Vicodin is a prescription painkiller and the brand name for the combination of the opioid hydrocodone and acetaminophen, a nonprescription medication used for treating mild pain and fever.
Vicodin is an extremely potent drug, equal in strength to the opioid morphine, which is rarely ever used outside of the strict confines of a hospital setting. Vicodin, however, is available for prescription and has played a major role in the ongoing opioid epidemic in the United States.
Even with Vicodin’s notoriety and well-publicized dangers, people still misuse and abuse it, with many under the impression that it is safe to do so because a doctor prescribes it, and because it’s not an illicit substance such as heroin.
Unfortunately, underestimating Vicodin can quickly lead to abuse, addiction, and overdose, as well as serious health problems, in part due to the severe liver damage that acetaminophen can
Like most other opioids, Vicodin works by creating an excess of opioid neurotransmitters in the brain and central nervous system to create strong blocks around the spinal cord and brain stem to keep out pain signals, producing strong feelings of sedation and pain relief.
Neurotransmitters are brain chemicals that perform many different key functions. Opioids that are naturally produced by the body regulate feelings of pain by slowing down central nervous system activity, inhibiting nerve signals carrying feelings of pain and stress to block them off from the brain.
Vicodin mimics these natural opioids to bind with what are known as opioid receptors, activating them to release opioids over and over until the brain and nervous system are flooded with opioids.
Along with this, Vicodin’s secondary effect is raising the levels of another neurotransmitter called dopamine. Dopamine is in what’s often referred to as the “pleasure center” of the brain and controls important functions like emotion, cognition, and how we process pleasure through the means of reward and motivation.
It’s the jolt of dopamine that provides the feeling of euphoria and pleasure associated with an opioid high, as well as what gets people addicted. While someone may initially misuse Vicodin for its painkiller properties, it’s the effects on dopamine that rewires the brain to associate the activity of using Vicodin with the reward of extra dopamine, creating the cycle of abuse and addiction.
Being able to recognize the early signs of Vicodin abuse and addiction can make all the difference in getting someone the help that they need in time so that they can make a successful recovery. Unfortunately, it is often more difficult to do than many people would think.
The signs of a growing addiction do not manifest all at once, and it is all-too-easy to dismiss isolated instances of abnormal behavior, especially if the person abusing Vicodin has a prescription for it.
That said, some of the more extreme side effects commonly associated with regular Vicodin abuse, such as jaundice due to the excess acetaminophen, tend to stick out.
It is important to note that substance abuse and addiction are not the same things. If someone is engaging in substance abuse, they still have at least some degree of control over how much they use and how often. The major characteristic of addiction is the loss of control over use. This means that someone addicted to Vicodin will use it compulsively with no level of control.
Once someone has reached this point, they will begin exhibiting behavior consistent with a substance use disorder: prioritizing obtaining and using Vicodin over nearly everything else in their life and continuing to do so even as they face financial issues, job loss, deteriorating relationships, and legal problems.
If you have observed these signs in your own behavior or otherwise in a family member or friend, it is vitally important that you waste no time getting help from a professional addiction treatment center. The longer you wait to do so, the greater the risk of a potentially fatal overdose.
As with nearly an addictive any substance, the first step in Vicodin addiction treatment begins with supervised medical detoxification, a process meant to remove any traces of Vicodin and other associated toxins from someone’s system. Ridding the body of Vicodin treats acute intoxication and stems the physical and mental damage the substance may have caused. Detox is especially important in the case of Vicodin because of the potential buildup of acetaminophen, which can cause liver failure.
While the withdrawal symptoms associated with opioid detox are on the milder end of the spectrum, they can still be uncomfortable, painful, and difficult to manage. Because of this, Vicodin detox should never be attempted alone or without the careful monitoring from a medical detox team to avoid any possible complications or a mid-detox relapse.
A medical detox professional also can use detox medications to help ease withdrawal symptom as well as slowly and safely taper down Vicodin usage, replacing it with substitute opioids like methadone or Suboxone and then tapering down those as well.
After completing detox, the next part of Vicodin addiction treatment is ongoing care in an inpatient or outpatient addiction recovery treatment program. Inpatient treatment involves living on-site at a treatment center for the duration of the program and is generally the most beneficial choice for those with more severe addictions, a history of relapse, and people who also would benefit from 24/7 access to medical and therapeutic services.
In outpatient treatment, the client lives at home or a sober living home and travels to the facility for therapy sessions and medical check-ins. This is a good option for people who are still in the early stages of addiction with a strong outside support system who do not require the same intensive level of care as inpatient treatment.
Throughout an addiction rehabilitation treatment program, clients will be given the therapeutic tools and treatments needed to help them address the physical and psychological aspects of addiction. They can better understand the issues at the root of their Vicodin addiction and from there be able to better manage it and maintain long-term sobriety.
A client will generally work with their therapist to create a treatment plan that is customized to meet their specific needs.
Not only does Vicodin have the same risks of addiction and overdose as other opioids, but it also has the added element of acetaminophen. This means that when people abuse Vicodin, they’re actually abusing two drugs in tandem: hydrocodone and acetaminophen, which at first might not seem like that big of a deal. After all, acetaminophen is available under the brand name Tylenol as an over-the-counter pain reliever in basically any grocery or convenience store.
However, though it may be surprising to hear, you’re actually more likely to overdose on the acetaminophen in Vicodin before taking enough to overdose on the opioids.
The line between a medically effective dose of acetaminophen and a toxic one that can trigger an overdose is extremely thin.
If someone is showing the signs of a Vicodin overdose, emergency medical services must be sought immediately to avoid death as well as potentially permanent damage to the brain and major organs.
While Vicodin overdoses are typically treated with the opioid overdose reversal drug Narcan, the medication will not have an effect on the acetaminophen poisoning.
Centers for Disease Control and Prevention. (2017, August 01). Prescription Opioid Overdose Data. Retrieved from https://www.cdc.gov/drugoverdose/data/overdose.html
Manuele, J. (2016, October 7). Acetaminophen Overdose: What You Need to Know. Retrieved from https://www.healthline.com/health/acetaminophen-overdose
National Institute on Drug Abuse. (2018, August). Overdose Death Rates. Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
Upham, B., Dolan, M., & Kritz, F. (2020, April 30). What Is the Difference Between Abuse and Addiction? Everyday Health. from https://www.everydayhealth.com/addiction/experts-difference-between-substance-abuse-and-drug-addiction.aspx
Opioid Overdose: Understanding the Epidemic. U.S. Centers for Disease Control and Prevention (CDC). from https://www.cdc.gov/drugoverdose/epidemic/index.html