Lortab Withdrawal

Definition

Lortab contains the opioid pain reliever, hydrocodone, which is in the same class of drugs as morphine. Opioids may cause physical dependence and withdrawal symptoms in people who these medications for a long time. Lortab also contains acetaminophen, which does not cause physical dependence and withdrawal symptoms.

Opioid withdrawal is a normal, predictable consequence of a sudden drop in the level of opioids in the body of a person who is physically dependent on Lortab or other opioids. Rehabilitation specialists call this process detoxification. As the levels of Lortab decrease, the opioid-dependent person will experience a variety of overpowering physical symptoms that can last five or more days. Psychological symptoms of Lortab withdrawal can last much longer, especially if these symptoms go undetected or poorly treated.

Causes

Your body adapts to the presence of certain foreign substances, including the opioids in Lortab. Your body may grow tolerant of certain chemicals, which means it takes an ever-increasing amount of Lortab to cause the intended euphoric or pain-relieving effect. With continued use, the body may become dependent on the chemical.

Physical dependence means you must maintain a certain level of opioids in order for your body to feel normal. If the level of opioids drops rapidly, your body struggles to keep its chemical balance. You experience this battle for chemical stability through flu-like withdrawal symptoms.

The rapid decline in opioid levels could be due to a missed dose, an insufficient dose or because you have taken a medication like naloxone, which quickly reduces opioid levels.

You can reduce withdrawal symptoms by taking more Lortab, using a drug that mimics Lortab or with medications that reduce individual symptoms.

Facts

According to the Centers for Disease Control and Prevention, or CDC, about 9 percent of people use opioids such as Lortab non-medically at some point in their lives. To use a drug for non-medical reasons means to take it either to get high or to treat a condition other than the one for which the doctor prescribed Lortab.

Lortab is especially attractive to recreational users because of the way it gets them high. The active ingredient in Lortab - hydrocodone - is also widely available as the most frequently prescribed painkiller in the United States. Hydrocodone is associated with more drug abuse than any other legal or illegal opioid, such as heroin.

Lortab withdrawal symptoms are uncomfortable and disheartening, but usually not life threatening.

Americans use more opioids than another other nation on earth. According to the Institute of Addiction Medicine, U.S. citizens account for only about 5 percent of global population but consume 80 percent of the world's supply of opioids.

Opioid dependence, Lortab withdrawal and other substance abuse problems are on the rise among Americans. The Substance Abuse and Mental Health Services Administration says the U.S. admission rate for opioids other than heroin jumped 414 percent between 1997 and 2007. In 1997, 7 people out of 100,000 were admitted for substance abuse problems; by 2007, this number had grown to 36 admissions for every 100,000 people.

Lortab withdrawal do not just happen to criminal drug abusers - studies suggest a high incidence of drug abuse among people who take opioids such as Lortab as prescribed to treat chronic pain. Experts think 20 percent to 58 percent of people in chronic pain abuse opioids.

The number of deaths attributable to opioid overdose is rising too. There was a 63 percent increase in opioid deaths in five years, spanning from 1999 to 2004.

Symptoms

Lortab withdrawal causes physical flu-like symptoms, but withdrawal also causes psychological symptoms. The individual may feel unworthy or incapable of recovery and return to drug abuse. The psychological aspects of Lortab withdrawal can be just as overpowering as the physical symptoms of withdrawal.

Symptoms last five or more days, with the worst symptoms occurring on or about the fourth day.

Physical

Individuals who go through Lortab withdrawal frequently experience physical symptoms, specifically insomnia, tremor, abdominal cramps, blurred vision, vomiting and sweating. General physical symptoms of opioid withdrawal include:

  • Abdominal Cramping
  • Diarrhea
  • Fever, Runny Nose or Sneezing
  • Goose Bumps and Abnormal Skin Sensations
  • Hot Sweats and Cold Sweats
  • Insomnia
  • Low Energy Level
  • Muscle Aches or Pains
  • Nausea or Vomiting
  • Pain
  • Rapid Heartbeat
  • Rigid Muscles
  • Runny Nose
  • Shivering, Tremors
  • Teary Eyes
  • Yawning

Psychological

If you are going through Lortab withdrawal, you may experience psychological symptoms, specifically agitation, restlessness and anxiety. You may also feel sad, depressed and demoralized.

General psychological symptoms of opioid withdrawal include:

  • Agitation
  • Anxiety
  • Depression
  • Hallucinations
  • Irritability
  • Poor concentration
  • Restlessness
  • Social isolation

Possible Complications

Complications of opioid withdrawal include vomiting and then breathing the stomach contents into the lungs, a condition known as aspiration. Aspiration can cause fluid in the lungs and lung infections.

Extreme vomiting and diarrhea may result in dehydration. Left untreated or poorly treated, dehydration can cause electrolyte imbalances and other health problems.

