- Generic Name or Active Ingridient: Hydrocodone
- Excessive yawning
- Muscle aches
- Runny nose
- Watery eyes
- Abdominal cramping
- Dilated pupils
- Goose bumps
- Nausea and vomiting
Vicodin contains hydrocodone and acetaminophen. Hydrocodone is a semi-synthetic opioid, which means drug makers create hydrocodone from extracts of the opium poppy plant. Acetaminophen is a non-opioid pain reliever that works differently than hydrocodone.
Hydrocodone and other opioids act directly on the nervous system, changing the way the brain interprets pain signals. The hydrocodone in Vicodin causes other neurological effects, including sedation, relaxation, and a pleasant feeling of euphoria. These effects make Vicodin a target for recreational drug users. Opioids also act on areas of the brain responsible for reward, learning, and stress in ways that increase the risk for addiction and physical dependence requiring detoxification.
The hydrocodone in Vicodin works with other body systems to cause various non-therapeutic effects that become evident during detoxification. For example, opioids stiffen smooth muscle groups in various locations, including intestinal muscles that propel food through the digestive tract and blood vessel muscles that control blood pressure. Smooth muscles are also responsible for dilating and contracting pupil size in the eyes and the development of goose bumps in the skin. These effects on the various body systems causes predictable side effects during Vicodin detoxification, including vomiting and diarrhea, increased blood pressure, large pupils, sweating, and goose bumps.
Hydrocodone is the most frequently prescribed opioid in the United States. In 2010, U.S. pharmacies filled more than 139 million prescriptions for Vicodin and other products containing hydrocodone. The U.S. Drug Enforcement Agency associates hydrocodone with more drug abuse than any other drug, legal or illegal.
Chronic Vicodin use causes some of its neurological and physical effects to become more permanent, altering the individual’s thinking, emotions, and behaviors in a way that adversely affects his ability to work, take care of personal responsibilities, and interact with others. In time, chronic drug abuse can result in job loss and financial crisis, divorce and loss of child custody, homelessness, criminal activity and incarceration, illness and infectious diseases, overdose, or death.
Scientists are not exactly certain how acetaminophen works but believe it reduces pain by decreasing the amount of prostaglandin in the body. Prostaglandins are a natural compound responsible for sending pain messages to the brain, causing inflammation, and raising body temperature resulting in fever. Acetaminophen does not cause neurological changes that result in addiction or dependence requiring detoxification.
However, acetaminophen does cause effects that become pertinent during chronic Vicodin abuse and detoxification. The body breaks acetaminophen into smaller metabolites that the liver clears from the system. The liver has no problem eliminating low levels of this metabolite but the liver may fall behind in its work when confronted by higher levels caused by chronic acetaminophen use or overdose. Accumulation of these metabolites in the liver may damage liver cells, sometimes resulting in acute liver failure.
The recommended dose of acetaminophen is 4,000 mg daily. Taking more than the recommended amount may lead to serious liver injury in some people. Doses greater than 7,000 mg may cause death. Acetaminophen overdose is the leading cause of acute liver failure in the U.S. and is one of the most common poisonings worldwide. Liver failure may cause dangerous complications during Vicodin detoxification.
A person can intentionally take an overdose of acetaminophen in a suicide attempt, or he can suffer an accidental overdose. Someone can take an accidental overdose as the result of using several medications that contain acetaminophen, as it is a common produce in many prescription and non-prescription drugs. A Vicodin-dependent person can potentially accumulate large, even toxic, amounts of acetaminophen due to his chronic consumption of Vicodin. Finally, someone can suffer an acetaminophen overdose because he took an acetaminophen-containing product to reduce the uncomfortable withdrawal symptoms associated with Vicodin detoxification.
