Maxidone Withdrawal

Maxidone withdrawal is the normal, predictable outcome of using Maxidone continually for more than a few weeks.


The body adapts to the presence of certain substances, including the opioid pain reliever in Maxidone, hydrocodone. With chronic use, some of these adaptations become more permanent. Using Maxidone every day for several weeks causes the body to become physically dependent on a certain levels of hydrocodone to feel “normal.” When hydrocodone levels fall abruptly, the body struggles to regain its chemical balance. Doctors refer to this as the detoxification process. The individual experiences detoxification through a variety of withdrawal symptoms.

The detoxification process starts when the opioid-dependent person misses a dose, takes an inadequate dose or uses a drug that counteracts the effects of hydrocodone. Detoxification causes physical and psychological withdrawal symptoms in an opioid-dependent person.

While opioid dependence usually develops after several weeks of continued use, some individuals feel withdrawal symptoms after using Maxidone for only a few days. Many people can avoid Maxidone withdrawal by tapering use gradually. Stubborn Maxidone withdrawal symptoms prevent some people from weaning themselves from this drug.

The acetaminophen in Maxidone does not cause dependence and does not produce Maxidone withdrawal symptoms.

If a pregnant woman takes Maxidone regularly before giving birth, her baby may experience Maxidone withdrawal after he is born. The newborn may be irritable, cry excessively, suffer tremors and have hyperactive reflexes. He has increased stools, fast breathing, vomiting and fever. He may sneeze or yawn excessively as well. The intensity of these symptoms does not always correlate with the amount of Maxidone the mother used during pregnancy. Taking Maxidone only during delivery and not before does not produces withdrawal symptoms in the newborn but it does increase the risk the baby will have breathing problems.

Taking Maxidone for a long time increases the body’s tolerance to hydrocodone. Someone with high tolerance must take Maxidone more often to relieve pain or get high. Low tolerance means the individual is more sensitive to the effects of Maxidone; smaller amounts have a more profound effect on the body.

Facts about this drug

Watson Pharma, Inc. produces Maxidone in tablet form, intended for oral administration Each Maxidone tablet contains 10 mg of hydrocodone bitartrate and 750 mg acetaminophen.

Hydrocodone is a semi-synthetic opioid pain reliever, created from codeine and thebaine extracted from the opium poppy plant, Papaver somniferum.

Chronic Maxidone use may cause permanent disability or death because it increases the appearance and severity of side effects, and raises the risk for overdose or infectious diseases, such as HIV/AIDS, tuberculosis, and hepatitis B and C.

According to the U.S. Drug Enforcement Agency, or DEA, hydrocodone is “the most frequently prescribed opioid in the United States and is associated with more drug abuse and diversion than any other licit or illicit opioid.” In 2010, American pharmacists filled more than 139 million prescriptions for products containing hydrocodone.

Drug makers usually combine hydrocodone is with acetaminophen or some other drug to enhance analgesia. The most common combination is hydrocodone and acetaminophen, like that in Maxidone.

The hydrocodone in Maxidone works with the central nervous system, or CNS, to relieve pain, reduce anxiety, sedate and cause euphoria. This interaction with the nervous system causes CNS withdrawal symptoms during the detoxification process.

Hydrocodone also works on smooth muscles, including the intestinal muscles used to move food through the digestive tract. Consequently, Maxidone withdrawal symptoms will affect the gastrointestinal tract.

Acetaminophen is an over-the-counter analgesic that relieves mild to moderate discomfort by slowing the production of prostaglandin, a natural compound that delivers messages of pain to the brain. Prostaglandins also influence swelling by stimulating injured cells to release fluid. Acetaminophen works to reduce a fever by acting on the hypothalamus, the temperature-regulating center of the brain.

Most people tolerate therapeutic doses of acetaminophen; acetaminophen is not associated with physical dependence or withdrawal symptoms. Using acetaminophen may cause acute liver failure, sometimes resulting in liver transplant and death. Most cases of liver failure are associated with consuming more than 4,000 mg a day. Acetaminophen overdose often occurs as the result of taking several medications containing acetaminophen.

Potential for Abuse

Doctors prescribe Maxidone to relieve moderate to moderately severe pain. Recreational users take Maxidone because of the way hydrocodone gets them high.

Non-medical Maxidone use increases the risk for developing opioid-dependency and suffering Maxidone withdrawal symptoms. To use a drug non-medically means to take it to get high or to treat a condition other than the illness the doctor intended to treat.

The DEA classifies drugs according to their relative potential for abuse. For example, heroin is a schedule I drug because it readily gets consumers extremely high, whereas someone would probably vomit before consuming enough of the schedule V cough suppressant, Robitussin AC. Maxidone is a schedule III drug, posing the same relative risk for abuse as anabolic steroids.

To reduce this risk, Maxidone is available only with a doctor’s prescription.