The return to opioid abuse is the greatest complication associated with Lortab withdrawal. A person who has recently attempted detoxification faces a greater risk for overdose because the detoxification process lowers his tolerance to Lortab. It is possible for a person who has experienced Lortab withdrawal even for a short time can overdose on a much smaller dose than he used to take.

Treatment options

Opioid abuse and dependence is a serious and widespread problem among American adults and youth. According to the National Institute on Drug Abuse, more than 23 million people in the United States over the age of 12-years sought treatment for alcohol or substance abuse in 2010; of these, only about 11 percent received treatment at a specialty facility. Opioid abuse accounted for more than 5 percent of admissions to publicly funded substance abuse programs. These treatment facilities feature detoxification and rehabilitation designed to help people to overcome their dependence and addiction to opioids such as Lortab.

Lortab withdrawal is different and separate from Lortab addiction but long-term drug use can cause a person to suffer from both conditions. An opioid-dependent person will experience flu-like symptoms when opioid levels drop; an addicted person will crave Lortab and become preoccupied with finding more Lortab.

Adequate treatment for Lortab withdrawal and addiction is essential for the individual's survival. The American Society of Addictive Medicine warns that addiction to Lortab or other substances causes "disability or premature death, especially when left untreated or treated inadequately." Without proper medical treatment, many people experience dangerous cycles of recovery and relapse.

Treatment for Lortab withdrawal and addiction consists of two phases: detoxification and rehabilitation. Detoxification is the medical process of lowering the level of Lortab in the body. Someone going through detoxification usually battles five or more days of intense withdrawal symptoms as his body adjusts to lower levels of the opioid component of Lortab.

Rehabilitation centers on restoring the neurological function disrupted by opioid addiction. Neurological dysfunction results in the craving and drug-seeking behavior associated with Lortab addiction. This phase of treatment includes behavior modification and counseling that helps the addicted individual learn how to live without Lortab.

Detoxification

Some people try to overcome Lortab withdrawal alone, without the help of medicine to reduce symptoms or trained professionals to monitor for and take action against complications. This process is officially known as self-detoxification but many people call it "going cold turkey," which refers to the cold, clammy, pale skin with goose bumps that addicted people experience as they go through detox.

Self-detoxification affords the individual no protection from withdrawal symptoms or complications. Lortab withdrawal symptoms, known in the medical world as opiate abstinence syndrome, often come in two waves several hours after the last dose of Lortab.

Early symptoms of withdrawal include:

  • Agitation
  • Anxiety
  • Insomnia
  • Muscle Aches
  • Runny nose
  • Sweating
  • Watery Eyes
  • Yawning

After a day or two, the individual will experience symptoms including:

  • Abdominal Cramping
  • Diarrhea
  • Dilated Pupils
  • Goose Bumps
  • Nausea
  • Vomiting

The goal of self-detoxification is to last five or more days, with the worst symptoms expected on or about the fourth day. Many people take another dose of Lortab just to ease the physical and psychological discomfort associated with Lortab withdrawal.

The Thomas Recipe

Some people develop homemade treatment plans including medications to ease withdrawal symptoms. One such treatment is The Thomas Recipe. In this treatment plan, the individual takes valium or some other benzodiazepine to calm him down and help him sleep. He will wean himself from this psychoactive replacement drug after he has completed Lortab withdrawal.

The Thomas Recipe also includes Imodium to stop diarrhea and mineral supplements relieve muscle aches. On or about the fourth day, the individual awakens with overwhelming malaise and lack of energy that makes it difficult for him to move around. The patient takes L-Tyrosine with vitamin B6 to give him a surge of energy.

While the Thomas Recipe eases withdrawal symptoms somewhat, complications such as aspiration, dehydration and relapse commonly occur. Because of lowered tolerance to opioids, returning to Lortab abuse after attempting the Thomas Recipe may result in life threatening overdose.

Overdose

Physical dependence on Lortab causes chronic use of this drug that may result in life threatening overdose. A person may overdose on either the opioid component or the acetaminophen in Lortab, or both.

Symptoms of Lortab overdose include:

  • Abdominal Pain
  • Bluish Skin
  • Cold or Clammy Skin
  • Difficult or Slow Breathing
  • Drowsiness Leading to Unresponsiveness or Coma
  • Excessive Sweating
  • Loss of Heart or Lung Function
  • Nausea and Vomiting
  • Pinpoint Pupils
  • Seizure

Someone may overdose on the acetaminophen in Lortab. Acetaminophen overdose is frequently the result of taking multiple medications containing this analgesic. Acetaminophen is a common ingredient in many prescription and over-the-counter medications. Taking more than 4,000 mg of acetaminophen may result in overdose or liver problems that may be fatal.

Lortab overdose is a serious, potentially fatal medical emergency requiring immediate care. If you suspect that you or someone you know has taken an overdose of Lortab, seek emergency assistance immediately. Contact your local poison control center at 1-800-222-1222 or go to the emergency room.

