Hydrocodone (Vicodin, Norco) Addiction & Rehab Treatment
American society is considered worldwide to be a “pill culture.”
The US has received this reputation due in part to the many advancements made in pharmacology here. However, medications that can be therapeutic, such as hydrocodone, can also become drugs of abuse.
Hydrocodone is a generic opioid pain reliever that is an active ingredient in numerous branded medications, including but limited to Norco, Lortab, Vicodin, and Lorcet—all of which were discontinued in the U.S. market. This narcotic is indicated for the treatment of moderate to severe pain. Hydrocodone is a highly addictive drug. However, individuals who take this drug by prescription as part of a medically supervised pain management plan do not risk addiction if they follow the doctor’s instructions for use.
These statistics reflect the magnitude of the prescription drug and opioid epidemic while also highlighting the interrelatedness of prescription opioids and heroin. Individuals who abuse hydrocodone may easily swap out this drug for another opioid, such oxycodone and, in some cases, even heroin. For this reason, it is a good idea to learn about hydrocodone abuse specifically, but also opioid abuse in general.
Hydrocodone addiction is only one facet of the US prescription painkiller epidemic. There are a variety of opioids on the legitimate and illegal drug market. Some individuals will find hydrocodone to be their primary drug of abuse, even if they are polydrug users. In fact, of all opioid pain relievers, hydrocodone is the most abused. It’s a potentially fast and slippery slope between recreational use of hydrocodone and the development of an opioid use disorder. Individuals who take hydrocodone as part of a pain management treatment plan may develop a physical dependency on hydrocodone, but not progress to addiction.
As the National Institute on Drug Abuse explains, the two main features of physical dependence are tolerance and withdrawal. In short, people who continually abuse hydrocodone will need to take more of this opioid over time in order to experience the desired psychoactive effects, such as a hydrocodone high. After a period of hydrocodone abuse, if a person stops using or significantly reduces the regular level of intake, then withdrawal symptoms will emerge. The following is a sample of some of the possible withdrawal symptoms that may be experienced:
- Mood swings
- Changes to appetite
- Suicidal thoughts
- Flu-like symptoms, such as fever and a runny nose
- Dilated pupils
- Nausea, diarrhea, and vomiting
It is important to understand that hydrocodone, as well as other opioids, can present particularly significant health risks during the withdrawal process. For this reason, there is a general recommendation that individuals who are seeking recovery undergo medical detox or substitution therapy. For instance, during the intake process at a rehab center, when the addiction team members learn that the person has been abusing oxycodone, they may advise that the safest approach is to start the person on narcotic-based medication (substitution therapy). After the recovering individual is safely stabilized on a substitution therapy program, primary addiction treatment will begin.
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Medications for Hydrocodone Abuse
For a public that is unfamiliar with opioid addiction treatment, it may seem illogical that narcotic-based medications are used to treat narcotic abuse. However, at present, this approach is the most effective one available. To illustrate, if a person has been abusing hydrocodone and stops, withdrawal symptoms will typically emerge within 30 -72 hours. Individuals with a history of hydrocodone or other opioid abuse report that at some point they want to continue to take these drugs just so they don’t have to go through withdrawal. It is particularly frustrating to consider that individuals may stay addicted to dangerous opioids because they, understandably, do not want to suffer through withdrawal.
Substitution therapy can effectively intervene here. Since substitution therapy medications are narcotic-based, they can act on the brain in a way similar to opioids without producing a high. At the same time, these medications can stop or reduce withdrawal effects. Substitution therapy is also referred to in addiction literature as medication-assisted treatment (MAT).
Substitution medications can be used during the withdrawal process from hydrocodone, and their use can continue indefinitely. Some individuals take these medications for years. Others will eventually use a substitution therapy medication to achieve a full detoxification (i.e., the body system is entirely opioid-free). The following medications can be used for the treatment of hydrocodone abuse:
- Methadone: Use of this manmade synthetic opiate has become a matter of common knowledge because of its pervasiveness. Provided individuals only take their allotted dosage, methadone will effectively suppress withdrawal symptoms and allow a person to function well in daily life. In this way, methadone can help a person to avoid an opioid relapse as well as give them time to develop the skills necessary to build a drug-free life. Note, in order to receive methadone, a person must visit a clinic every 24-36 hours.
