Vicodin is a brand name for a powerful opioid narcotic that’s a combination of hydrocodone and acetaminophen, which many people take to manage pain.¹ It is one of the most frequently prescribed combinations of hydrocodone.¹

If you or your loved one is struggling with Vicodin misuse or addiction, it is important to know more about Vicodin, how addictive it can be, and what the signs of Vicodin addiction are. Furthermore, knowing about the potential for overdose and the dangers of mixing Vicodin and alcohol—as well as other substances—may be important for your safety and well-being.

What Is Vicodin?

Vicodin is a brand name for a combination medication that’s made up of the opioid drug hydrocodone, a narcotic painkiller, and acetaminophen, a non-opioid analgesic.¹ Vicodin is prescribed for the treatment of moderate to moderately severe pain and can come in capsule, liquid, or tablet form.^{1, 16} Similar hydrocodone/acetaminophen products are sold and marketed as Norco, Lortab, Lorcet, Vicoprofen, and Hydrocmet.¹

Vicodin is frequently misused, with the U.S. Drug Enforcement Administration (DEA) citing that its main ingredient, hydrocodone, is the second most common prescription drug involved in American criminal cases.¹ The DEA notes that the combination of hydrocodone and acetaminophen is the most commonly misused form of hydrocodone in school-age children.¹

Street names for Vicodin include Vike and Watson-387.²

The DEA classifies Vicodin as a Schedule II controlled substance, which means it has a high potential for misuse and dependency.^1, ³ Vicodin misuse can look like:⁴

Taking it in ways it was not prescribed.
Taking it even though it was prescribed for someone else.
Using it for recreational purposes to get high.

What Is Vicodin Addiction?

Opioid addiction is a complex condition in which a person compulsively uses Vicodin or other opioids despite the significant negative consequences that result from its use.^{4, 5} When people repeatedly misuse Vicodin, there can be changes in the brain, which can lead people to engage in risky behaviors such as compulsive drug use.⁴

Vicodin is a type of opioid medication, which means it attaches to opioid receptors in the brain to relieve pain.⁴ Opioids increase the activity of dopamine in the brain, a neurochemical that is related to feelings of reward and pleasure, which can reinforce repeated use and contribute to addiction.⁴ The longer someone takes Vicodin, even as instructed by a doctor, the more likely they are to experience tolerance to the drug’s effects, which means they need to increase their dose (or the dose frequency) of this drug to keep feeling its effects.⁴

Over time, a person may also develop a physiological dependence on Vicodin, in which their body adapts to the presence of Vicodin. If they stop using it, they will experience withdrawal symptoms.³ However, being physiologically dependent on Vicodin does not necessarily mean a person is addicted to it, although both tolerance and dependence can contribute to addiction.

Signs of Vicodin Addiction

Opioid use disorder (OUD) is the clinical term for an addiction to opioids. An OUD can only be diagnosed by a medical professional. Medical professionals use the following criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, (DSM-5) to determine whether a person has an OUD. If a person has displayed 2 or more of the criteria during the past 12 months, they may be diagnosed with an OUD. These criteria include:⁶

Having strong cravings for Vicodin or other opioids.
Taking more opioids than needed.
Failing to fulfill responsibilities at work, school, or home due to opioid use.
Spending a lot of time and money to get opioids, use them, and recover from using them.
Making unsuccessful attempts to quit or cut back on using opioids.
Using opioids despite experiencing serious negative consequences.
Taking opioids while driving, swimming, or engaging in other potentially dangerous activities.
Abandoning things that used to be important, like recreational pursuits or hobbies, to use opioids.
Continuing to take opioids even though it has caused a medical or psychological condition or made them worse.
Increased conflict with loved ones or a significant impact on other interpersonal relationships because of using opioids.
Showing signs of tolerance to opioids (needing to use more of the drug to feel its effects).
Experiencing withdrawal symptoms after stopping opioid use or significantly reducing one’s dose.

Effects of Vicodin

Vicodin’s primary effect is pain reduction, and its side effects are like those of other prescription opioids. In the short term, this may include:^{4, 16}

Sleepiness.
Dizziness.
Constipation.
Euphoria.
Nausea.
Respiratory depression (i.e., slowed breathing).

Some of the long-term effects of opioid use include:^{6, 16}

Dryness of the nose and mouth.
Severe constipation.
Menstrual cycle irregularities in women.
Sexual difficulties for some men.
Severe depression (which may include suicidal thoughts and suicide attempts).
Increased risk for overdose or addiction (especially if misused).

Significant health risk of using Vicodin is hypoxia, a condition caused by a shortage of oxygen in the brain resulting from the slowed breathing caused by Vicodin or other opioids. Hypoxia typically occurs because of an overdose and can cause serious brain damage and can lead to a coma or even death.⁴

Certain people are at higher risk for adverse effects. For example, older people are at higher risk of complications from Vicodin use due to its interaction with other medications.⁴ Since metabolism function varies by person, the body may break down Vicodin differently.⁴

Pregnant women who use Vicodin or other opioids run the risk of low-weight babies and miscarriage. They also risk giving birth to an opioid-dependent baby who will likely experience withdrawal symptoms as a newborn, which is called neonatal abstinence syndrome.⁴

Vicodin Overdose

An overdose can occur when someone takes enough Vicodin to cause life-threatening symptoms or even death.⁴ As with other opioids, there is a risk of overdosing on Vicodin if it is prescribed to you.⁴ The most recent data indicates that more than 49,000 people died in 2019 from opioid overdoses.⁷

When people overdose on Vicodin and other opioids, their breathing can slow down or even stop. The lack of oxygen to the brain (i.e., hypoxia) can cause them to lapse into unconsciousness and possibly die.⁴ Other symptoms of a Vicodin overdose may include:⁸

Loss of consciousness (or an inability to respond).
Highly constricted, or pinpoint, pupils.
Slowed, shallow, or stopped breathing.
Cold, pale, or clammy skin.
Bluish lips or nails.
Limpness of the body/extremities.
Slowed heart rate.
Choking or snorting noises.

