Hydrocodone is an opioid. It belongs to a group of drugs also called narcotics and is used to treat pain.

Doctors may prescribe hydrocodone for severe or long-lasting pain that is not well controlled with other pain medicines. It may also be prescribed in some cases to treat a persistent (ongoing) cough.

Understanding that hydrocodone is an opioid is important, especially for people with a history of opioid use disorder (OUD) or concerns about opioid misuse. Opioids can be habit-forming, meaning the body and brain may become dependent on them over time.

Knowing the risks can help people use hydrocodone more safely and talk with their doctor about pain management and recovery considerations.

What Is Hydrocodone?

Hydrocodone is a prescription opioid medication used to treat pain. In the United States, it’s classified as a Schedule 2 controlled substance, meaning it has a high risk for misuse, dependence, and addiction.

Like other opioids, hydrocodone works by attaching to opioid receptors in the brain, spinal cord, and gastrointestinal (digestive) tract. These receptors help control how the body senses pain and also affect mood and the brain’s reward system.

When hydrocodone activates opioid receptors, it can block pain signals and may create a sense of euphoria (intense pleasure or happiness). Although these effects can help relieve short-term pain, they can also increase the risk of misuse and OUD.

Other common side effects of hydrocodone include:

• Constipation (difficulty having a bowel movement)
• Drowsiness
• Nausea
• Dizziness

With ongoing use, some people may develop physical dependence, meaning their body adapts to the medication over time. They may need higher doses to achieve the same pain-relieving effect, known as tolerance. If hydrocodone is stopped suddenly or the dose is lowered too quickly, withdrawal symptoms can occur.

Other serious risks include opioid overdose and dangerous drug interactions with:

• Alcohol
• Certain supplements
• Sleep medications
• Benzodiazepines (anti-anxiety medications)
• Other prescription drugs

What Are the Different Forms of Hydrocodone?

Hydrocodone comes in several forms. Many commonly prescribed products are short-acting tablets or capsules that usually combine hydrocodone with acetaminophen.

There are also extended-release (long-acting) hydrocodone products that release the medication slowly over time to help manage ongoing, severe pain.

Hydrocodone is also found in combination products, most often with acetaminophen, which can help with pain in a different way.

Can Hydrocodone Be Mistaken for Other Medications?

Hydrocodone can sometimes be confused with other types of pain medicines or drugs.

Some people mistake hydrocodone for over-the-counter pain relievers such as ibuprofen or acetaminophen. Others may confuse it with stimulants, such as amphetamines, which increase energy, attention, and alertness. However, hydrocodone works very differently from these medications.

For starters, hydrocodone is an opioid, not a non-opioid pain reliever. Non-opioid pain medicines work in different ways, such as reducing inflammation (swelling and irritation) or blocking pain signals without affecting opioid receptors in the brain.

Hydrocodone also isn’t a stimulant. Instead of raising heart rate and energy levels, hydrocodone can cause relaxation, drowsiness, and slowed breathing. Slowed or stopped breathing is the most dangerous effect of an opioid overdose and can become life-threatening.

The effects and risks of hydrocodone are more similar to other opioid medications, such as codeine and oxycodone, than to non-opioid pain relievers or stimulants.

What Are the Risks of Hydrocodone?

If you’re in recovery from OUD, it’s important to use extra caution with hydrocodone. Like other opioids, hydrocodone carries risks that can affect both physical health and recovery.

Potential for Misuse

One of the main risks of any opioid medication is misuse. Misuse can include:

• Taking more medication than prescribed
• Taking it more often than directed
• Using it in ways other than prescribed, such as crushing or snorting pills

Even when someone starts by following their prescription, patterns of misuse can develop over time. Using opioid medications for longer periods increases the risk of misuse.

Physical Dependence

Another important risk is physical dependence. This means your body adapts to the amount of the medication you’re taking. A person may feel the medication becomes less effective over time, which can be a sign of tolerance. And if you stop taking it suddenly, you may feel withdrawal symptoms.

Dependence can happen even when a person takes hydrocodone exactly as prescribed, especially if they’re on it for a longer period. Dependence isn’t the same as addiction, but it can make hydrocodone harder to use safely.

Overdose Risk

Hydrocodone also comes with a risk of overdose. Because hydrocodone slows breathing, taking too much can cause breathing to become dangerously slow or stop.

This risk increases if hydrocodone is combined with other substances that also depress the central nervous system, such as alcohol, benzodiazepines, or certain sleep medications.

Overdose can happen by accident, especially if someone takes more than intended or returns to a previous dose after a period of not using.

If you’re at risk for overdose, ask your doctor or pharmacist about naloxone, a medicine that can quickly reverse an opioid overdose. If you think someone may be overdosing, call emergency services right away. If naloxone is available, give it as directed while waiting for help.

When Is Hydrocodone Use a Problem?

It’s possible to use opioids like hydrocodone safely. Not everyone who takes a prescribed opioid develops OUD. The difference depends on how you use your medication and how it affects your life.

Taking hydrocodone as directed for a clear medical reason is an appropriate use. This also includes stopping (or tapering down) when instructed to do so.

Using hydrocodone in a way that isn’t prescribed may be a sign that you need more support. If your prescribed dose isn’t working well enough or you’re having trouble tapering down, talk with your healthcare provider.

Even people who start with a prescription can develop dependence or misuse over time. Keep open communication with your healthcare team about your pain management so they can help you use opioids as safely as possible.

Should You Take Hydrocodone?

OUD is a medical condition. It describes a pattern of opioid use that leads to problems or distress.

OUD can include strong cravings, difficulty controlling use, and continued use despite harm. Hydrocodone, like other opioids, can contribute to this condition because of how it affects the brain’s reward system.

It’s helpful to know about the risks of opioids. But you should also remember that taking hydrocodone as prescribed for pain doesn’t mean you have or will develop an OUD. Many people who are prescribed opioids for short-term pain don’t end up using their full prescription.

Hydrocodone can be helpful after surgery or an injury. Like any medication, doctors prescribe hydrocodone when they feel the benefits outweigh the risks. To help keep you safe, they’ll recommend the lowest effective dose for the shortest possible time.

Join the Conversation

On MyOpioidRecoveryTeam, people share their experiences with opioid use disorder, get advice, and find support from others who understand.

Have prescription opioids like hydrocodone affected your recovery or pain management? Let others know in the comments below.