centers for Disease Control and Prevention website. https://www.cdc.gov/drugoverdose/opioids/prescribed.html Updated March 16, 2016. Accessed January 16, 2017.
  5. 2015 Key Substance Use and Mental Health Indicators report. Substance Abuse and Mental Health Services Administration website. https://www.samhsa.gov/samhsa-data-outcomes-quality/major-data-collections/reports-detailed-tables-2015-NSDUH Updated November 7, 2016. Accessed January 16, 2017.
  6. Overdose Death Rates. National Institute on Drug Abuse website. https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates Updated January 2017. Accessed January 16, 2017.
  7. 2016 National Drug Threat Assessment. United States Drug Enforcement Administration website. https://www.dea.gov/resource-center/2016%20NDTA%20Summary.pdf Published December 6, 2016. Accessed January 19, 2017.
  8. Elzey MJ, Barden SM, Edwards ES. Patient Characteristics and Outcomes in Unintentional, Non-Fatal Prescription Opioid Overdoses: A Systematic Review. Pain Physician. 2016 May;19(4):215-28.
  9. David Sack. How Medication Can Help Prevent Opioid Relapse. Psychology Today. August 12, 2016. https://www.psychologytoday.com/blog/where-science-meets-the-steps/201608/how-medication-can-help-prevent-opioid-relapse Accessed January 16, 2017.
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