Hydrocodone Side Effects: Lightheadedness, Constipation, and More

What is Hydrocodone?

Hydrocodone, an semisynthetic opioid medication comes in tablet form—in a variety of doses—to be taken orally.¹ It is often found in combination with acetaminophen or ibuprofen. Although hydrocodone can be beneficial when taken as directed under a physician’s supervision, as a Schedule II narcotic, under the Controlled Substances Act, it has a high potential for misuse, which can lead to addiction.^2,3

Why is Hydrocodone Prescribed?

Hydrocodone is most often prescribed to help individuals suffering from moderate to moderately severe pain.¹

Side Effects of Hydrocodone Use

Even when using hydrocodone as prescribed, side effects can occur. The most frequently reported side effects include:¹

• Lightheadedness.
• Dizziness.
• Sedation.
• Nausea.
• Vomiting.

Adverse Effects of Hydrocodone

Other, less common, adverse effects may include:¹

• Lethargy.
• Mental clouding.
• Anxiety.
• Constipation.
• Irregular breathing, such as feeling short of breath.

Though hydrocodone is generally considered to be safe when taken as directed by a doctor, even taking it as prescribed can lead to tolerance and physiological dependence.^1,3

Tolerance occurs when the body adapts to having the substance present and requires a higher or more frequent dose to feel the same effects that the drug had previously produced.^3,4

Physiological dependence means that with repeated use the body has adapted so it only functions normally when hydrocodone or another opioid is present in the system. Suddenly stopping or drastically reducing use causes physiological reactions. These are the withdrawal symptoms.^3,4

Addiction, on the other hand, is a chronic disease characterized by compulsive or uncontrollable drug seeking and use despite the harmful consequences.³

Anyone who is prescribed opioids runs the risk of misuse, which can increase the chance of overdose and addiction.³

Hydrocodone Misuse

As an opioid, hydrocodone works by interacting with opioid receptors in the central nervous system and blunts pain.³ In addition to the analgesic properties, opioids, including hydrocodone, can cause feelings of extreme pleasure (i.e., euphoria) and relaxation (i.e., sedation)—particularly at higher doses. The euphoric “high” is one of the reasons opioids are often misused.³

Hydrocodone may be misused in a few different ways, including:³

• Taking hydrocodone in a dose or way other than prescribed, such as crushing the tablet and snorting it or dissolving it in water and injecting it.
• Taking someone else’s hydrocodone prescription.
• Taking hydrocodone to get high.

When hydrocodone is misused, it can lead to a substance use disorder, the clinical term for addiction. More specifically, a hydrocodone addiction is an opioid use disorder (OUD).³ An OUD is a chronic, treatable medical condition that involves the compulsive use of hydrocodone (or other opioid) despite the harmful consequences.

Additionally, misusing opioids like hydrocodone can increase the risk of experiencing a potentially life-threatening overdose. An opioid overdose can result in harmful respiratory effects, such as slowed or stopped breathing, which can cause hypoxia, a condition that results from a lack of oxygen to the brain. Hypoxia can result in brain injury, coma, and death.³

Mixing Hydrocodone with Other Substances

Polysubstance use—the use of more than one substance at the same time or close in time—is a dangerous practice that can result in  unpredictable effects and increases the risk of overdose.⁵ Combining hydrocodone with other opioids or with other central nervous system depressants, such as benzodiazepines, sleeping pills, or alcohol, increases the risk of overdose, as these other substances can potentiate the effects of hydrocodone, leading to respiratory depression or arrest and over-sedation.^1,6

In recent years, there has been a rise in individuals reporting use of both opioids and stimulants.⁵ Studies suggest that individuals who use opioids and stimulants may have a number of motivations, including enhancing feelings of euphoria or taking one drug to offset negative effects or withdrawal symptoms of the other.⁷ Regardless of the reason, combining these substances carries an increased risk of overdose.⁶

Symptoms of Hydrocodone Overdose

Overdose occurs when someone takes enough hydrocodone to cause potentially life-threatening symptoms, which may include:^3,6

• Unconsciousness or the inability to be awakened.
• Slow or shallow breathing or difficulty breathing, which may include someone who cannot be awakened making choking or gurgling sounds.
• Blue or purple fingernails or lips on lighter skin-toned people; grayish or ashen fingernails or lips on darker-skinned people.
• Pinpoint pupils or pupils that don’t react to light.

