Treatment for Hydrocodone Withdrawal

Withdrawal from hydrocodone is a type of opioid withdrawal, meaning it can be alleviated with Medication for Addiction Treatment (MAT). With medications like Suboxone, hydrocodone withdrawal can be managed, so you don’t experience intense withdrawal symptoms or cravings for the drug. 

Symptoms of hydrocodone withdrawal include anxiety, restlessness, aches, nausea, and other unpleasant side effects. Although it is usually not life-threatening, it can lead to relapse, which can be life-threatening.

Medications may also be used to treat elements of hydrocodone withdrawal less directly, such as medications to help with nausea or sleep issues.

What Is Hydrocodone?

Hydrocodone is a powerful opioid medication used to relieve pain.[1] It’s a semi-synthetic opioid, meaning it is synthesized using compounds that are processed from the opium poppy. 

Hydrocodone is a Schedule II controlled substance in the United States. This classification is used for substances that have significant potential for misuse and dependence but still serve accepted, legitimate medical purposes.

As a powerful painkiller, hydrocodone can help with moderate to severe pain.[2] It is ideally prescribed in the short term for pain from serious injury or surgery, but it is sometimes used long term for more chronic conditions when non-opioid painkillers won’t provide needed relief. Hydrocodone comes in many forms, and it is often combined with acetaminophen or ibuprofen.[3]

Hydrocodone Addiction Treatment

Hydrocodone addiction can be a difficult and challenging condition to manage, but with the right treatment, recovery from opioid use disorder (OUD) is possible. There are several effective approaches to treating hydrocodone addiction, including MAT, behavioral therapies, and other forms of support.

MAT is considered the gold standard in treating opioid use disorder, including hydrocodone addiction.[4] Drugs such as methadone or buprenorphine are used to reduce a person’s opioid cravings while also allowing them to stop using more potent opioids without experiencing significant withdrawal symptoms. Suboxone, a combination of buprenorphine and naloxone, is often the preferred medication used for MAT.

MAT is often combined with therapy, with one of the most common types being cognitive behavioral therapy (CBT).[5] CBT helps a person identify what drives them to misuse drugs, such as the triggering thoughts or events that may lead to intense drug cravings. They then learn how to avoid engaging in drug misuse and how to channel potentially dangerous thoughts and feelings in healthier ways.

Support groups, such as Narcotics Anonymous (NA) and other peer support programs, can be an important part of hydrocodone addiction treatment.[6] These groups provide group support and a sense of community for people in recovery. These meetings are often a critical part of people developing the skills and confidence they need to stay sober over the long term.

How Long Does Hydrocodone Withdrawal Last?

The duration of hydrocodone withdrawal can vary from person to person, depending on several factors such as the length of use, the dose of the medication, and individual differences in metabolism.[7] Generally, hydrocodone withdrawal symptoms will start to appear within 6 to 12 hours of the last dose and peak between 72 and 96 hours.

The initial symptoms of hydrocodone withdrawal include the following:

• Restlessness
• Anxiety
• Insomnia
• Sweating
• Muscle aches

As withdrawal progresses, symptoms can intensify, and individuals may experience the following:

• Gastrointestinal issues, including nausea, vomiting, and diarrhea. 
• Dilated pupils
• Elevated heart rate
• High blood pressure
• Respiratory depression

The acute phase of hydrocodone withdrawal usually lasts 7 to 10 days, during which time symptoms will gradually improve. However, some individuals may experience post-acute withdrawal syndrome (PAWS), which can last for several weeks to months after stopping hydrocodone.[8] PAWS may include persistent anxiety, depression, irritability, and insomnia.

The length of hydrocodone withdrawal is influenced by several factors like average dose, length of consumption, the method used to take the drug, and individual disparities in metabolism. In addition, people with prior drug dependence, psychiatric problems, or other medical concerns might experience issues that complicate the average withdrawal experience. This is part of why talking to medical professionals when you want to quit using opioids of any kind is so important.

Next Steps

While MAT is the core of hydrocodone withdrawal treatment, your care provider may prescribe short-term medications to alleviate some uncomfortable symptoms. These treatments may include clonidine or tizanidine to reduce hyper-stimulation associated with withdrawal, hydroxyzine to relieve anxiety and insomnia, ondansetron to alleviate nausea and vomiting, loperamide to relieve diarrhea, and acetaminophen, ibuprofen, or naproxen for muscle and joint soreness.[9,10]

Once you begin taking buprenorphine/naloxone (Suboxone), you will experience lasting relief from hydrocodone withdrawal symptoms without the need for additional medications. 

Your provider will direct you to take anywhere from 2 to 12 mg of buprenorphine on the first day. While you will experience relief from withdrawal on the first day, it may take until the second day to reach an effective stable dose. By day two or three, you and your provider will determine the most effective dose for you. The goal is to help you feel well without withdrawal or opioid-related sedation, allowing you to return to your normal self without severe cravings for opioids.