Hydrocodone Withdrawal Symptoms, Timeline, and Detox Treatment
Typically prescribed to manage pain, hydrocodone is a semisynthetic opioid that’s often found in combination with acetaminophen, aspirin, or ibuprofen.1 Many people might be familiar with hydrocodone/acetaminophen combinations such as Vicodin, Norco, and Lortab. However, these brands have been discontinued. Other brands (e.g., Hysingla) and generic versions of hydrocodone and assorted combinations are currently available.2,3
Aside from its therapeutic effects, hydrocodone is sometimes misused for its reinforcing opioid effects such as feelings of euphoria and relaxation.4 Along with an increased risk of overdose, hydrocodone has a high potential for misuse and can lead to addiction.4,5
Those who take hydrocodone regularly can develop opioid dependence and may experience a set of signs and symptoms known as withdrawal if they discontinue or reduce opioid use.6 While symptoms can be uncomfortable, they shouldn’t be a barrier to recovery. Medically assisted detox followed by behavioral and pharmaceutical therapies can help patients through withdrawal and into treatment to promote long-term recovery.
Hydrocodone Withdrawal Symptoms
Symptoms of withdrawal for hydrocodone and other opioids vary based on a host of factors, such as the length of use, interval between doses, quantity taken, etc.7 However, opioid withdrawal syndromes often involve a similar range of symptoms that include:7
- Enlarged pupils.
- Nausea, vomiting.
- Abnormally heightened reflexes (i.e., hyperreflexia).
- Muscle spasms.
- Bone and muscle pain.
- Fast pulse (i.e., tachycardia).
- High blood pressure (i.e., hypertension).
- High body temperature (i.e., hyperthermia).
- Runny nose.
Some people might refer to hydrocodone withdrawal as Norco withdrawal or Vicodin withdrawal. But again, these brands have been discontinued, so these terms are misnomers.
Hydrocodone Withdrawal Timeline
Just as no two people are alike, no two experiences with opioid withdrawal are identical. Thus, timelines for hydrocodone withdrawal are slightly different for everyone. Generally speaking, however, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides some broad guidance on withdrawal timelines for short-acting opioids such as hydrocodone:8
- 6-12 hours after the last dose: Most people who are dependent on hydrocodone will begin to have withdrawal symptoms.
- 1-3 days: Acute withdrawal symptoms typically peak during this time.
- 5-7 days: Acute withdrawal symptoms gradually subside.
- Weeks-months: Chronic symptoms—e.g., anxiety, insomnia, generalized unease/dissatisfaction, and a lack of interest, enjoyment, or pleasure—may persist for weeks to months.
Hydrocodone Detox Options and Withdrawal Treatment
Although the symptoms of opioid withdrawal are rarely life-threatening, they can be uncomfortable and can be associated with medical complications such as dehydration.7 Additionally, fear of withdrawal symptoms or a real or perceived inability to tolerate them can prompt some individuals who want to quit to continue hydrocodone use or resume other opioid use. Thus, medical withdrawal management (sometimes called medically assisted detox) can help to ensure patients have a safe and comfortable environment during withdrawal.9
Detoxing from hydrocodone and other opioids may take place in inpatient or outpatient settings depending on factors such as duration and severity of use, the substance(s) involved, etc.10 Offering a safe environment and compassionate staff, detox centers provide supportive measures to better manage withdrawal symptoms—via physical and emotional support, pain management, adequate nutrition, etc.— along with access to opioid withdrawal and opioid use disorder treatment medications (see below).11 Since withdrawal symptoms and substance use factors are unique to each individual, hydrocodone detox timelines vary accordingly.
While detox can be an effective first step on the road to recovery, hydrocodone detox alone rarely supports a long-term recovery. Some form of inpatient or outpatient treatment is typically a best practice following detox.10
Medications for Hydrocodone Withdrawal
Depending on the range and severity of symptoms and a host of factors that vary by individual, treatment centers may employ the following medications to manage moderate to severe opioid withdrawal symptoms.12, 13,14,15
- Clonidine. Provides relief of some physical symptoms of opioid withdrawal including sweating, diarrhea, vomiting, chills, anxiety, insomnia, etc.
- Buprenorphine. Aids in managing symptoms and reducing cravings.
- Lofexidine. Mitigates symptoms of opioid withdrawal.
- Methadone. Helps to decrease cravings and manage symptoms. (Distribution and use is restricted to hospital pharmacies and physicians authorized by the Food and Drug Administration and Drug Enforcement Administration.)
Two medications used to treat opioid use disorder can be started as withdrawal symptoms appear and will eliminate or lessen the severity of hydrocodone/opioid withdrawal symptoms:15
These medications can be continued long-term—i.e., they’re safe to use post-detox and following formal drug rehab treatment—to reduce the risks of opioid overdose, relapse, and a return to illicit opioid use.15
Hydrocodone Rehab Treatment
Following detox, multiple levels of care and various types of behavioral and pharmaceutical therapies are available to treat opioid use disorders such as those related to hydrocodone. Each care plan is unique and tailored to the needs of each individual. However, levels of care include:7,10,16
- Inpatient treatment. Patients live in a treatment facility 24/7, allowing for care and monitoring in a safe and supportive environment with structured activities. Treatment includes pharmaceutical and behavioral therapies paired with healthy nutrition, physical activities, and more.
- Outpatient care. With outpatient treatment, patients live in their own homes or a sober living environment outside of treatment sessions. Outpatient programs sometimes allows patients to maintain responsibilities such as jobs, school, families, etc. while also receiving treatment. Outpatient treatment options can be further divided into varying levels of intensity including: traditional outpatient treatment, intensive outpatient programs (IOPs), and high-intensity outpatient programs (HIOPs) aka partial hospitalization programs (PHPs). Also note that many outpatient programs offer telehealth services, which provide for even more flexibility.
- Aftercare and sober living. Following inpatient and/or outpatient programs, some form of aftercare, such as ongoing sober living, 12-Step programs, and continuing outpatient therapy, is often recommended.
Treatment facilities such as those offered by American Addiction Centers often provide multiple levels of care. Thus, patients can complete a full treatment program with the same provider.
Within these treatment programs, professionals often use pharmacological care for opioid use disorders (as described above) along with behavioral therapies including individual, group, and family therapies. The National Institute on Drug Abuse recognizes the following behavioral therapies, among others, as effective for opioid use disorders:9
- Cognitive behavioral therapy (CBT). CBT helps change problem behaviors by altering how people think and behave. As a goal-oriented type of talk therapy, CBT is based on the fact that thoughts, feelings, and behaviors are all connected. By changing one of these factors, people can often change the others.
- Contingency management. This behavioral approach rewards patients for positive change. Points or vouchers are given for positive behavior modifications, and these tokens can be redeemed for items that further encourage healthy living.
Find a Hydrocodone Detox Center Near You
Are you afraid of–or experiencing—withdrawal symptoms related to hydrocodone, other opioids, or even alcohol or other substances? American Addiction Centers can help. Along with medically assisted detox, AAC provides all levels of care via various U.S. accredited rehab centers.
Available for a free and confidential conversation 24/7, admissions navigators at can not only help you explore various treatment options and facilities but also answer your treatment questions, discuss financing, and more. Additionally, staff can verify any insurance benefits, or you can verify your insurance benefits online. And if you don’t want to talk right now, you can sign up for text-based support.
Take your first step toward recovery today. Reach out for support and information now.
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