Dependence, Detoxification, and Withdrawal
Doctors prescribe Vicodin to relieve moderate to moderately severe pain. Most patients take Vicodin as prescribed and dispose of unused portions when they no longer need it. Some people use Vicodin non-medically to get high or to treat a condition other than the one the doctor had intended to treat when she wrote the prescription. Each year, approximately 5 million Americans use Vicodin or other pain relievers for non-medical reasons. About 10 percent of Americans use hydrocodone for non-medical reasons.
Anyone who uses Vicodin regularly for longer than a few weeks can become physically dependent on opioids, whether he uses it as directed for therapeutic reasons or for non-medical use. The human body adjusts to the presence of some toxic substances, including the hydrocodone in Vicodin. With continued use, the body begins to depend on a certain level of hydrocodone to feel normal - the person becomes opioid-dependent.
The Institute of Addiction Medicine estimates there are almost 2 million opioid-dependent people in the United States. Each of these individuals must undergo some form of detoxification to reach an opioid-free state.
When an opioid-dependent person takes an inadequate dose or discontinues Vicodin, his body struggles to stabilize and recover from the toxic effects of Vicodin. Doctors refer to this as Vicodin detoxification. Some medications may lower opioid levels drastically to initiate the detoxification process.
Vicodin Withdrawal Symptoms
An opioid-dependent person experiences detoxification through unpleasant physical and psychological withdrawal symptoms that tend to appear in two waves. The first set of symptoms begins a few hours after the final dose or inadequate dose.
Early withdrawal symptoms include:
Later, the individual may develop:
She may also develop high blood pressure, increased heart rate and other symptoms. These withdrawal generally symptoms persist for five or more days and increase in severity towards the end of detoxification. Unless interrupted, withdrawal symptoms fade as the person completes the detoxification process and do not return unless the individual relapses to an opioid-dependent state.
Someone can use non-opioid drugs to reduce the intensity of withdrawal symptoms without disrupting the detoxification process. He could stop withdrawal symptoms altogether by taking more Vicodin or another product containing hydrocodone, but this relapse would halt the detoxification process, reverse the positive effects of detoxification, and return the individual to an opioid-dependent state.
Benefits of Vicodin Detoxification
Vicodin detoxification begins to reverse some of the neurological and physical effects of chronic drug abuse but detoxification is only one part of the recovery process - most opioid-dependent people benefit from some rehabilitation to learn how to live without drugs. Rehabilitation usually includes counseling and behavior modification that teaches the individual to identify situations that may lead to drug abuse and to refuse Vicodin when offered.
Detoxification helps the individual overcome withdrawal symptoms and allows him to think clearly about recovery. These benefits facilitate his entry into rehabilitation and help him stay there long enough to continue reversing some of the neurological and physical effects of substance abuse.
Detoxification cleanses the body of the toxic effects of hydrocodone, making the patient feel healthier physically and psychologically. These benefits promote abstinence, as patients enjoy the benefits of good health. Detoxification reduces the frequency and severity of drug use episodes when relapses do occur.
Vicodin detoxification improves the patient’s cognitive functioning along with his social and psychological well-being. Detoxification helps people get back to work, fulfill personal responsibilities, and interact with others. Vicodin detoxification restores as much of the person’s life as possible.
Types of Vicodin Detoxification
The word “detoxification” also refers to the medical process of lowering opioid levels and relieving withdrawal symptoms. The detoxification process can occur at home, with the help of an outpatient clinic, or in a hospital or special inpatient detoxification facility.
Only about 10 percent of the people who need help with a substance abuse problem, like Vicodin detoxification, get it at a specialty facility like an outpatient drug clinic, hospital, detoxification center, or mental health institution. Everyone else engaged in self-help, went to a private physician, sought treatment in an emergency department, or endured detoxification while in jail or prison.
All of these approaches are viable as long as they bring the individual to an opioid-free state in a safe and effective manner. Each person arrives at opioid dependence in a slightly different way and every patient will have different needs when it comes to Vicodin detoxification. Some treatment approaches may not be suitable for all patients, depending largely on individual needs.
