Vicodin is a prescription painkiller and the brand name of a combination of the opioid hydrocodone and acetaminophen, an over-the-counter medication used to treat mild pain and fever. Vicodin is a powerful drug whose potency is equal to that of morphine, a prescription opioid that is rarely ever used outside of a strict hospital setting.
According to the U.S. Centers for Disease Control and Prevention (CDC), about 46 people fatally overdose on prescription opioids like Vicodin every day in the United States, and the medication has played a significant role in the ongoing opioid crisis.
Despite this, because Vicodin is a prescription medication, it is seen as safer than other illicit opioids like heroin, causing people to underestimate just how easily misuse can progress to dependence and then addiction, along with a high risk of overdose.
Vicodin’s combination of opioid and acetaminophen also creates an additional risk of severe, permanent liver damage as a result of acetaminophen poisoning.
The human body naturally produces opioids, which are used to help regulate feelings of pain and stress by inhibiting the nerve signals carrying these feelings throughout the central nervous system, blocking them off from the brain.
Vicodin, like other opioids, works by mimicking the body’s naturally created opioids and entering the brain to bind with what are known as opioid receptors. When Vicodin binds with the opioid receptors, it activates them, stimulating them into overproduction to flood the nervous system with opioids, creating much stronger blocks around the brainstem and spinal cord for significant pain relief, as well as strong feelings of sedation and relaxation.
Vicodin also causes a spike in the levels of a neurotransmitter called dopamine.
Dopamine works in the limbic system and controls things like mood, emotion, cognition, and how we process feelings of pleasure. The increase in dopamine is what causes the euphoric “high” associated with opioid abuse.
Many people will start off misusing Vicodin for its effects as a painkiller, but it’s the dopamine boost that kick-starts the cycle of addiction, rewiring the brain to associate the use of Vicodin with the reward of dopamine.
When it comes to recognizing the behaviors associated with substance abuse, hindsight is 20/20. It may seem obvious in retrospect, but if you’re not looking signs of Vicodin abuse, they can be difficult to spot until it has progressed to full-blown addiction, especially if the person abusing it has a Vicodin prescription.
However, noticeable side effects manifest during the course of regular Vicodin abuse, largely because of the often extreme physical effects that come from abusing acetaminophen. Common effects associated with the long-term abuse of Vicodin include:
The turning point at which Vicodin abuse becomes an addiction is when someone has developed a psychological and physical dependence on Vicodin to the point where they cannot control their usage. Compulsively seeking out and using Vicodin becomes the driving force behind the majority of their decisions, prioritizing the drug over responsibilities, relationships, and nearly everything else in their life.
The transition to addiction can sometimes be subtle even to the point where even the person who is becoming increasingly dependent on Vicodin may not realize what is happening. However, when someone’s substance abuse escalates to addiction, they will typically begin exhibiting behavior consistent with a developing substance use disorder.
The behavioral signs of Vicodin addiction include:
If you recognize these signs in your own behavior or have observed them in someone you care about, don’t wait to take action. Now is the time to get help from professional addiction treatment to prevent further mental and physical damage and to avoid overdose.
Medical detox should generally always be the first step in any addiction treatment, but it is especially important in the case of Vicodin addiction. Detox is meant to remove Vicodin from someone’s system and clear out the acetaminophen before it can cause any more damage to the liver is critical.
While opioid detox is on the milder end of the withdrawal spectrum, it should still never be attempted without the supervision of an experienced team of medical detox professionals to avoid potential complications or a mid-detox relapse.
Once the detox process has been completed and the withdrawal period has passed, the next phase of Vicodin addiction treatment is ongoing care in addiction rehabilitation program. This is necessary to address not only the physical aspects of addiction but the underlying psychological issues at the root of it as well.
Addiction recovery can be done on an inpatient or outpatient basis, depending on factors unique to each person, including the substance of abuse, the severity of addiction, the person’s general health, and if they have a history of addiction and relapse.
During treatment, people are given the resources, guidance, and skills necessary to help them heal and learn to better manage their addictive behaviors with positive coping strategies and tools so that they can maintain long-term sobriety.
There are different therapies and treatments available, and each person’s treatment plan will be customized to what will best fit their individual needs. Some standard treatment types include behavioral therapy, medication-assisted treatment, stress management, addiction education classes, dual diagnosis treatment, and more.
Vicodin carries the same risk as other opioids, prescription or otherwise, including overdose and organ failure as a result of a lack of oxygen in the body. The inclusion of acetaminophen, however, adds a secondary dimension of danger.
People who abuse Vicodin are, in fact, abusing two separate drugs in tandem: hydrocodone and acetaminophen, and while it may be surprising, you’re more likely to overdose on the acetaminophen in Vicodin rather than the opioids. You only need a fairly small amount of acetaminophen in your body for it reach toxic levels and trigger an overdose.
Along with these typical signs associated with opioid overdoses:
Someone overdosing on Vicodin also will exhibit symptoms of acetaminophen poisoning, such as:
If someone is showing signs of a Vicodin overdose, it is vital that they get emergency medical attention as soon as possible to avoid a fatal overdose as well as permanent brain and organ damage.
While a Vicodin overdose is usually treated with the opioid overdose reversal drug Narcan (naloxone), it will not an affect an acetaminophen overdose.
In 2016, more than 40% of opioid overdose deaths in the U.S. involved prescription opioids like Vicodin.
U.S. Centers for Disease Control and Prevention. (2017, August 01). Prescription Opioid Overdose Data. Retrieved from from https://www.cdc.gov/drugoverdose/data/overdose.html
National Institute on Drug Abuse. (2018, June 07). Prescription Opioids. Retrieved from from https://www.drugabuse.gov/publications/drugfacts/prescription-opioids
National Institute on Drug Abuse. (2018, March 06). Opioid Overdose Crisis. Retrieved from from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis#seven