In the emergency department, doctors give the patient naloxone and other medications to reduce Lortab to non-toxic levels. Nurses establish an airway to help the patient breathe, monitor his vital signs and watch for complications. Nurses may empty the patient's stomach or introduce charcoal into the patient's stomach to absorb excess Lortab. If necessary, nurses and doctors perform life-saving measures such as CPR or breathe for the patient.

Drug Replacement Therapy

A person addicted to Lortab who is otherwise in stable physical condition might benefit from Drug Replacement Therapy, or DRT. Drug Replacement Therapy replaces illegal drugs with medications such as methadone, Suboxone or buprenorphine.

DRT medications act in a way similar to opioids, so the patient does not experience withdrawal symptoms, but DRT drugs do not cause euphoria - the patient does not get high on them. This way, a person with a Lortab addiction can temporarily put off the detoxification stage while he begins behavioral modification. After the patient develops the skills to live without opioids such as Lortab, he weans himself from the replacement drug.

Many patients choose DRT because it allowed them to continue living normally while they participate in treatment, rather than spending weeks at a hospital and missing valuable time at work and home. Patients can remain on DRT drugs for months or years.

Opponents of Drug Replacement Therapy say this form of treatment is merely trading one addiction for another. Many never wean themselves from the replacement drug. Harvard Medical School says about a quarter of methadone DRT patients eventually quit all drugs including methadone, another 25 percent continues to take the replacement drug, and the remaining 50 percent go on and off methadone for years.

Drug Replacement Therapy is just one kind of Medication-Assisted Treatment, or MAT. Using medications to reduce Lortab withdrawal symptoms makes the detoxification process tolerable. MAT increases the patient's chances of completing detoxification.

Rehabilitation professionals say that using medications is an important and effective treatment approach to Lortab withdrawal because MAT is shown to:

  • Improve Survival Rates
  • Increase Retention in Treatment
  • Decrease Illicit Opioid Use
  • Decrease the Risk for Hepatitis and HIV
  • Decrease Criminal Activities
  • Increase Employment
  • Improve Birth Outcomes for Pregnant Women Battling Addiction

Standard MAT involves a hospital stay lasting for a week or more. During inpatient detoxification, doctors give the patient naloxone and other medications to reduce Lortab levels along with other medications to ease the ensuing withdrawal symptoms.

While standard inpatient MAT relieves the strength and duration of symptoms significantly, patients still battle lengthy, uncomfortable and demoralizing psychological symptoms that interfere with rehabilitation. Medically assisted detoxification is only the first step in treating Lortab withdrawal and addiction treatment. MAT by itself does little to change long-term drug abuse or Lortab addiction that leads to endless cycles of remission and relapse.

Rapid detox is the most humane form of detoxification available today. During rapid detox, board certified anesthesiologists administer the typical detoxification and anti-withdrawal drugs. These specialists also give the patient sedatives and anesthesia to help the individual doze in a pleasant "twilight sleep." When the patient awakens, well rested and refreshed, she will have no recollection of the Lortab withdrawal process. With rapid detox, she is ready for meaningful behavior modification in a few hours rather than in a few days.

Rehabilitation

Rehabilitation for addicted patients experiencing Lortab withdrawal saves money. Conservative estimates suggest that every dollar invested in treating opioid dependence can save $4 to $7 by reducing drug-related crime, criminal justice system costs, and thefts. When considering healthcare costs, every dollar spent could save up to $12.

Lortab addiction is a neurological disease that causes behaviors such as craving and drug seeking; as a result, behavioral modification is essential for recovery. Addiction can lead the opioid-dependent person back to drug use, forcing him to battle Lortab withdrawal each time he tries to free himself from opioids.

Addiction is a complex but treatable neurological disease; everyone experiences addiction a little differently, therefore no one treatment is appropriate for everyone. Additionally, a counselor should continually assess each patient's needs and adjust treatment accordingly.

Effective treatment addresses the individual's multiple needs, including her personal, physical, social, mental and legal needs; treatment never focuses on just her drug abuse. Many who suffer addiction to Lortab or other drugs have other mental disorders, legal trouble, social problems or relationship issues that make the disease of addiction and Lortab withdrawal more difficult.

Counselors should assess patients for conditions such as HIV/ AIDS, hepatitis B and C, tuberculosis, and other infectious diseases. Rehabilitation programs include counseling to help someone identify and change behaviors that increases his risk for contracting or spreading infectious diseases.

Treatment programs commonly use individual counseling, group therapy and other behavioral modification programs to treat drug abuse. The treatment plans needs to be readily available to the patient to encourage participation.

It is critical that the person remains in treatment for an adequate amount of time to prevent relapse. Rehabilitation professionals monitor the patient's treatment course and progress to make sure treatment meets the individual's needs. Relapse is common and professional monitoring reduces the risk for return to Lortab abuse.