Hydrocodone Withdrawal Timeline: How to Detox from Opioid Drug

Last Updated: February 10, 2021

Authored by Olivier George, Ph.D.

Reviewed by Michael Espelin APRN

Hydrocodone is an opioid medication that has been making headlines over the past decade as the opioid epidemic in America has garnered more and more attention. Classified as a narcotic analgesic, it is used in medical settings to treat moderate to severe pain or, less commonly, severe coughing. However, it turned out that hydrocodone withdrawal symptoms are quite severe, requiring medical detoxification. The medication is likely to cause addiction, both physical and mental, despite its legitimate applications. As a result, those using it as prescribed often become dependent on the substance, and those who abuse it develop a crippling addiction. Hydrocodone withdrawal and detox rehabilitation programs are increasingly common to address a growing need. If any signs of abuse are noted, help is required.

Causes Of Hydrocodone Withdrawal

Hydrocodone withdrawal occurs for the same reason opioid elimination in general occurs—the body adjusts to the presence of the substance, becoming used to it, and once there is an absence of it, the process is triggered. Even if one has not developed an addiction to the drug, the symptoms can still appear when stopping the use. It is estimated that approximately 2.1 million people in the United States currently abuse opioid medications.  Withdrawal from Hydrocodone requires treatment because some of the symptoms can be life-threatening.

Woman experiencing hydrocodone withdrawal.

Why exactly does the absence of the drug trigger withdrawal? Prolonged use of the drug alters how the central nervous system functions, and over time, the nerve receptors in the brain can essentially forget how to function without the drug presence. Once the substance is removed from the system or the amount present reduced, the body will struggle to revert to its natural function, triggering responses in the body that make the individual feel unwell and might even put their life at risk.

Hydrocodone Withdrawal Symptoms

Hydrocodone withdrawal symptoms are essentially the same as those seen during the elimination of other opioid medications and illegal drugs. Depending on how much of the drug has built up in the system and which formula is being used, symptoms of hydrocodone withdrawals can start within a few hours of the last dose taken.

The Symptoms Include:

  • Watery eyes
  • Muscle pains and spasms
  • Shaking
  • Irritability
  • Disrupted sleep patterns
  • Increased anxiety
  • Runny or stuffy nose
  • Fever
  • Excessive perspiration
  • Racing heart
  • High blood pressure
  • Severe nausea
  • Vomiting
  • Diarrhea
  • Stomach cramps
  • Skin reactions
  • Depression
  • Intense cravings for the medication

Once these symptoms lessen or disappear, many of the mental and behavioral symptoms will remain. Some consider this to be the third stage.

Factors That Determine the Severity of Withdrawal

It is impossible to know just how severe hydrocodone withdrawal symptoms will be until the individual begins the process of battling abuse and addiction. However, certain factors tend to correlate with a more difficult time withdrawing.

People who have been on the substance long term tend to have a harder time, as well as those who took high doses. The overall health condition of a person plays a role too. The exact drugs taken with hydrocodone can also determine what withdrawal looks like as well as underlying health conditions.

Hydrocodone Withdrawal Timeline

The way the hydrocodone withdrawal timeline looks will vary from person to person and how it is approached. And of course, withdrawal is dependent upon how long Hydrocodone stays in the system, as this determines how long it will take for the medication to wear off. With that said, there is a general pattern it follows.

Below Is What Can Be Expected:

  1. The onset of symptoms begins. For people taking an immediate-release formula, onset may begin within 6-12 hours. For those taking extended-release formulas, it may take as many as 36 hours to begin.
  2. At this point, stage one begins. During this time, symptoms tend to mimic those of colds or the flu closely, and the individual may believe themselves to be sick. However, this is just the early stage of withdrawal. This will last up to five days from the onset of symptoms and is usually at its worst 72 hours after symptoms begin. Detox may help.
  3. As withdrawal stage one peters out, Hydrocodone withdrawal stage two begins. This is the stage where symptoms move beyond just being uncomfortable and become risky. Not only can these symptoms lead to significant health issues, but they also make relapse more likely. Supervision is most important during this stage, which can last for as long as two weeks.
  4. Once stage two has passed , individuals will still have mental and behavioral symptoms lasting for about two months. These can include mood disorders, behavioral disorders, and cravings for the drug. Getting through this time period and maintaining a life of sobriety usually requires rehabilitation and recovery programs.

While in the thick of it, it can feel like the withdrawal process is unending. However, it is temporary, and it is not the most difficult part of the recovery process. Instead, it is just the first step towards getting and staying clean.

How to Quit the Drug

Signs that a user needs to quit the substance use include developing serious hydrocodone side effects, such as reduced pain relief from the same dose of opioid painkillers and the development of mental and behavioral changes.

Female experiences breathing problems after hydrocodone.

Extended use, abuse, and illicit use of opioids are associated with many severe reactions, including behavioral disorders, psychosis, depressed respiration, convulsions, loss of consciousness, and death.

More than 40% of all opioid overdose deaths in the United States in 2016 involved a prescription opioid, with more than 46 deaths occurring daily from overdoses involving prescription opioids.

Dangers of Quitting Cold Turkey

People who use opioids often inquire about the consequences of quitting cold turkey. While getting off the drug, it is essential to achieve this slowly so that the body can re-adjust gradually to an opioid-free system without health risks. Users who abruptly quit the medication develop withdrawal symptoms, and for certain reasons, it’s advisable to get treatment while struggling with the symptoms.

