Withdrawal symptoms for hydrocodone parallel those for other opioids (an opioid is a derivative of opium). Exactly which symptoms appear are related to the extent of the addiction, the ‘depth’, the duration of use, and how quickly the drug is removed. Some symptoms can be reduced or eliminated if the established dose is decreased slowly, over several days to weeks.
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Withdrawal symptoms
Within 12 to 24 of the start of abstinence, withdrawal symptoms will appear. Generally symptoms peak after 2 – 3 days and then decrease.
The order is variable. For instance, diarrhea may depend on what someone has eaten recently. Symptoms can be lessened to a large degree if the drug is tapered off instead of stopped completely. The usual method (for those who have become dependent under medical care) is to reduce the daily dosage by 25% every two days. This works for hydrocodone taken orally (as opposed to injectable heroin, for instance) because the drug has a longer half-life and milder side-effects when it is discontinued.
Physical symptoms
- Flu-like symptoms
- Commonly, addicts will describe hydrocodone withdrawal as similar to a bad bout of the flu. Some add, because of the muscle aches and pains, “Like the flu if you got beat up the night before…”
- Excessive yawning
- One of the hallmarks of opioid withdrawal, it is a spontaneous event not associated with being tired or boredom.
- Sweating and/or chills
- This reflects trouble with temperature regulation in the body when the drug is removed.
- Runny nose and watery eyes
- A reaction of the autonomic nervous system.
- Diarrhea or loose stools
- More common than nausea (which may occur) it is made worse by drinking coffee or caffeinated beverages.
- Loss of appetite/stomach cramps
- Food may taste bland and unappealing, or this may be a reaction to nausea and diarrhea.
- Muscle aches or pains
- Although even otherwise healthy people experience this, those that were taking the drug some actual medical, pain related condition are likely to see the condition temporarily worsen. Back pain is common.
Physical symptoms will largely disappear after a week.
Psychological symptoms
- Anxiety and irritability
- Either about whether or not quitting will be successful or a reflection of craving when withdrawal is unintended.
- Depression
- Sometimes from a realization of how hard it will be to ‘shake’ the drug, but also due to the fatigue and the ‘feeling sick’ that comes with the physical symptoms.
- Insomnia and sleep disturbances
- Inability to sleep deeply or get restful sleep. Partly physical, partly mental.
- Cravings
- Feelings of craving and an inability to think of other things besides the drug and the withdrawal process. This presents as a lack of concentration and loss of focus. This can add to anxiety about how life will be without the drug.
While most acute psychological symptoms will parallel the physical symptoms, a long-term desire to return to use extends withdrawal over months, years, or even a lifetime. Recovering addicts will describe happening upon some trigger – a situation that is otherwise insignificant – that brings cravings back and reawakens drug seeking behaviors. This chronic psychological ‘withdrawal’ makes identification of underlying problems important. The reasons drug use started in the first place cannot be ignored without danger of the cycle repeating.
photo by Paul Bodea
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