- Buprenorphine: This is a generic drug that is the active ingredient in two branded drugs used in substitution therapy treatment: Subutex and Suboxone. During medical detox, the first phase of addiction treatment, a team of addiction professionals may start a person on Subutex (buprenorphine only) or Suboxone (buprenorphine plus naloxone) directly. A person who starts on Subutex usually does so after two days of being off hydrocodone. Subutex comes only in a sublingual tablet format. Shortly after the person is stabilized on Subutex, the treatment team may now transition the recovering individual to Suboxone.
Suboxone has two formats: sublingual tablet and sublingual film. Like Subutex, Suboxone works in the brain by attaching to opioid receptors while at the same time stopping or reducing withdrawal symptoms, including cravings for opioids. The presence of naloxone in Suboxone means that if a person abuses a narcotic, withdrawal symptoms will emerge. Naloxone, therefore, creates a deterrent effect, discouraging the individual from relapsing.
- Naltrexone: This drug can both reduce withdrawal effects during recovery from hydrocodone as well as block the effects of a narcotic if one is taken.
- Naloxone: This is mainly an emergency response medication. If a person is experiencing an opioid overdose, this drug can reverse the deleterious effects. Many states are expanding public access to this lifesaving drug and working to ensure that emergency medical response teams and police stations have it in stock. Naloxone may also be available to the public at pharmacies in some areas. In this way, anyone who is concerned that an opiate or opioid overdose may occur can obtain naloxone in advance.
As the National Institute on Drug Abuse makes clear in their Principles of Effective Treatment statement, medical detox alone is never enough. Looking at addiction treatment broadly, there are two main pillars of care: medications and therapy. The rest of the architecture of addiction treatment, including complementary therapy, can be seen as supporting beams. The phases of treatment — medical detox to primary addiction treatment to aftercare — are like connecting rooms.
Some rehabs are not equipped to offer medical detox onsite, but a rehab that offers a full continuum of care will be able to do so. To understand the full range of treatments available after hydrocodone detox, it is necessary to look at what goes on during primary care for addiction at a rehab center.
Hydrocodone Treatment & Rehab Options
The following is a sample of the different types of recovery programs available:
- Detox (residential, outpatient, or hospital-based)
- Residential treatment (also called inpatient treatment; may be short-term or long-term)
- Hospital-based residential treatment
- Partial hospitalization (a step below residential treatment but more intensive than outpatient care)
- Outpatient care (intensive or standard)
- Opioid maintenance (a methadone clinic or ongoing visits to a doctor who is qualified to prescribed Suboxone)
- Extended care
A tailored plan does not mean the process is entirely individualized. Rehabs have daily schedules, which everyone follows, but they do still have personalized plans and care.
As Moods Magazine explains, after a person completes a drug treatment program, the recovery process continues. Known as aftercare, this phase can, and may very well, last a lifetime. During primary care treatment for addiction, days of abstinence accumulate, giving recovering individuals time for their bodies to heal and their minds to absorb all the new information, education, and life skills that they are learning. After graduation from a program, it becomes necessary for a person to take even greater control of the recovery process. While there is always professional help and support, recovering people must create and follow their own effective plans of action.
The following are some of the most common types of aftercare for a person who has finished hydrocodone abuse treatment at a rehab center:
- Residence in a sober living home
- Ongoing individual therapy
- Group therapy meetings
- Group recovery meetings (such as Narcotics Anonymous)
- If applicable, regularly (can be daily) going to a methadone clinic
- If applicable, regularly visiting a doctor who is prescribing Suboxone
- Getting regular checkups, including drug tests
- Taking care of any legal, family, or other problems related to prior drug use (Living in healthy circumstances with little stress can help to prevent a relapse.)
The range of services and programs available at rehab centers ensures that there are many opportunities for a person to effectively recover from hydrocodone abuse.
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