Abuse and Addiction Rates

About 12 million people in the U.S. used a prescription opioid for non-medical reasons in 2010. This widespread abuse has resulted in prescription drug addiction rates that eclipse the number of people addicted to illicit drugs. In 2010, about 1.9 million Americans were addicted to prescription painkillers while only 329,000 people were addicted to heroin that year.

Americans consume more painkillers than anyone does. Even though the population of the United States accounts for only about 5 percent of the population, they gobble up about 80 percent of the world’s opioid supply.

Facts about Withdrawal

Anyone can become opioid-dependent. Experiencing Maxidone withdrawal is not necessarily an indication of criminal activity; it is possible to become dependent while using Maxidone at therapeutic doses as directed by a physician.

Maxidone withdrawal symptoms usually begin a few hours after the last dose. Symptoms last for five days, growing progressively worse until about the fourth day, when symptoms are at their worst. Uninterrupted, withdrawal symptoms fade in time and do not reappear unless the individual again develops drug dependence.

Some medications reduce the severity of withdrawal symptoms without disrupting the detoxification process. Other drugs, like methadone, mimic the effects of hydrocodone to prevent withdrawal symptoms without causing euphoria; methadone stops the detoxification process. Taking more Maxidone stops withdrawal symptoms and halts the detoxification process. Many individuals relapse to stop intolerable Maxidone withdrawal symptoms.

Maxidone Withdrawal Symptoms

Detoxification from Maxidone causes physical and psychological withdrawal symptoms that may cause an individual to feel incapable or unworthy of recovery. While Maxidone withdrawal symptoms are uncomfortable and discouraging, detoxification from Maxidone dependence is not usually life threatening.

Maxidone dependence causes withdrawal symptoms typical of other types of opioid dependence. Opioid withdrawal symptoms tend to come in two waves.

Early symptoms of withdrawal include:

  • Agitation
  • Anxiety
  • Muscle aches
  • Increased tearing
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Late symptoms of withdrawal include:

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea
  • Vomiting

Possible Complications

While detoxification from Maxidone dependence is not usually life threatening, severe Maxidone withdrawal symptoms may cause dangerous complications. The patient may vomit then inhale stomach contents, a condition known as aspiration. This complication may result in fluid in the patient’s lung and lung infection. Excessive and prolonged sweating, vomiting and diarrhea cause dehydration and electrolyte imbalances.

Relapse to Maxidone use is the primary complication of Maxidone withdrawal. Any amount of detoxification lowers the body’s tolerance to hydrocodone. Consequently, it is possible for someone to overdose on a smaller dose of Maxidone than he took before experiencing even moderate withdrawal symptoms.

Treatment options

Widespread hydrocodone use and abuse leads to a rising need for qualified treatment for Maxidone withdrawal and other substance abuse problems. In the United States, more than 23 million people needed treatment in 2010. Of those that needed treatment, only about 11 percent got it in a specialty facility staffed with employees who received special training in detoxification and rehabilitation procedures. The rest sought help from a general hospital or psychiatric unit without trained staff.

There are two phases of treatment for Maxidone withdrawal: detoxification and rehabilitation. Detoxification focuses on lowering hydrocodone levels and dealing with the ensuing Maxidone withdrawal symptoms. Rehabilitation teaches the individual how to recognize situations that might lead to drug abuse and ways to refuse Maxidone when offered.

Self Detoxification

Countless people try to deal with Maxidone withdrawal symptoms alone, without drugs to ease withdrawal symptoms or the guidance of trained professionals. Doctors call this “self-detoxification,” or commonly known as “going cold turkey.” Cold turkey refers to the appearance of the addict’s skin during detoxification: pale, cold and clammy with goose bumps, much like frozen turkey skin.

Self-detoxification is prolonged, uncomfortable and demoralizing. Without professional monitoring, self-detoxification may result in complications such as aspiration, dehydration and relapse.

The Thomas Recipe

Many people create homemade treatment plans including a variety of medicines to reduce Maxidone withdrawal symptoms. One plan is The Thomas Recipe, which calls for a benzodiazepine such as Valium, Librium, Ativan or Xanax to calm anxiety and encourage sleep. This recipe recommends Imodium for diarrhea, L-Tyrosine for malaise, Vitamin B6 and supplements along with hot baths to soothe muscle aches and quiet restless leg syndrome.

While The Thomas Recipe eases symptoms, it does not shorten detoxification or reduce the risk for complications, including relapse leading to overdose.


Relapse increases the risk for toxic overdose because detoxification reduces the body’s tolerance to hydrocodone. Consequently, it is possible for someone to overdose on a smaller amount of Maxidone than he used to take before experiencing even moderate Maxidone withdrawal symptoms.

It is possible to overdose on either the hydrocodone or the acetaminophen in Maxidone; both types of overdose are serious, potentially fatal medical emergencies. Overdose of prescription painkillers including Maxidone kill nearly 15,000 Americans every year. Acetaminophen overdose is one of the most common poisonings worldwide and is the leading cause of acute liver failure in the United States.