First of all, the individual cannot know for certain how severe withdrawal will be, and it is possible to die from opioid withdrawal. Second of all, when unsupervised, it can be too tempting to begin using again to stop hydrocodone withdrawal symptoms rather than toughing it out and getting clean. Finally, in clinical settings, patients have access to both the Hydrocodone withdrawal remedies and more powerful detox options, making the treatment process more comfortable.

Benefits of Tapering Off Hydrocodone Gradually

Stopping drug abuse may be difficult, but it is possible. The slow tapering off the drug is the best way how to stop hydrocodone without side effects.

Tapers Are Better For the Following Reasons:

  • Tapers are better because it gives the body time to re-adjust to a reduced amount of the opioid and the absence of the substance in the system.
  • A tapering off hydrocodone schedule prevents symptoms of hydrocodone withdrawals because the body slowly adjusts to the system's reduced amounts of medicine.
  • It reduces the risk of drug cravings.

The physician will create an effective tapering schedule as per the individual’s medical profile. The prescribing physician will also prescribe other medications or recommend certain tips to reduce cravings for the medicine and cope with the side effects of opioid withdrawal associated with quitting.

How to Taper Off Hydrocodone

People who use it should visit their physicians to determine the best way to taper off hydrocodone. They should avoid creating a plan by themselves.

The Following Are Steps Involved In Weaning Off:

  • Physicians recommend a 25-percent dose reduction every other day for persons who have been using the medicine for a short period of time and a 10-percent weekly reduction for long-term users.
  • This is usually done by reducing the medicine dose taken weekly or daily and reducing it further after a few days. For example, if a user takes medicine 3 times per day, getting off hydrocodone pills will involve reducing it to 2 times per day for the next one week, then reducing to 1 daily afterward.
  • Once the body tolerates the minimum dose, the individual can consider getting off the drug completely.
  • During the taper, physicians will ensure the individual's blood pressure, pulse, and temperature are closely monitored to forestall any side effects of hydrocodone withdrawal or other complications.
  • During the process of tapering off hydrocodone, doctors prescribe other non-opioid painkillers and recommend lifestyle modifications to help control the pain.

Battling Addiction With Hydrocodone Detoxification

Hydrocodone detoxification can help to lessen the symptoms of withdrawal and speed the treatment process along. While there are online guides for detoxing at home, an effective detox often requires the use of prescription medications and supervised treatment therapies. Individuals looking to make getting clean faster and easier should seek to do so in a medical setting.

Doctor talking to a patient during hydrocodone detox.

Hydrocodone detoxification timeline will vary from person to person based on various factors, including the dosage of the drug, age, genetic variations of the patient, and others. In some cases, detox may be completed in a matter of days, while in others, it could take up to two weeks to be complete. There are four primary types of Hydrocodone detoxification.

They Are As Follows:

  • Unsupervised Detox: Done at home without assistance or guidance from medical professionals. Often based on advice found online, this form of detox can be hazardous, especially if the individual attempts to access prescription detox medications.
  • Inpatient Detox: Done at a hospital or rehabilitation center, the patient is supervised around the clock and engages in various therapies to manage the detox process. Medications may be used to make the process faster and easier for the patient.
  • Outpatient Detox: Done both at home and a rehabilitation center, the patient sees their medical team during the day for detox-related therapies but returns home at night. It is not recommended in cases of severe addiction where relapse is highly likely.
  • Rapid Detox: This form of detox is only done in medical settings and under heavy supervision. Because it can be deadly, doctors only use this type of detox with very healthy individuals. Any online guides for rapid detox at home should be ignored as they are highly unsafe.

No matter what type of detox is undertaken, the individual should consult with a medical professional in advance to ensure they are making the right choice and setting themselves up for success with substance abuse therapies.

For those who are suffering from Hydrocodone addiction or dependence, there is help available. Rehabilitation centers across the country know how to help manage Hydrocodone withdrawal and detox, making the process safe and as comfortable as possible for the patient and putting them on the right path to treat the addiction. Do not take on this difficult process alone.

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Page Sources

  1. National Institute on Drug Abuse, America’s Addiction to Opioids: Heroin and Prescription Drug Abuse, 2014. https://archives.drugabuse.gov/testimonies/2014/americas-addiction-to-opioids-heroin-prescription-drug-abuse
  2. Centers for Disease Control and Prevention, Prescription Opioid Data, 2020. https://www.cdc.gov/drugoverdose/data/prescribing.html
  3. U.S. National Library of Medicine, Opiate and opioid withdrawal. https://medlineplus.gov/ency/article/000949.htm
  4. Mansi Shah; Martin R. Huecker., Opioid Withdrawal, 2020. https://www.ncbi.nlm.nih.gov/books/NBK526012/
  5. Harvard Health Publishing, Treating opiate addiction, Part I: Detoxification and maintenance, 2019. https://www.health.harvard.edu/mind-and-mood/treating-opiate-addiction-part-i-detoxification-and-maintenance
  6. WHO, Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings., Withdrawal Management, 2009. https://www.ncbi.nlm.nih.gov/books/NBK310652/

Published on: March 13th, 2017

Updated on: February 10th, 2021

About Author

Olivier George, Ph.D.

Olivier George is a medical writer and head manager of the rehab center in California. He spends a lot of time in collecting and analyzing the traditional approaches for substance abuse treatment and assessing their efficiency.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.