Doctors normally suggest patients taper Vicodin use gradually rather than quitting abruptly, especially if the patient has taken Vicodin every day for longer than a few weeks. Patients taper Vicodin by taking a smaller dose each day until reaching an opioid-free state. Self-detoxification is appropriate for those dependent on hydrocodone for a short time, have no underlying medical conditions that may cause complications, and who are likely to suffer only moderate withdrawal symptoms.
Stubborn withdrawal symptoms prevent some people from reaching an opioid-free state through tapering. These individuals might try quitting cold turkey by discontinuing Vicodin abruptly.
Quitting cold turkey can be profoundly uncomfortable, producing severe and prolonged withdrawal symptoms. The phrase “cold turkey” refers to the skin’s poultry-like appearance during Vicodin detoxification: pale, cold, clammy with goose bumps.
Some natural remedies make quitting cold turkey less uncomfortable. A person could take ginger or peppermint to ease nausea, for example. Chamomile or cayenne slows diarrhea. Acupuncture, meditation, yoga, and massage ease body aches and reduce other withdrawal symptoms.
The Thomas Recipe
Some people create homemade treatment plans that use prescription and non-prescription drugs to treat withdrawal symptoms. One remedy is The Thomas Recipe, which calls for a benzodiazepine such as Xanax or Librium to reduce anxiety and insomnia, Imodium for diarrhea, and vitamin B6 along with hot baths for muscle aches.
Medication-assisted detoxification, sometimes referred to medical detoxification, uses opioid and non-opioid drugs to control the onset of detoxification and manage withdrawal symptoms. Outpatient clinics, hospitals, and special detoxification clinics perform this type of Vicodin detoxification using potent, medical grade drugs.
An outpatient clinic may offer opioid replacement therapy that uses methadone or buprenorphine as an aid to tapering. Methadone and buprenorphine are opioids, so they mimic the effects of hydrocodone to reduce withdrawal symptoms but therapeutic doses of methadone and buprenorphine are too weak to get the patient high. Patients start out on a high induction dose of the replacement drug then take a smaller dose of methadone or buprenorphine each day until achieving a drug-free state.
Outpatient detoxification is appropriate for someone who has been dependent on opioids longer than one year and could not quit through tapering, requires little supervision, and cannot spend time detoxifying in a hospital.
Outpatient detoxification is appropriate for those patients that have been dependent on opioids for more than a year and who require little supervision.
A previously unknown German chemist synthesized methadone for the first time in 1939, in his search for a safe, effective pain reliever. While doctors around the world still prescribe methadone as an analgesic, U.S. physicians usually reserve methadone for treatment of opioid dependence, most notably as a maintenance program for heroin addiction.
About 100,000 Americans use a methadone maintenance program. These patients come to a clinic each day to drink a beverage containing methadone. The effects of one dose of methadone lasts about 24 to 36 hours. Patients remain on methadone maintenance while engaging in rehabilitation; once the patient gains the tools he needs to lead a drug-free life, he weans himself from methadone or participates in methadone detoxification.
Many detoxification specialists now prescribe methadone as aid to tapering; patients start out on a high induction dose then decrease dosages each day until reaching an opioid-free state. Doctors normally start patients on 10 to 15 mg of methadone and increase dosages by 10 mg each day until the patient no longer experiences withdrawal symptoms. Once the physician determines a safe and effective induction dose, he decreases subsequent doses by 10 mg each day until the patient is no longer dependent on opioids.
Buprenorphine is similar to methadone in that it mimics the effects of hydrocodone without causing euphoria. Many doctors now recommend buprenorphine over methadone for tapering, as it seems to be a safer alternative. As with methadone, patients start on a high induction dose and lower daily dosages through the tapering phase.
Buprenorphine is for sublingual use. The patient places the buprenorphine tablet under his tongue, where it dissolves and enters the bloodstream at the appropriate rate. Buprenorphine is available under the brand name, Subutex.