Large doses of hydrocodone cause respiratory depression, a serious and possibly fatal breathing condition. During respiratory depression, the lungs do not adequately exchange oxygen for carbon dioxide and other gases, causing oxygen starvation and a buildup of toxic gases. Symptoms of respiratory depression include slow or shallow breathing, irregular breathing patterns and a blue color around the victim’s eyes, mouth and fingertips.

Symptoms of hydrocodone overdose include respiratory depression, extreme grogginess that progresses to a coma, limp muscles and cold, clammy skin. Sometimes the patient will have a slow heartbeat and low blood pressure. In cases of severe hydrocodone overdose, the victim will stop breathing, experience a collapse of the circulatory system, suffer a cardiac arrest or die.

Large doses of acetaminophen may result in liver injury. The most serious adverse effect is potentially fatal liver failure, known as dose-dependent hepatic necrosis. Acetaminophen overdose may cause kidney damage, coma and bleeding problems.

Acetaminophen overdose symptoms and clinical signs, like laboratory blood tests, may not appear for 48 to72 hours after ingestion. Early symptoms following a dose strong enough to cause liver damage may include nausea and vomiting, profuse sweating and general malaise.

Transport all suspected victims of Maxidone overdose to the hospital immediately. Emergency department physicians will administer naloxone to counteract the effects of hydrocodone along with the antidote to acetaminophen, N-acetylcysteine. The patient may be put on a ventilator to help him breathe. Nurses will pump the stomach or introduce charcoal into the stomach to absorb excess Maxidone.

Drug Replacement Therapy

An opioid-dependent person not in immediate danger of overdose may choose DRT, or drug replacement therapy. DRT drugs, including methadone, Suboxone and buprenorphine, have an action similar to hydrocodone so the consumer does not experience withdrawal symptoms when he stops taking Maxidone but DRT drugs do not produce euphoria.

When the individual learns how to live without drugs, he weans himself from the DRT drug by taking smaller doses less frequently. As when trying to taper Maxidone use, many people have a hard time weaning themselves from methadone and other DRT drugs.

While Maxidone withdrawal is not normally life threatening, there is a growing risk with using methadone, described as a prescription painkiller because it is an opioid drug. Even though methadone sales account for only 2 percent of the prescription painkiller market, methadone accounts for one-third of opioid pain reliever deaths, up six fold in ten years.

Standard detox

Many institutions now offer inpatient detoxification services where the physician administers drugs to lower hydrocodone levels along with drugs to relieve the ensuing Maxidone withdrawal symptoms. Standard detoxification eases the severity but not the duration of Maxidone withdrawal; patients must still deal with psychological effects of a lengthy detoxification procedure.

Rapid Detox

Rapid detox is the most humane and efficient means of detoxification available today. Board-certified anesthesiologists receive advanced rapid detox training. During rapid detox, the patient is sedated and anesthetized while receiving the standard detoxification and anti-withdrawal drugs so she rests in a comfortable “twilight sleep.” She awakens a few hours later, unaware of the grueling detoxification process and ready for meaningful rehabilitation.


The detoxification process alone does not change the behaviors associated with drug abuse. Someone who participates in detoxification but not rehabilitation is likely to return to drug abuse and battle Maxidone withdrawal repeatedly.

The goal of any rehabilitation plan is to help the individual stop using drugs and return him to his normal life. Rehabilitation reduces criminal activity, improve performance at work and restore relationships affected by drug abuse and Maxidone withdrawal.

Someone can participate in outpatient rehabilitation by making regular visits to a counselor’s office, or he may choose a long-term, highly structured rehabilitation program at a residential setting. Treatment does not have to be voluntary to be effective - some people participate in treatment more vigorously when under legal coercion to do so.

Most treatment plans include behavior modification and individual, family or group counseling. Some recovery plans include medications, as many opioid-dependent people have co-existing physical or mental problems that could interfere with recovery efforts. Effective rehabilitation treats the whole person, not just his Maxidone withdrawal. No one treatment is right for everyone and many people engage in several forms of treatment during the course of recovery.

Whatever forms of treatment the individual participates in, it must be readily available to promote maximum participation. It is critical that he remains in treatment long enough to make behavioral changes significant enough to reduce the risk for relapse.

A rehabilitation specialist will create a treatment plan based on an initial assessment of the patient’s condition then monitor the patient’s condition and modify the treatment plan to ensure treatment fits the patient’s changing needs. The counselor may request testing for the presence of infectious diseases and educate the patient in ways to avoid contracting or spreading these diseases.

The counselor will likely require drug tests, as estimated relapse rates for drug addiction range from 40 to 60 percent. Relapse does not mean treatment has failed; relapse does mean the opioid-dependent should return to treatment, modify his treatment plan or choose a different form of treatment.