Vicodin is the brand name for the prescription painkiller that is a combination of the opioids hydrocodone and acetaminophen, a medication used to treat fevers as well as minor pain. The potency of Vicodin is roughly on par with morphine, another extremely potent prescription opioid that is rarely used outside of a hospital setting.
Like other prescription painkillers, Vicodin has played a major role in the ongoing opioid epidemic ravaging the United States. In fact, according to the Drug Enforcement Administration (DEA), Vicodin is prescribed more frequently in the U.S. than any other opioid medication.
Despite Vicodin being such a well-known part of the opioid crisis, people will still frequently underestimate just how dangerous it is to misuse, as well as how rapidly that misuse can progress to abuse and addiction, with major health consequences and a high risk of overdose.
The presence of acetaminophen as one of the main ingredients also puts those who abuse Vicodin at risk for severe liver damage and organ failure from acetaminophen poisoning.
Like other opioids in its drug class, Vicodin works by mimicking the natural opioids produced by the body to enter the brain and bind with what is known as the opioid receptors.
Naturally-occurring opioids are neurotransmitters used to help you deal with feelings of stress and pain by inhibiting the nerve impulses that trigger these feelings within the central nervous system, blocking them from being able to reach the brain.
When Vicodin binds to the brain’s opioid receptors, it repeatedly activates them to overproduce an excess level of opioids that creates far stronger feelings of relaxation and sedation, as well as pain relief, blocking off the spinal cord and brainstem to keep pain signals out.
As an opioid, Vicodin also affects the amount of another brain chemical called dopamine. Dopamine is a neurotransmitter in the limbic system that controls important functions dealing with mood, emotion, and how the brain processes motivation and reward. The spike of dopamine that Vicodin provides is what creates the feeling of euphoria, the “high” that people who take a large enough dosage experience.
While many people will begin abusing Vicodin for its ability to decrease pain, it is the extra boost of dopamine that creates the cycle of addiction, as the brain begins associating the activity of Vicodin use with the reward of dopamine.
And as someone grows more tolerant to Vicodin’s effects, they will have to take more of it to satisfy the brain’s increasing need for dopamine, experiencing intense and unpleasant withdrawal symptoms otherwise.
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While in hindsight, the signs of someone’s Vicodin addiction may feel obvious, at the time, they can be difficult to notice, especially if you are not looking for them and if the person using has had a prescription for Vicodin.
Still, there are some noticeable side effects that accompany Vicodin abuse and can point to potential addiction, especially due to the often extreme effects of abusing acetaminophen. Some physical and mental signs that signal long-term abuse outside of prescribed use include:
When someone has developed a strong physical and psychological dependence on Vicodin to the point of addiction, they no longer be able to control their usage and things like hobbies, relationships, and responsibilities will be pushed aside in favor of obtaining and using Vicodin. As this goal becomes the top priority, they will begin to exhibit behavior typically associated with those struggling with a substance use disorder, including:
If you have observed these signs of Vicodin addiction in a family member or friend, or recognize them in your own behaviors, the next step should be seeking addiction treatment services as soon as you can.
The first step in effective Vicodin addiction treatment is to undergo medical detox to safely flush it from your system. This is especially important when it comes to clearing the acetaminophen from your body before it can cause any more long-term damage than it may have already.
After the withdrawal period is over and detox has been completed, the next stage of Vicodin addiction treatment is ongoing care at an addiction recovery treatment facility. While detox is an extremely important first step toward recovery, it is still just that, the first step.
Depending on factors such as your physical and mental health as well as the severity of your Vicodin addiction, your addiction rehabilitation may be completed on an inpatient or outpatient basis, with treatments like individual or group counseling, addiction education workshops, relapse prevention planning, and more.
These therapies give you the support, resources, and skills you need to address the underlying issues that led to your addiction.
They can also help you control and manage them to stay sober long after you have completed your recovery program.
While Vicodin is dangerous for the same reasons as other opioids, including the risk of overdose and organ failure due to lack of oxygen, the acetaminophen makes it even more potentially dangerous than other prescription opioids. People who chronically abuse Vicodin long-term are actually abusing two drugs: the hydrocodone and the acetaminophen.
Though it may be surprising to some, you’re actually more likely to overdose on the acetaminophen in Vicodin rather than on the opioid aspect of the drug. It only takes a small amount to suffer acetaminophen poisoning and overdose. Along with the common signs of an opioid overdose, such as:
There are also the signs caused by acetaminophen poisoning, which includes:
If someone is exhibiting these symptoms, contact emergency medical services as soon as possible to avoid not only death but permanent damage to the brain and major organs as well.
Vicodin overdoses are generally treated in the same way as other opioid overdoses, with the opioid overdose reversal drug Narcan. However, Narcan will not have any effect on an acetaminophen overdose.
Roughly 80 percent of heroin users in the United States reported as first misusing prescription opioids like Vicodin before progressing to heroin.
Centers for Disease Control and Prevention. (2017, August 01). Prescription Opioid Overdose Data. Retrieved from https://www.cdc.gov/drugoverdose/data/overdose.html
National Institute on Drug Abuse. (2018, June 07). Prescription Opioids. Retrieved from https://www.drugabuse.gov/publications/drugfacts/prescription-opioids
National Institute on Drug Abuse. (2018, March 06). Opioid Overdose Crisis. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis#seven