Vicodin is a brand name for a prescription pain medicine that combines hydrocodone, an opioid, with acetaminophen. It can relieve severe pain, but it can also be habit-forming and can cause serious or life-threatening breathing problems, especially when mixed with alcohol or other sedating drugs. Taking too much can also damage the liver because of the acetaminophen.
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Hydrocodone is a semi-synthetic opioid, made by chemically processing natural opioids. MedlinePlus classifies it as an opiate (narcotic) pain reliever: it changes the way the brain and nervous system respond to pain. In Vicodin it is combined with acetaminophen, the same pain reliever sold in many over-the-counter products. Norco and Lortab are similar hydrocodone-acetaminophen products, and other hydrocodone combinations are used to treat cough.
Like other prescription opioids, hydrocodone can be addictive, especially when it is misused. Misuse means taking it in a way other than prescribed, taking someone else’s prescription or taking it to get high.
How Vicodin Affects the Body
If you are prescribed Vicodin, MedlinePlus advises taking it exactly as directed and not changing the amount or stopping it without talking to your doctor. Before starting, tell your doctor about any liver, kidney, heart, thyroid, pancreas or gallbladder disease.
Hydrocodone eases pain but also causes drowsiness and can produce a sense of well-being that some people come to seek out. MedlinePlus lists common side effects such as nausea, vomiting, stomach pain and increased sweating. Some side effects are serious and need emergency care, including seizures, extreme drowsiness and trouble breathing or swallowing.
Main Risks
Breathing problems
Hydrocodone can cause serious or life-threatening breathing problems. MedlinePlus says the risk is highest during the first 24 to 72 hours of treatment and any time the dose is increased. Warning signs include slowed breathing, long pauses between breaths and shortness of breath.
Alcohol and other drugs
Drinking alcohol, using street drugs or taking certain other medicines with a hydrocodone product can increase the risk of serious breathing problems, heavy sedation or coma. MedlinePlus advises not drinking alcohol at all while taking it. Tell your doctor and pharmacist about every medicine you take, including sleep aids and anxiety medicines.
Liver damage from acetaminophen
Because Vicodin contains acetaminophen, taking more than prescribed can harm the liver. MedlinePlus warns that too much acetaminophen can cause liver damage serious enough to need a transplant, or death. Many cold, flu and pain products also contain acetaminophen, so taking them together can add up to an overdose. Ask your pharmacist before combining any of them. MedlinePlus also warns against taking acetaminophen if you have three or more alcoholic drinks every day, which is one more reason alcohol and Vicodin don’t mix.
Pregnancy and other people in the home
Regular use during pregnancy can cause a newborn to have life-threatening withdrawal symptoms after birth, so tell your doctor if you are pregnant or planning to be. Hydrocodone can also harm or kill other people who take it, especially children. Keep it out of sight and reach, and get rid of unneeded pills through a medicine take-back program.
Overdose: Signs and What to Do
Signs of a hydrocodone overdose include:
- slow, shallow or stopped breathing, or trouble breathing
- extreme sleepiness, or being unable to respond or wake up
- a slow heartbeat
- cold, clammy or blue skin
- narrowed or widened pupils
Call 911 right away. Give naloxone (Narcan) if you have it; it can reverse the life-threatening effects of an opioid overdose. Stay with the person until help arrives, because naloxone can wear off before the opioid does and breathing can slow again. MedlinePlus recommends asking your doctor or pharmacist about keeping a rescue medicine, naloxone or nalmefene, at home while you take hydrocodone, and making sure the people you live with know how to use it.
Naloxone is easy to get. NIDA notes that many pharmacies carry it, and community programs and local health departments often give it out free. It only reverses opioids, and it does not replace emergency care: always call 911 first.
Is Vicodin Addictive? Dependence and Withdrawal
Yes. MedlinePlus warns that hydrocodone combination products may be habit-forming. With regular use the body becomes physically dependent and builds tolerance, so a person may need more for the same effect. Dependence can happen even when the medicine is taken as prescribed; addiction, or opioid use disorder, means continuing to use despite harm and having trouble stopping. Tell your doctor if you find yourself taking more than prescribed or thinking about the medicine often.