Risk Factors for Vicodin Overdose

Anyone who takes Vicodin risks experiencing an overdose, however, some people may be at higher risk of a Vicodin overdose. Those who take Vicodin may be at higher risk of an overdose if they:⁹

Take it with alcohol or certain other drugs, such as benzodiazepines or other drugs that cause sedation (e.g., Ambien).
Take a dose that is higher than what was prescribed.
Take illicit Vicodin, which could contain unknown substances that are harmful, like fentanyl, a powerful synthetic opioid.
Have a medical condition, like sleep apnea or impaired kidney functioning.
Are age 65 or older.

Treating a Vicodin Overdose

If you or anyone you know is experiencing an overdose, call 9-1-1 immediately. If someone is experiencing an opioid overdose, you can help while waiting for emergency medical services to arrive by:^{8, 9}

Giving naloxone if you have it.
Trying to keep the person alert and breathing.
Laying the person on their side to prevent choking.
Remaining with the person until emergency personnel arrives.

Naloxone is a medicine that can reverse the effects of an opioid overdose.^{10, 13} Naloxone is available as either an injection or as a nasal spray.¹⁰ Naloxone reverses an opioid overdose by attaching to the opioid receptors in the body and blocking the effects of opioids. Naloxone’s effects may only be temporary, so it’s critical that the person receives medical care even if the naloxone has appeared to have successfully reversed the overdose.¹⁰

Risks of Mixing Vicodin with Alcohol and Other Drugs

When a person mixes Vicodin with another drug or alcohol, it is known as polysubstance use. Polysubstance means using more than one substance at a time.¹¹

People can engage in polysubstance use both intentionally and unintentionally. They may combine drugs on purpose to enhance or decrease certain effects or to experience the various sensations substances may cause.¹¹

Unintentional combinations can occur when people take a substance that has been laced with another, of which they are unaware. Polysubstance use can have deadly outcomes, regardless of a person’s intention or awareness of it happening.¹¹

If you combine Vicodin with another type of opioid, benzodiazepines, sleep aid medication, or alcohol, it increases the respiratory depression effects of Vicodin and increases the risk of overdose.¹¹ Vicodin use leads to slowed breathing, and combining substances like alcohol and opioids can risk slowing breathing so much that a person stops breathing altogether.¹²

Older people can be at increased risk of unintended outcomes of combining Vicodin with other substances due to the number of medications they are often taking.⁴

Vicodin Withdrawal

Vicodin withdrawal occurs when a person stops using it after they have developed a physiological dependence upon it.⁴ You do not have to be addicted to Vicodin to experience withdrawal symptoms.

As with any opioid, Vicodin withdrawal can be highly uncomfortable and unpleasant. Quitting Vicodin without appropriate professional support is not advisable.¹⁴ Common withdrawal symptoms and signs may include:^{14, 16}

Nausea.
Vomiting.
Abdominal cramping.
Diarrhea.
Sweating.
Yawning excessively.
Body aches.
Spasms.
Rapid heart rate.
Problems with sleep.
Anxiety.
Gooseflesh and chills.

Treatment for Vicodin Addiction

No one addiction treatment works for everyone, however, there are many options to treat Vicodin addiction.¹⁵ Addiction is not curable, but it can be successfully managed and treated.¹⁵ There are many aspects of a person’s life, including medical, behavioral, social, legal, or vocational that are often part of a person’s overall treatment needs.^{14, 15}

For many, medication is an integral part of treating addiction to Vicodin or other opioids. Some of the most commonly used medications for treating opioid use disorder are:¹³

Methadone, which eliminates or reduces withdrawal symptoms and cravings and can be used during acute withdrawal or as part of a long-term treatment plan.
Buprenorphine helps to ease withdrawal symptoms and cravings and can also be used in both short- and long-term treatment.
Naltrexone, which blocks the effects of opioids can help to reduce cravings and avoid relapse to aid in the long-term treatment of OUD.

In addition to medication, behavioral therapy is an important aspect of treating an OUD and can include individual, group, and family therapy.⁴ Cognitive-behavioral therapy (CBT) is a commonly used approach to treating OUD and other substance use disorders.⁴ It helps people to work on the patterns of thinking that are part of drug use. It can also help people learn new ways to cope with stress without using substances and address issues with problem-solving or communication a person may have.⁴

Addiction treatment can take place at various levels of care and settings depending on the person’s needs and substance use. There are many types of treatment programs, and treatment options can include:^{15, 17}

Outpatient addiction treatment allows people to live at home and take care of family responsibilities or go to work while visiting the facility to receive treatment interventions. Telehealth options are sometimes available.
Inpatient treatment or residential treatment involves staying at a facility 24/7 while getting treatment. Some people require this level of treatment, but it depends on the severity of substance use and other factors, such as underlying mental health issues.
Detoxification is often an important first step towards recovery from Vicodin addiction; however, detox alone may not be as effective at promoting long-term abstinence and additional treatment is beneficial. Detox can take place in an inpatient or outpatient setting.

If you or your loved one are struggling with Vicodin addiction, American Addiction Centers (AAC) is here to help. Our friendly admission navigators are available 24/7 via our confidential helpline at to listen to your story and help you find treatment. Call us today to learn about the right program for your treatment needs and verify your insurance coverage.

Vicodin Addiction: Symptoms, Overdose, and Treatment