If you suspect that you or someone else has overdosed on hydrocodone or another opioid, attempt to wake the individual up by calling their name. If they don’t respond, rub your knuckles on their upper lip or the center of their chest. If they don’t respond, follow these steps:^1,6

1. Call 911. An overdose needs immediate medical attention. Tell the dispatcher that someone is “unresponsive and not breathing.” Provide them with the address or a detailed description of your location.
2. Administer naloxone if it is available. Naloxone (Narcan) can immediately combat the effects of opioids and reverse respiratory depression caused by opioid overdose. If the person does not start breathing within 2-3 minutes, administer a second dose of naloxone.
3. Support the individual’s breathing. If you’re able, provide rescue breaths. If it’s not something you have training in, follow the instructions given to you by the 911 dispatcher. When breathing returns, gently turn the individual on their side with the top leg bent to support them in this recovery position.
4. Remain with the individual until medical professionals arrive. Naloxone wears off after 30-90 minutes and overdose symptoms can return

Naloxone—available as a pre-filled nasal spray or an injectable medication—is the most well-known opioid overdose reversal medication. It has been used for decades to reverse opioid overdose and resuscitate individuals who have experienced an overdose involving opioids. Nalmefene, a lesser-known medication, also reverses the effects of opioids and can treat the symptoms of an acute overdose. The drug was first approved in 1995 and was just approved as a nasal spray in 2023.⁶

Experts agree that everyone should keep an opioid reversal medication on hand, but especially individuals who use opioids or other drugs, or who have family members or loved ones who do. While both naloxone and nalmefene are available with a prescription and through community distribution channels and harm reduction organizations, naloxone can also be purchased as an over-the-counter medication without a prescription at pharmacies in all 50 states.⁶ If you or a loved one are prescribed hydrocodone, you should ask about a prescription for an opioid overdose reversal medication as well.

Hydrocodone Addiction Treatment

If you or a loved one have lost control of your hydrocodone use, help is available. Seeking treatment for hydrocodone addiction provides you with the resources and support you need to begin to manage your addiction and safely stop using hydrocodone.⁸

Treatment for opioid use disorder may begin with medically managed detox, which is often the first step in a more comprehensive treatment plan that includes inpatient or outpatient rehab, or both.

Medical detox: Medical detox provides medical oversight and management of withdrawal symptoms in an inpatient or outpatient setting. While generally not life-threatening, withdrawal symptoms associated with opioid cessation can be uncomfortable. Medical professionals may prescribe specific medications during detox to reduce withdrawal symptoms and keep you safe and as comfortable as possible as your body rids itself of the hydrocodone or other substances.⁹

Medications: Medications approved by the U.S. Food and Drug Administration to manage opioid use disorder include:^3,11

• Methadone. Methadone is a full opioid agonist that has been used to manage opioid dependence and addiction for decades. It attaches to and activates opioid receptors in the brain to reduce withdrawal symptoms, help people to not use illicit opioids, and reduce drug cravings.
• Buprenorphine. Buprenorphine is a partial opioid agonist that attaches to and partially activates opioid receptors to ease drug cravings and withdrawal symptoms.
• Naltrexone. Naltrexone is an opioid antagonist. It prevents opioids from attaching to opioid receptors; thus, blocking hydrocodone (or other opioid) effects and reducing cravings for opioids.

Methadone and buprenorphine may be started during medical detox, as both can also help to eliminate or lessen the severity of withdrawal symptoms. Both can be continued during and after treatment to maintain abstinence from illicit opioid use. Naltrexone may be started during treatment after a person’s body is clear of opioids (i.e., they are fully detoxed and are no longer experiencing withdrawal symptoms). Lofexidine or clonidine are non-opioid medicines that may be used during medical detox to help reduce the severity of certain opioid withdrawal symptoms.

Following detox, individuals will likely be encouraged to enter a treatment program to address the underlying issues that led to their hydrocodone addiction.

Inpatient treatment programs: Inpatient treatment provides 24/7 care and support, either in a hospital or residential setting. Treatment typically includes different forms of behavioral therapy such as cognitive-behavioral therapy (CBT)—which helps you understand and change the maladaptive thoughts, emotions, and behaviors that cause your substance use—and contingency management, which provides incentives for certain things like clean drug tests that will help reinforce certain behavioral changes.^3,10,11

Outpatient treatment programs: There are many levels of intensity of outpatient treatment programs, which range from intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs), which may require many hours of treatment multiple days per week, to standard outpatient programs, which may mandate attending treatment 1-3 times each week for a couple of hours each time. Regardless of the intensity, outpatient programs look similar in terms of services and therapies to inpatient rehab but allow you to return home or to a sober living environment at the end of the day, permitting you to potentially continue with school or work while receiving the level of care you need.^10,11

Aftercare: Also called ongoing care, an aftercare plan may include a variety of components to reduce the risk of relapse after you’ve completed a formal treatment program. Examples of aftercare services may involve regular check-ins with a physician, involvement in mutual-help groups such as Narcotics Anonymous or SMART Recovery, or moving into a sober living house.¹⁰

If you’re ready to find treatment for an opioid use disorder, American Addiction Centers (AAC) can help. Call 24/7 and speak with an admissions navigator, who can listen to your story, answer your questions, explain your options, verify your insurance, and help you begin your recovery journey now.