Vicodin Uses, Effects, and Risk for Addiction

Author: Hannah Sumpter

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Vicodin has been widely prescribed for moderate to severe pain management since it was first approved for use by the U.S. Food and Drug Administration (FDA) in 1997.¹ Since then, it has been the most commonly prescribed opioid pain reliever on the market.

Vicodin differs from other narcotics with its combination of two medications in one: hydrocodone and acetaminophen, or more commonly called Tylenol.

Vicodin and Other Medications

Vicodin vs. Norco

Vicodin and Norco are similar medications that are often confused for one another. While both contain hydrocodone and acetaminophen, Norco contains higher amounts of acetaminophen. Both are equally effective in pain reduction.

Vicodin vs. Percocet

Vicodin and Percocet are also very similar in their ingredients. The main difference between Vicodin and Percocet is that Percocet contains the opioid oxycodone, while Vicodin contains hydrocodone. Because oxycodone is 1.5 times more potent, Percocet carries a higher potential for abuse and addiction.

Vicodin Side Effects

If your medical professional has recommended Vicodin to treat your pain, there are things you should be aware of and consider before taking the medication. As with all medications, the use of Vicodin comes with side effects.

Possible side effects that usually do not require medical attention include:

• Dizziness and drowsiness
• Nausea and vomiting
• Constipation
• Dry mouth
• Headache
• Trouble sleeping

Possible side effects that should be reported to your medical provider as soon as possible:

• Allergic reaction- skin rash, itching, hives, swelling of the face, lips, tongue or throat. In the case of a severe reaction, call 9-1-1 immediately.
• Central Nervous System Depression – feeling faint, dizziness, confusion. In the case of slow or shallowed breathing, shortness of breath or trouble staying awake, call 9-1-1 immediately.
• Liver injury- right upper abdominal pain, loss of appetite, nausea, light- colored stools, dark yellow or brown urine, yellowing of the eyes or skin and unusual weakness and fatigue
• Low adrenal function- nausea, vomiting, loss of appetite, unusual weakness or fatigue and dizziness
• Low blood pressure- dizziness, feeling faint or lightheaded or blurry vision
• Redness, blistering or peeling of the skin
• Symptoms of or worsening depression
• Myoclonus or muscle spasms

Pain Sensitivity

Another potential side effect of Vicodin use is an increased pain sensitivity, called opioid-induced hyperalgesia (OIH). OIH is a rare phenomenon and most often occurs in those taking opioids at higher doses than prescribed and for long periods.

When OIH occurs, individuals will experience heightened sensations of painful stimuli and a decreased efficiency of the prescribed opioid medication. Unfortunately, no known treatment is available for OIH. If possible, the patient will be prescribed another medication with the hopes of achieving pain reduction.¹⁰

Vicodin and Addiction

The Substance Abuse and Mental Health Services Administration found that in 2024, 4.8 million people aged 12 and older had an opioid use disorder in the past year. During that same period, an estimated 3.4 million people reported misusing hydrocodone-containing products, such as Vicodin.

Vicodin is considered a Schedule II medication by the Federal Drug Enforcement Agency. Receiving a Schedule II classification means that the medication or substance carries a high potential for misuse and addiction. Although Vicodin is extremely useful in reducing pain, it should always be used with extreme caution.

Opioids work by binding to opioid receptors in the body, blocking pain signals and at the same time releasing high amounts of dopamine. Dopamine is often referred to as the brain’s “feel-good neurotransmitter.” When dopamine is released, it causes intense feelings of euphoria and relaxation. When opioids, like Vicodin, are used frequently, the brain starts to adapt to the exposure, leading to tolerance. This begins a cycle of needing to take more frequent and higher doses to get the same level of pain relief or euphoric effect.

Over time, tolerance leads to dependence/addiction. When a person with Vicodin addiction stops using or has a decrease in dosage, they experience physical withdrawal symptoms. In these situations, Vicodin use becomes more about preventing the uncomfortable withdrawal symptoms than pain control.

The most current recommendations state that using the lowest effective dose for pain control and the shortest duration possible is the best way to prevent tolerance and addiction.  Additionally, efforts should be made to ensure continued medical oversight, as years of studies have demonstrated that addiction prevention is far more effective than addiction treatment.³

Call 800-934-1582(Sponsored) to learn more about your options for treatment.

Opioid Use Disorder

Opioid Use Disorder or OUD is a chronic, relapsing disorder characterized by problematic use of opioids that leads to significant impairment or distress.

Signs or symptoms of OUD or Vicodin addiction include:

• Continued use despite negative consequences
• Cravings or strong urges to use opioids
• Taking larger or more frequent doses than intended
• Failure to meet responsibilities at work, school or home
• Spending a lot of time thinking about using, using or obtaining the drug
• Skipping social, recreational or occupational activities because of use
• Physical withdrawal symptoms when not using.