Some individuals abuse buprenorphine to get high by dissolving the tablet before injecting the solution into a vein. The drug maker Reckitt Benckiser addresses this problem by adding naloxone to the brand name buprenorphine preparation, Suboxone. Naloxone does not affect the consumer when taken sublingually, but intravenous administration of naloxone neutralizes the effects of buprenorphine to prevent the consumer from getting high. Furthermore, intravenous administration of naloxone causes withdrawal symptoms in an opioid-dependent consumer.
Inpatient Vicodin Detoxification
Hospitals and inpatient clinics administer strong non-opioid medications to control the Vicodin detoxification process and ease the resulting withdrawal symptoms. Inpatient physicians may administer naltrexone or other drugs to lower hydrocodone levels and initiate the Vicodin detoxification process. Doctors may give hydroxyzine or promethazine to calm nausea, Loperamide for diarrhea, and clonidine for a variety of symptoms including watery eyes, sweating and restlessness.
Additionally, inpatient detoxification usually includes screening for underlying conditions that may complicate care, especially for signs of acute liver failure associated with high acetaminophen levels. Inpatient staff members monitor patients closely and respond immediately to any complications that may arise.
Inpatient Vicodin detoxification helps anyone with a documented history of not engaging in or benefiting from self-detoxification or outpatient care. This approach is right for anyone who might suffer severe withdrawal symptoms or complications, or who have co-existing substance abuse problems that make outpatient detoxification ineffective.
Inpatient Vicodin detoxification is necessary for anyone recovering from an overdose or who suffers another physical or psychological condition that makes other approaches to treatment unsafe. Inpatient care is appropriate for someone with psychiatric problems, including acute psychosis or depression with suicidal thoughts, which prevent him from participating in less restrictive forms of treatment. Anyone who may harm himself or others must engage in inpatient detoxification.
Rapid detox brings patients to an opioid-free state quickly and safely. Rapid detox physicians sedate and anesthetize the patient before administering the usual detoxification and anti-withdrawal drugs so the patient rests in a comfortable “twilight sleep” during the procedure. Patients awaken a few hours later with no memory of the grueling detoxification process.
Our detox center: Who we are and what we do
We are a group of board-certified anesthesiologists and other medical professionals dedicated to delivering compassionate and effective care to people who need help overcoming dependence on Vicodin or other drugs. We have helps thousands of people through detoxification since opening the doors of our fully accredited hospital more than a decade ago.
We prescreen every patient for any condition that might undermine her success. We then develop an individualized treatment plan that may include rapid detox. After completing the detoxification process, the patient may continue her recovery in our qualified aftercare center.
Dependence on Vicodin is a chronic medical condition that can be difficult to treat. Many people find choosing the right form of treatment to be a confusing process. It can therefore be helpful to compare the various treatment approaches to highlight the benefits and disadvantages of each.
Self-detoxification is the least expensive approach because it spares the patient the cost of ant-withdrawal drugs or visits to a doctor’s office or hospital. However, the absence of prescreening, professional treatment and medications, self-detoxification is associated with severe withdrawal symptoms and an increased risk for complications. As long as the individual does not use opioids to reduce withdrawal symptoms, self-detoxification brings the patient to an opioid-free state more quickly than outpatient detoxification.
Outpatient detoxification does provide greater protection from withdrawal symptoms and complications but this approach usually takes longer than self-detoxification or inpatient care. Outpatients can remain in treatment for months or even years.
Inpatient Vicodin detoxification provides the greatest protection from complications through prescreening, professional treatment plans, potent detoxification and anti-withdrawal drugs, and close patient monitoring. Inpatient care does require the most extended stay in a hospital but delivers the patient to an opioid-free state sooner than outpatient care does: the average length of stay for detoxification is 4 days, compared with 197 days for medication-assisted therapy.
