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Analgesic opioids — known commercially as Vicodin and Norco, among others — are a fairly common prescription. Vicodin is available as oral tablets or solutions that contain between 5 and 10 mg of hydrocodone and between 300 and 325 mg of acetaminophen (paracetamol), optimized for temporary pain relief.
These drugs were approved by the FDA in 1982 and are currently listed as Schedule II controlled substances by the U.S. Drug Enforcement Agency. Schedule II drugs are those that have a high potential for abuse that can lead to severe physical and psychological dependence.
As long as it’s taken responsibly, the drug shouldn’t cause addiction or severe consequences — but the side effects can cause other concerns. Read on for an overview of Vicodin side effects and the associated risks.
Why Do Doctors Prescribe Vicodin?
Vicodin is prescribed to relieve moderate to severe pain associated with dental work, postoperative recovery, accident-related injuries or other conditions causing temporary discomfort. It’s not intended for long-term use, including treatment of chronic or psychological issues.
The CDC reports that, in 2020, 43 prescriptions per 100 individuals were for opioids like Vicodin. To encourage safe use, the FDA has issued a black box warning for Vicodin, detailing the risk of suffering acute liver failure when doses of acetaminophen exceed 4000 milligrams in 24 hours.
What Are the Most Common Side Effects of Vicodin?
Hydrocodone produces the bulk of Vicodin side effects, such as:
- Drowsiness or sedation
- Dizziness
- Euphoria
- Confusion or disorientation
- Lack of coordination or inability to walk without stumbling
- Slurred speech
Acetaminophen side effects include:
- Nausea
- Constipation
- Abdominal pain/cramping
Not all Vicodin users will experience the side effects of acetaminophen. If someone who previously took acetaminophen alone developed nausea and stomach pain, they’ll probably feel these side effects when they take Vicodin.
Is Depression a Side Effect of Vicodin?
Though it’s less common, depression may occur in people who take Vicodin or other prescription opioids longer than 1 month. A study investigating 100,000 individuals prescribed opioids for pain found that 10% reported feeling moderately depressed, even though they’d never been diagnosed with depression.
This effect could be attributed to pain impacting a person’s physical and mental well-being or a Vicodin-induced chemical imbalance in the brain that will stabilize over time.
Vicodin Anxiety Side Effects
Although hydrocodone is a powerful opioid with sedative properties, people taking Vicodin as prescribed often report feeling anxious and sometimes panic-stricken for no reason. Doctors think this counterintuitive side effect is due to the way hydrocodone disrupts neurotransmitter levels in the brain.
Insomnia and Vicodin
Vicodin can cause insomnia, or difficulty falling asleep and staying asleep. One study compared subjects who didn’t take prescription opioids and subjects who did. The results found that insomnia symptoms were 42% higher in subjects who took opioids than in non-opioid users.
Researchers believe this is also linked to the depression and anxiety associated with prescription pain relievers containing hydrocodone.
Acetaminophen Toxicity
Vicodin contains acetaminophen, which can increase the risk of liver damage in people who abuse Vicodin. Taking more than 4000 milligrams of acetaminophen per day for just a few months can cause permanent liver damage and liver necrosis.
Excessive acetaminophen over time kills liver cells through a process called mitochondrial oxidative stress. Signs of acetaminophen toxicity include jaundice, severe diarrhea, nausea and worsening pain around the liver area.
Hydrocodone Toxicity
Hydrocodone is generally safe when taken as prescribed by a licensed physician. However, tolerance builds quickly to the drug’s analgesic properties. Consequently, individuals using Vicodin for pain may start abusing their prescription by taking two or three pills in 24 hours instead of one pill to get relief from pain.
Signs of overdosing on hydrocodone demand emergency medical treatment to prevent shock and coma. Shallow breathing, vomiting, inability to stay awake, pinpoint pupils and clammy skin indicate the person could be overdosing on Vicodin or another drug containing hydrocodone.
How Long Do Vicodin Side Effects Last?
Side effects are proportionate to how many milligrams of hydrocodone are in one Vicodin. For example, the strongest Vicodin tablets contain 10 mg of hydrocodone and 300 mg of acetaminophen. The usual dosage for adults is one pill every 4 to 6 hours. No more than six tablets should be taken in a day.
A prescription of Vicodin with 10 mg of hydrocodone is typically for those suffering from severe pain that significantly impairs their quality of life. Though the side effects may feel potent initially, within an hour of taking one Vicodin, they generally subside.
Although Vicodin users will have strict prescriptions, they may start abusing Vicodin for its addictive effects (euphoria, sense of well-being and relaxation) even though their pain has diminished. Vicodin tablets with fewer milligrams of hydrocodone naturally cause shorter-term effects. However, you can easily get addicted to Vicodin of any strength due to its high risk of abuse.
Side Effects of Vicodin Combined With Other Drugs
To enhance the effects of hydrocodone, Vicodin abusers may combine their prescription with other drugs. Mixing Vicodin with other central nervous system depressants, such as heroin, alcohol or benzodiazepines, dramatically increases the risk of severe respiratory depression, coma and death.
People under the influence of Vicodin and a CNS depressant can lapse into unconsciousness and choke on their vomit. They can forget how much Vicodin they have taken in 24 hours and overdose on hydrocodone. They can also have seizures that leave them with permanent neurological damage.
Can Taking More Vicodin Than Prescribed Result In Addiction?
Even taking Vicodin as prescribed presents a risk of addiction. In the brain, hydrocodone is converted to hydromorphone, a chemical resembling morphine that’s much more potent than hydrocodone. Available by prescription only as a narcotic analgesic called Dilaudid, hydromorphone eases severe pain in people with chronic late-stage diseases.
Additionally, Vicodin withdrawal symptoms are intense. Joint and muscle pain, nausea, vomiting, insomnia and anxiety can make a person feel so sick they start abusing Vicodin again. Unfortunately, as their addiction worsens, so does the severity of withdrawal symptoms each time they try to quit Vicodin.
It’s Never Too Late to Get Help
If you or someone you know is struggling with an addiction to Vicodin, the professional team at FHE Health is here to help. Our inpatient and outpatient treatment programs include medical detoxification, intensive therapy and support services. Contact us today.
