Hydrocodone Withdrawal Symptoms And Timeline

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

April 2, 2019

Hydrocodone is a commonly prescribed opioid pain reliever. This medication has a high potential for abuse, and can cause a person to become dependent. If someone cuts back or stops taking hydrocodone after heavy usage, they may experience symptoms of withdrawal.

Withdrawal symptoms usually start within 12 hours of last usage. While opioid withdrawal is not typically life-threatening, the physical and mental symptoms can be agonizing. Common symptoms include sweating, nausea, diarrhea, and chills.

What Causes Hydrocodone Withdrawal?

Hydrocodone is a semi-synthetic opioid. This class of drugs binds to opioid receptors in the brain, and changes the way the body experiences pain. This drug is highly addictive, and can quickly lead a person to experience physical dependence.

Being dependent on hydrocodone means a person relies on the drug in order to prevent withdrawal symptoms. Over time, their body will begin to require a higher dose in order to achieve the same effects. This is called a tolerance.

When a person stops taking hydrocodone, their body needs time to recover from the period of drug dependence. This is known as the detoxification process. The body’s natural way of detoxing is what causes the symptoms known as opioid withdrawal.

Hydrocodone Withdrawal Symptoms

Hydrocodone withdrawal symptoms happen in several phases. The first phase is called early symptoms of withdrawal, and includes excessive yawning, runny nose, and sweating. Later symptoms of withdrawal may include abdominal cramping, nausea, and vomiting.

Additional symptoms of hydrocodone withdrawal include:

• agitation
• body aches
• trouble sleeping
• diarrhea
• dilated pupils
• uncontrollable leg movements
• body chills
• severe cravings

The severity of these symptoms will depend on a number of factors. Symptom severity can be influenced by factors such as how much hydrocodone a person was ingesting, how long they’ve been using the drug, and the overall status of their health.

Uncomfortable withdrawal symptoms are the reason many people find it so hard to stop using opioids like hydrocodone. If a person engages in polydrug use (abusing more than one substance at once), their withdrawal symptoms may be even more difficult to manage.

Withdrawal Timeline

Hydrocodone withdrawal symptoms may be classified as mild, moderate, or severe. The exact timing of withdrawal symptoms will differ with each individual.

Although these phases can be painful, it’s important to remember that withdrawal symptoms are temporary. These symptoms are your body’s natural way of detoxing the drug traces that have been built up over time.

Withdrawal from opioids, including hydrocodone, can occur within 8-24 hours of last use. The duration of symptoms usually lasts anywhere from four to ten days.

Phase 1 of acute withdrawal: Days 1-3

During this phase of withdrawal, people may suffer from physical and psychological symptoms. This can include aggressive behavior and feeling highly irritable.

Initial symptoms of withdrawal can also include:

• severe anxiety
• panic attacks
• nausea
• vomiting
• teary eyes
• hot and cold flashes
• loss of appetite
• excessive sweating
• insomnia

Phase 2 of acute withdrawal: Days 3-5

The second phase of withdrawal is less intense, but still requires close monitoring. It’s important to make sure people suffering from withdrawal symptoms are resting and staying hydrated.

The second phase of withdrawal symptoms may include:

• exhaustion
• muscle aches
• chills
• shivering

Phase 3 of withdrawal: May last up to six months

After acute withdrawal symptoms have passed, people detoxing from opioids may experience a period of extended withdrawal symptoms. These tend to be less severe, but may have an impact on a person’s mood.

Extended withdrawal symptoms may include depression and a reduced feeling of well-being. People may battle repeated, strong cravings for opioids.

Because of these strong cravings, people who are not detoxing in a supportive environment may succumb to relapse and begin the cycle all over again.

Potential Dangers Of Hydrocodone Withdrawal

Dehydration is the main danger associated with hydrocodone withdrawal. Because the body is expelling fluids through diarrhea, vomiting, and excessive sweating, it’s important to remain hydrated. Patients should drink as much water as possible during this time.

Withdrawal can also have a significant impact on a person’s mental health. Depression and anxiety are common side effects, both of which should be treated with counseling and/or medication-assisted treatment.

Unfortunately, withdrawal can also increase a person’s chance of overdose. When a person withdraws from opioids, their tolerance decreases. This means that if a person relapses, their lowered tolerance could result in an overdose.

It’s vital for people to know that post-detox, their body cannot handle the same dose they were previously using.

Medication-Assisted Treatment And Detox For Withdrawal

Due to the severity of these withdrawal symptoms, it’s best to withdraw in a medical detox program. In medical detox programs, patients are supervised and provided with physical and emotional support.

Most detox programs also provide medication-assisted treatment (MAT). MAT can be a life-saving tool for those who are battling the cravings associated with hydrocodone withdrawal.

There are several types of medication administered during opioid withdrawal, including:

• Clonidine: this adrenergic agonist helps to relieve the physical symptoms of withdrawal, including sweating, nausea, chills, anxiety, and tremors. It should not be given at the same time as an opioid substitution medication.
• Buprenorphine: this medication alleviates withdrawal symptoms, and also helps to prevent relapse. If a person was taking an especially high dose of hydrocodone, buprenorphine doses may be similarly raised, in order to control symptoms. Brand names include Suboxone or Zubsolv.
• Methadone: this drug is not offered as frequently anymore, due to its high potential for abuse. While methadone does reduce withdrawal symptoms as well as cravings, it should be administered with caution.

Getting Hydrocodone Drug Treatment For Withdrawal

Hydrocodone withdrawal is a serious condition that is best treated in a medical detox program. Inpatient (residential) rehab centers across the U.S. offer detox programs, along with medication-assisted treatment and recovery therapies, like the 12 steps.

To learn more about the symptoms and timeline of hydrocodone withdrawal, or to explore detox programs near you, reach out to one of our treatment specialists today.