Rapid detox is the most humane and efficient approach, offering fast and complete Vicodin detoxification in the shorted time as compared to all other approaches, bringing the patient to a drug-free state in hours rather than days or months. Rapid detox provides the greatest protection against suffering from withdrawal symptoms, freeing the patient from the uncomfortable and demoralizing effects that interfered with his recovery in the past.
Possible Complications to Vicodin Detoxification
While Vicodin detoxification is not normally a life-threatening process, underlying medical conditions, co-existing problems with alcohol or other drugs, pregnancy, and acute or prolonged Vicodin abuse can cause dangerous complications. There are complications associated with all approaches to Vicodin detoxification. Acute liver failure associated with high acetaminophen levels can cause complications during any detoxification procedure. Detoxification can cause pain to return in patients who take Vicodin to treat chronic pain.
Relapse is the primary complication associated with all forms of Vicodin detoxification. Some people relapse during the detoxification process to stop overpowering withdrawal symptoms. Others relapse sometime after completing the detoxification process.
Relapse increases the risk for overdose. The detoxification process reduces the body’s tolerance to opioids, making the individual more sensitive to the effects of hydrocodone. This lowered tolerance and heightened sensitivity make it possible for someone to overdose on a weaker dose of Vicodin than he took just hours before experiencing even moderate withdrawal symptoms. Overdose from Vicodin and opioid pain relievers killed 14,800 people in 2008, claiming more lives than overdose from cocaine and heroin combined.
Self-Detoxification Possible Complications
Self-detoxification is associated with severe withdrawal symptoms that can cause direct complications, or aggravate underlying conditions to cause complications indirectly. Extreme vomiting or diarrhea can cause dehydration and imbalances of potassium and other electrolytes. Withdrawal symptoms such as increased blood pressure and pulse may aggravate a heart condition.
Someone might be tempted to treat withdrawal symptoms with acetaminophen and accidently exceed the maximum daily dosage and suffer acute liver failure. To make matters worse, the symptoms of acute liver failure can mimic withdrawal symptoms, tempting the patient to consume even more acetaminophen.
Complications to Outpatient Detoxification
Outpatient detoxification reduces complications associated with withdrawal symptoms but underlying conditions can still interfere with treatment. In addition, someone may grow dependent on the replacement drug and remain on methadone or buprenorphine for an extended time.
Methadone and buprenorphine are not entirely safe. The number of methadone overdoses has increased in the past decade; there were 5.5 times as many methadone overdose deaths in 2009 than there were in 1999. Death from buprenorphine overdose is possible, especially when combining buprenorphine with benzodiazepines like those used in The Thomas Recipe.
Complications to Inpatient Detoxification
Inpatient care provides a high level of protection from complications but patients may still face obstacles to care. One main complication to inpatient Vicodin detoxification is withdrawal from multiple substances, especially alcohol, benzodiazepines, sedatives and anti-anxiety drugs.
Rapid Detox Possible Complications
Rarely, someone may suffer an allergic reaction to the drugs used in rapid detox procedures. Strong sedatives can interfere with breathing, blood pressure, and pulse. Anesthesia patients may experience bruising, swelling, or infection at the injection site.
Myths about Vicodin Detoxification
Scientists have been researching opioid dependence and detoxification for decades, conducting studies and compiling information gathered from doctors and opioid-dependent people. Despite the wealth of information about opioid dependence, myths surrounding Vicodin detoxification prevent an untold number of people from getting the help they need. Accurate information helps the patient make sound choices regarding treatment and makes the detoxification process easier.
Myth: Acetaminophen safely reduces withdrawal symptoms during Vicodin detoxification.
Fact: The patient may already have high acetaminophen levels from chronic Vicodin abuse; taking acetaminophen to reduce withdrawal symptoms could potentially cause acute liver failure. Furthermore, the patient may take even more acetaminophen to control the symptoms of acute liver failure, which often mimic Vicodin withdrawal symptoms.
Myth: The prescription and non-prescription drugs included in The Thomas Recipe make self-detoxification safe.