Vicodin Detox and Withdrawal

If you or a loved one is struggling with an addiction to Vicodin, your medical provider can direct you on a safe and effective tapering schedule that helps to minimize uncomfortable withdrawal symptoms. This strategy often includes a gradual decrease in the amount of Vicodin that is used daily until discontinuation is achieved.⁸ 

As well, they can refer you to an addiction treatment program or addiction counselor to help you manage the psychological impact of addiction and work with you to develop healthy coping skills and a relapse prevention plan. Additionally, they may refer you to a pain management specialist who can help you manage your chronic pain while considering your addiction.

Always consult with a medical professional before attempting to quit Vicodin use on your own.

Vicodin Withdrawal Symptoms

Withdrawal from Vicodin can be extremely uncomfortable but is usually not life-threatening. Withdrawal symptoms from Vicodin may include:

• Intense cravings
• Hot flashes, chills, excessive sweating and piloerection or goose bumps on the skin
• Anxiety, restlessness and irritability
• Nausea, vomiting, diarrhea
• Loss of appetite and abdominal pain
• Muscle, bone and joint pain
• Muscle cramps
• Headache
• Yawning
• Watery eyes and sneezing
• Disturbed sleep
• Tremors

Medical and addiction professionals are ready and able to help you through the withdrawal process. One effective treatment for opioid withdrawal is medication-assisted treatment (MAT). These FDA-approved medications include methadone, buprenorphine, lofexidine and naltrexone. They are used to decrease cravings, ease withdrawal symptoms and decrease the likelihood of overdose and relapse and are safe for use during both the withdrawal process and as maintenance therapy.⁸ 

Ongoing Treatment for Vicodin Addiction

The safest and most effective way to combat OUD is through comprehensive treatment that begins with detox and includes a program that offers individual, group and family therapy. Depending on the severity of your Vicodin addiction, there are several levels of care available to meet your unique needs.

Many people who are overcoming OUD receive inadequate treatment because they are uncertain of who to speak with or where to get the care they need. If you or your loved one needs support, please call 800-934-1582(Sponsored) 24/7 to begin your recovery journey today.

References

1. U.S. Food and Drug Administration. (2021). FDA-approved drugs.
2. O’Connell T.F., Carpenter, P.S., Caballero, N., Putnam, A.J., Steere, J.T., Matz, G.J., & Foecking, E.M. (2014). Increased thermal pain sensitivity in animals exposed to chronic high dose Vicodin but not pure hydrocodone. Pain Physician.17(4):353-7. PMID: 25054394.
3. Caldwell, W.K., Freedman, B., Settles, L., Thomas, M.M., Camacho, E.T., & Wirkus, S. (2019). The Vicodin abuse problem: A mathematical approach. J Theor Biol, 12(21).
4. Torres, K. C. (2018). Norco vs. Vicodin: Differences, similarities, and which is better for you.
5. Westphalen, D. (2021, January 29). Vicodin and Percocet: A comparison.
6. Lauterbach, E.C. (1999). Hiccup and apparent myoclonus after hydrocodone: review of the opiate-related hiccup and myoclonus literature. Clin Neuropharmacol, 22(2):87-92.
7. Oh, A. K., Ishlyama, A., & Baloh, R. W. (2020). Deafness associated with abuse of hydrocodone/acetaminophen. Clinical/Scientific Notes, 52(12).
8. Pergolizzi, J. V., Raffa, R. B., & Rosenblatt, M. H. (2020). Opioid withdrawal symptoms, a consequence of chronic opioid use and opioid use disorder: Current understanding and approaches to management. Journal of Clinical Pharmacy and Therapeutics, 45(5), 892–903.
9. Belujon, P., & Grace, A. A. (2017). Dopamine system dysregulation in major depressive disorders. Int J Neuropsychopharmacol, 20(12), 1036–1046.
10. Lee, M., Silverman, S.M., Hansen, H., Patel, V.B., & Manchikanti, L. (2011). A comprehensive review of opioid-induced hyperalgesia. Pain Physician, 14(2):145-61.
11. Goetz, T.G., Becker, J.B., & Mazure, C.M. (2021). Women, opioid use and addiction. FASEB J, 35(2):e21303.
12. Green, T. C., Grimes Serrano, J. M., Licari, A., Budman, S. H., & Butler, S. F. (2009). Women who abuse prescription opioids: Findings from the Addiction Severity Index-Multimedia Version Connect prescription opioid database. Drug and Alcohol Dependence, 103(1-2), 65–73.
13. Caldwell, W. K., Freedman, B., Settles, L., Thomas, M. M., Murillo, A., Camacho, E., & Wirkus, S. (2013). Substance abuse via legally prescribed drugs: The case of Vicodin in the United States. arXiv:1308.3673, 1–47.
14. Forman, R.F., Marlowe, D.B. & McLellan, A.T. (2006). The internet as a source of drugs of abuse. Curr Psychiatry Rep, 8, 377–382.

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