Don’t stop taking Vicodin suddenly without talking to your doctor. Stopping abruptly after regular use can cause withdrawal, with restlessness, sweating, nausea, vomiting, muscle aches, anxiety and diarrhea. Doctors usually lower the dose gradually. If you have been misusing Vicodin, ask about medically supervised withdrawal, where medications can ease symptoms and cravings. Our medical detox guide explains how that works.
If Someone You Love Won’t Accept Help
Watching someone you love struggle with prescription pills is frightening, and many families don’t know where to start. A first step is to talk with a doctor, counselor or the SAMHSA National Helpline about options for your situation. In Florida, the Marchman Act allows a family member or other concerned person to petition a court for involuntary assessment and stabilization of a person with a substance use problem. It is a serious legal step, so it helps to learn how it works before you need it.
Vicodin and the Law
Since October 6, 2014, the DEA has classified hydrocodone combination products, including Vicodin, as Schedule II controlled substances. They were moved from Schedule III because of their potential for misuse, and now carry the same federal controls as other Schedule II opioids such as oxycodone. Possessing them without a valid prescription is illegal.
Treatment for Vicodin Addiction in Florida
Addiction to Vicodin is treated as opioid use disorder. Medication is the standard of care: the FDA has approved methadone, buprenorphine and naltrexone, and NIDA reports that these medications lower the risk of returning to drug use and of dying from an overdose. They work best alongside counseling.
Many people start treatment in an intensive outpatient program while living at home, and others need residential care. Our guide to medication-assisted treatment in Florida explains your options, and you can search licensed Florida rehabs by location and level of care. If you are taking Vicodin for pain and are worried about your use, your prescriber is also a good first call.
Getting Help Now
- Emergency: call 911 for any sign of overdose, a seizure, trouble breathing or someone who cannot be woken.
- SAMHSA National Helpline: 1-800-662-4357. Free, confidential, 24/7, in English and Spanish, for treatment referrals and information.
- Crisis: call or text 988 (Suicide & Crisis Lifeline) if you or someone you love is in emotional crisis or thinking about suicide.
- Poison Control: 1-800-222-1222 for questions that are not emergencies.
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Frequently Asked Questions About Vicodin (Hydrocodone and Acetaminophen): Risks and Treatment
What is Vicodin?
Vicodin is a brand name for a prescription painkiller that combines hydrocodone, an opioid, with acetaminophen. Norco and Lortab are similar hydrocodone combination products. Since October 6, 2014, the DEA has classified hydrocodone combination products as Schedule II controlled substances, the same category as oxycodone, because of their high potential for misuse. Prescriptions for them can't include refills.
Is Vicodin addictive?
Yes, Vicodin can be addictive. MedlinePlus warns that hydrocodone combination products may be habit-forming. The hydrocodone in Vicodin can cause euphoria, and with repeated use the body can become dependent and tolerant, so people may take more to get the same effect. The risk is higher with misuse, higher doses and long-term use. Tell your doctor if you are taking more than prescribed.
Can you drink alcohol while taking Vicodin?
No, you should not drink alcohol while taking Vicodin. MedlinePlus warns that drinking alcohol or using street drugs with hydrocodone combination products can increase the risk of serious breathing problems, sedation or coma. Benzodiazepines and sleep medicines carry the same danger. If someone on Vicodin is very hard to wake or breathing slowly, call 911 and give naloxone (Narcan) if you have it.
Can Vicodin cause breathing problems?
Yes, Vicodin can cause serious or life-threatening breathing problems, especially in the first 24 to 72 hours of treatment and after a dose increase. The risk is higher with alcohol or other sedating drugs. MedlinePlus recommends talking with your doctor about keeping a rescue medicine, naloxone or nalmefene, at home, and making sure family members know how to use it.
What happens when you stop taking Vicodin?
If you have been taking Vicodin regularly and stop suddenly, you may go through opioid withdrawal, with restlessness, sweating, vomiting, muscle aches, anxiety and diarrhea. Doctors usually lower the dose gradually to avoid this. If you have been misusing Vicodin, ask about medically supervised withdrawal; medications can ease symptoms and cravings.
How do I get help for Vicodin addiction in Florida?
Vicodin addiction is treated as opioid use disorder, and medication is the standard of care. Methadone, buprenorphine and naltrexone reduce cravings and the risk of overdose death and work best with counseling. Florida has outpatient, intensive outpatient and residential programs that offer this care. Learn how it works in our guide to medication-assisted treatment in Florida.