Fact: Combining prescription and over-the-counter remedies make result in dangerous drug interactions, especially in the presence of high hydrocodone and acetaminophen levels and possible acute liver failure.
Outpatient Detox Myths
Myth: It would be cheaper to toss all the drug-dependent people in jail than to provide treatment.
Fact: Treatment is less expensive than incarceration. A year of imprisonment costs an average of $24,000 per inmate whereas the same 12 months of methadone would cost about $4,700 per patient.
Myth: Methadone causes bone rot.
Fact: Inadequate methadone doses may cause bone ache, a symptom of methadone withdrawal. Any methadone patient that experiences bone ache should consult with her clinician to discuss a dosage increase.
Inpatient Detox Myths
Myth: Putting opioid-dependent people in a hospital is a waste of time as substance abuse problems are incurable.
Fact: Dependence on Vicodin is a chronic condition but it is treatable. Relapse rates for drug addiction are similar to those of other chronic diseases, such as high blood pressure, diabetes or asthma.
Myth: In this bad economy, communities cannot afford investing in drug treatment programs.
Fact: Communities cannot afford to ignore the financial benefits of investing in drug treatment. Experts estimate every dollar spent on drug treatment programs returns a yield between $4 and $7 in reduced drug-related crime rates, criminal justice costs and theft. When these experts add in healthcare costs associated with dependence, yields jump to $12 gained for every dollar spent.
Rapid Detox Myths
Myth: The pain and humiliation of withdrawal are important features of Vicodin detoxification, as they punish the individual for abusing drugs.
Fact: Punishment and suffering are never part of any medical treatment and not all patients become opioid-dependent as the result of improper or illegal behavior. Rapid detox is the most humane approach to medical detoxification, sparing patients the uncomfortable and demoralizing withdrawal symptoms that prevented successful detoxification in the past.
Myth: Medical detoxification takes eight or more hours.
Fact: It takes a reputable expert one to two hours to perform rapid detox.
Detox and Pregnancy
The effects of opioid dependence can make detoxification unsafe for pregnant women. Methadone is currently only approved treatment plan for pregnant women, although a recent study published in the New England Journal of Medicine suggests buprenorphine may be appropriate for treating opioid dependence in pregnant women.
Self Detox and Pregnancy
A pregnant woman should consult a physician before attempting even tapering.
Inpatient Induction to Methadone Maintenance during Pregnancy
A doctor usually admits a pregnant woman to a hospital to start methadone maintenance treatment. He will typically start pregnant women on 10 mg to 20 mg of methadone then increase daily dosages by 5 - 10 mg of methadone based on her response. The maximum dosage for a pregnant woman is 60 mg of methadone daily.
Inpatient induction should include fetal monitoring to evaluate how well the unborn baby tolerates treatment. The pregnant woman should expect to stay in the hospital about three days before discharge to outpatient care, where she will continue methadone treatment until she delivers the baby.
Outpatient Induction for a Pregnant Woman
A pregnant woman may choose to start methadone maintenance as an outpatient. She will visit the clinic twice daily at first, once for a dose of methadone and again later for evaluation. She will reduce visits to once daily after the clinician establishes a safe and effective dose.
Women using methadone to maintain opioid dependence may suffer withdrawal symptoms late in pregnancy and require larger doses of methadone; the outpatient clinician will adjust dosages as needed.
Babies born to women taking methadone during pregnancy will remain under close observation in the hospital for 72 hours after delivery.
What is the Best Method of Vicodin Detoxification?
The best method of Vicodin detoxification relies heavily on individual need. Someone considering detoxification should assess the extent of his own dependence on Vicodin, his likelihood for developing severe withdrawal symptoms and complications, and his ability to refrain from drug use then choose the least restrictive approach that is still likely to bring him to an opioid-free state in a safe and effective manner.
Please contact us for more information on what approach to Vicodin detoxification may be right for you or for someone you love.