Hydrocodone Misuse and Addiction: How It Happens and How to Get Help

How Does Hydrocodone Lead to Addiction?

“As with most opiates,” says the DEA, “abuse of hydrocodone is associated with tolerance, dependence, and addiction.”⁶

When you take hydrocodone, it binds to opioid receptors in your brain. This not only reduces pain but also releases dopamine, which creates feelings of pleasure and relaxation. Over time, your brain and body adapt to its constant presence. Here’s how that can lead to addiction:

• Tolerance: You need more hydrocodone to feel the same effects.
• Dependence: You feel “off” without it, and may experience withdrawal symptoms.
• Cravings: You feel a strong urge to keep taking hydrocodone even if it’s causing problems in your life.

Addiction isn’t about weakness or lack of willpower—it’s a complex condition that causes changes in the brain. Being aware of addiction and other risks can help you approach hydrocodone use with more safety and caution.

Risks and Dangers of Hydrocodone Misuse

While hydrocodone can be a helpful short-term strategy for managing acute pain, it also carries risks. These risks increase even more if you mix it with other substances, take more than you’re prescribed, or use it without a prescription.

Overdose Risks

Taking too much hydrocodone can slow your breathing and heart rate, which can be life-threatening. Most fatal opioid overdoses are caused by respiratory depression. Combining hydrocodone with alcohol or sedatives heightens this risk.

If you’re concerned about hydrocodone overdose,⁷ watch for these signs: 

• Slow or shallow breathing
• Extreme drowsiness
• Cold or clammy skin
• Slow heartbeat 

If you believe someone is overdosing, administer naloxone and call 911 immediately. Call SAMHSA’s National Helpline at 1-800-662-HELP (4357) for 24/7 support and more information about accessing naloxone.

Impact on Daily Life

Hydrocodone misuse can affect your work, relationships, and overall quality of life as it becomes harder to manage daily responsibilities. You might find yourself withdrawing from relationships, missing important commitments, or struggling to accomplish tasks that once felt easy. While many people start misusing hydrocodone to self-soothe emotional challenges, the reality is that it compounds these struggles. Meanwhile, the guilt, shame, and frustration that come along with addiction can make it feel even harder to reach out for help.

Physical Health Effects

Long-term effects of hydrocodone use⁸ include: 

• “Liver problems
• Hearing loss
• Nausea
• Headaches
• Chronic constipation”

Because hydrocodone products often contain acetaminophen, long-term use is especially dangerous for the liver. The National Institutes of Health (NIH) explains: 

When combined with acetaminophen, hydrocodone combinations have become a common cause of acetaminophen acute liver injury.⁹ The typical history is of a patient who began taking more than the prescribed number of pills over several days, attempting to achieve more of an opiate effect and leading secondarily and unintentionally to an overdose of acetaminophen. 

Opioid combinations that contained over 325 mg were discontinued because of this high risk for liver damage.

Mental Health Effects

Misusing prescription painkillers like hydrocodone doesn’t just affect your body—it changes the way your brain works, which can seriously affect your mental health. If you take hydrocodone for a prolonged period, your brain may start to rely on it to feel okay, disrupting your natural ability to regulate your mood and emotions.

This can make you feel anxious, irritable, or depressed when the drug leaves your system. For people already living with mental health conditions, hydrocodone misuse can make symptoms worse by intensifying mood swings or increasing instability. Regularly dealing with overpowering cravings can add stress to your life and make it harder to focus on managing your mental health.

Dependence and Addiction

Using hydrocodone regularly, even as prescribed, can lead to dependence. Misusing it—for example, taking higher doses or mixing it with other substances—increases the likelihood of addiction. The NIH warns,

Hydrocodone combination products may be habit forming.¹⁰ Take your hydrocodone combination product exactly as directed. Do not take more of it, take it more often, or take it in a different way than directed by your doctor. While taking hydrocodone combination products, discuss with your healthcare provider your pain treatment goals, length of treatment, and other ways to manage your pain.

To reduce the risk of addiction, you should always take hydrocodone (or any other prescription opioid) under medical supervision.

Signs and Symptoms of Hydrocodone Addiction

Recognizing the signs of addiction can help you or someone you care about take action. Here are some common indicators:

Behavioral Signs

• Spending a lot of time thinking about or obtaining hydrocodone
• Visiting multiple doctors to get prescriptions (“doctor shopping”)
• Pulling away from friends and family or neglecting your responsibilities
• Using someone else’s medication

Physical Symptoms

• Often feeling sleepy, drowsy, or fatigued 
• Pinpoint pupils (small, constricted pupils)
• Nausea, vomiting, or constipation that doesn’t seem to go away
• Slurred speech
• Dizziness or lightheadedness
• Difficulty concentrating

Emotional and Psychological Signs

• Mood swings or irritability
• Feeling anxious, restless, or down when you don’t have hydrocodone
• Guilt or shame about your use but feeling unable to stop

Risk Factors 

Certain factors can make you more likely to form a hydrocodone addiction.¹⁰ According to the NIH, you might be more susceptible if “anyone in your family drinks or has ever drunk large amounts of alcohol, uses or has ever used street drugs, or has overused prescription medications, or has had an overdose, or if you have or have ever had depression or another mental illness.” 

Treatments for Hydrocodone Addiction

There’s no one-size-fits-all approach to treatment—what works best depends on your unique situation. Here are some common treatment options:

1. Medication-Assisted Treatment (MAT)

MAT uses medications like buprenorphine or methadone to ease withdrawal symptoms and cravings. These medications can help you stabilize while you work on your recovery.

2. Behavioral Therapy

Therapies like cognitive behavioral therapy (CBT), contingency management, and motivational interviewing can help you work through the patterns and triggers behind your use and develop healthier strategies for dealing with challenges.

3. Inpatient and Outpatient Programs

• Inpatient programs provide a safe, structured environment where you can focus on recovery full-time.
• Outpatient programs offer flexibility, allowing you to attend therapy while living at home and continuing to be involved in your day-to-day responsibilities.

4. Support Groups

Groups like Narcotics Anonymous (NA) and SMART Recovery connect you with others who understand what you’re going through. Peer support can be incredibly powerful.

5. Holistic Approaches

Rehabs often use yoga, meditation, and other holistic therapies to complement core treatments. These work on different parts of the brain than talk therapy, helping you manage stress and reconnect with yourself as you journey through the stages of recovery.

Find an Opioid Drug Treatment Center

Recovery is a journey, not a quick fix. What’s important is finding a path that feels right for you.

If you’re ready to stop using hydrocodone but struggling to do so on your own, there are resources available to help. As with all opioids, it’s important to detox from hydrocodone under medical supervision to make the withdrawal process as safe and comfortable as possible. After detox, a comprehensive addiction treatment program can help you address the root causes of your addiction and start making lifestyle changes that empower you to live hydrocodone-free for good.

Explore your opioid addiction treatment options and find the support that works for you.