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Hydrocodone Addiction: 4 Signs You May Have a Problem

By Jacqueline Hensler
Medically Reviewed by Yilang Tang, MD, PhD on June 28, 2021
Hydrocodone is a powerful painkiller that can turn into an addiction and lead to abuse of even stronger drugs. Find out how to spot some hydrocodone dependency signs.

Hydrocodone is a prescribed pain reliever similar to codeine and often combined with acetaminophen. It’s sold under the household name Vicodin and poses a potential risk to cause addiction. According to a 2016 report by the American Society of Addiction Medicine, about two million Americans have a substance use disorder involving prescription painkillers. Here are four signs of hydrocodone addiction to look out for. 

Physical and mental dependency occur rapidly.

Hydrocodone is the most commonly prescribed opioid narcotic used for moderate-to-severe pain management. Oftentimes, users will begin their exposure to prescription hydrocodone following a surgery or an injury. Within a short time frame, tolerance to the drug can accumulate. 

“A physical dependency can develop after about five to seven days of use, while a psychological dependency can develop almost immediately,” Michael Damioli, LCSW, CSAT, clinical director at Colorado Medication Assisted Recovery, tells WebMD Connect to Care. 

There are telltale signs of hydrocodone addiction. 

A key sign of hydrocodone use is drowsiness and small “pinpoint” pupils. Often, a user will experience mood swings between periods of intoxication and withdrawal.

According to Damioli, hydrocodone dependency signs can be both physical and psychological. These include: 

  • Insomnia 
  • Anxiety 
  • Sweating 
  • Increased heart rate
  • Preoccupation 
  • Compulsion 
  • “A clear sign of addiction is when someone cannot control or stop their use despite their desire and best efforts to do so,” Damioli says. “You can be at dinner with your family, comfortable and content in your own home, yet all a hydrocodone addict can think about is using.”

Hydrocodone may lead to the use of other drugs.  

It’s not uncommon for hydrocodone users to switch to heroin and fentanyl. According to the National Institute on Drug Abuse, nearly 80% of heroin users reported using prescription opioids previously. “When I speak with habitual opioid users, almost all of them report using hydrocodone as their first experience with narcotics,” Damioli says. 

Hydrocodone and heroin have similar chemical compositions and produce the same feelings of euphoria. “Hydrocodone often leads to heroin or fentanyl abuse since they are more readily available street opiates,” Joelene Knight, CADC-CAS, executive director and co-founder of Grace Recovery, tells WebMD Connect to Care. “Users will ‘doctor shop’ for a while, and then they turn to these more accessible street drugs,” Knight says. 

The effects of withdrawal tend to be immediate.  

The signs of hydrocodone withdrawal depend on the individual, and the intensity of symptoms can vary. Typically, withdrawal symptoms begin 6 to 12 hours after the last dose and remain for a week to a month, according to the American Addiction Centers. Muscle aches, nausea, and insomnia are frequent withdrawal symptoms. It’s an uncomfortable experience and can be challenging to complete without support. “Hydrocodone can be stopped on its own, but it does depend on the intensity of symptoms,” Knight says.

Don’t wait. Get help now.

If you or a loved one are struggling with addiction, WebMD Connect to Care Advisors are standing by to help.


Editor's Note: Many advocates have moved away from the term "abuse" in an effort to destigmatize addiction and conditions related to it. However, those experiencing addiction who are interested in locating treatment may encounter the term occasionally.

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