What Is Vicodin Withdrawal?

Vicodin, which is a combination of hydrocodone and acetaminophen, is used to treat moderate levels of pain. People may experience Vicodin withdrawal symptoms when they try to cut back on or quit the drug, especially if they are misusing it. The symptoms of Vicodin withdrawal are similar to those of opioid withdrawal syndrome and may include nausea, insomnia, anxiety, and muscle aches.

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Vicodin Withdrawal Symptoms

Symptoms of Vicodin withdrawal include:^4,9

Agitation and anxiety
Insomnia
Muscle aches
Muscle spasms
Tearing
Yawning
Sweating
Runny nose
Goose bumps
Dilated pupils
Nausea

Vomiting
Abdominal cramping
Diarrhea
Increased blood pressure
High body temperature

Risks of Withdrawal

Overdose. The biggest concern with Vicodin withdrawal is a return to drug use because of the potentially increased risk of overdose. Since tolerance decreases during abstinence, a person can potentially overdose on a much smaller dose than he or she used prior to detoxing.⁴
Dehydration. In rare cases, severe vomiting and diarrhea due to withdrawal can lead to dehydration and electrolyte imbalance. ^4,9
Cardiac illness. Heart conditions may also be aggravated due to a withdrawal-associated arousal of the autonomic nervous system, which can elevate blood pressure and heart rate. ⁹
Increased sensitivity to pain. In addition, underlying pain conditions may worsen during withdrawal due to the sudden lack of analgesic medication combined with a reduced pain threshold.⁹

Vicodin Withdrawal Timeline

Many people wonder how to taper off Vicodin, and the answer is that breaking habits requires changing the way we think. This helps users to change behavioral patterns that have developed over the years. The first step is detox and the timeline of that process is as follows:

6-12 hours after last dose. Symptoms begin to appear. Early effects include insomnia, muscle aches, anxiety, watering eyes, runny nose, sweating, and yawning.
1-3 days. Symptoms begin to peak and can include abdominal cramps, diarrhea, dilated pupils, goose bumps, nausea, and vomiting.
5-7 days. Symptoms begin to improve and eventually subside.^4,8

The type of effects someone experiences during Vicodin detox, and how long he or she will experience them, will vary and will also be affected by how long and how much someone used the drug.

Post-Acute Withdrawal Syndrome

People recovering from a Vicodin addiction may continue to experience withdrawal symptoms beyond the typical timeframe outlined above. These symptoms may persist for weeks and months after quitting Vicodin and include:

Difficulties with learning, memory, and problem-solving
Irritability
Anxiety
Depression

Cravings
Low motivation
Sleep problems
Sensitivity to stress

The cause of these post-acute withdrawal symptoms (PAWS) is still being researched. But the symptoms are believed to be caused by physical changes in the brain that occur as substance abuse issues develop.¹¹

Causes of Vicodin Withdrawal

When a person uses Vicodin for long periods of time, compulsive patterns of use can develop. Those who use the drug frequently often develop tolerance, or an increased resistance to the current levels of use. How quickly someone builds tolerance depends on the individual,² as well as how the drug is used.

Physical dependence usually occurs in conjunction with tolerance and can develop within several weeks.²Once physical dependence develops, withdrawal symptoms may appear when the person stops using.

Though the side effects of Vicodin withdrawal are uncomfortable, they are not lethal. Symptoms can be reduced or prevented by gradually reducing the dose over a period of time (a process known as tapering),³ or by using medication-assisted treatment (discussed in more detail below).

Treatment for Vicodin Withdrawal

If you or a loved one needs Vicodin withdrawal help, medical assistance can ease the process. This is especially the case if the person has been using Vicodin for a long time, is abusing other drugs, or has a concurrent mental health condition.

Following the completion of Vicodin detox, many newly sober individuals seek out some form of ongoing substance abuse treatment to continue their recovery work and to help them remain abstinent from Vicodin and other drugs. Detox alone is rarely sufficient to maintain recovery, and users are at greater risk for relapse without some form of follow-up care.¹⁰

Treatment options for Vicodin withdrawal and addiction include:

Detox centers. A detox center can provide a controlled environment with medical oversight. A team of healthcare professionals monitor the person in detox, prescribe medication, and treat any medical complications. Standalone detox facilities do not usually provide treatment beyond the detoxification stage.
Inpatient rehab programs. Residential or inpatient addiction treatment programs may provide detox or require that the person detox elsewhere before coming to the facility. People in these programs live at the center and participate in group and one-on-one counseling, 12-step meetings, and other recovery activities such as outdoor recreation, yoga, meditation, and art and music therapy.
Outpatient rehab programs. Outpatient programs can vary in intensity and the time commitment required. These are not live-in programs and allow participants to continue to live at home. The programs may offer outpatient detox for those with relatively mild substance dependence and offer group therapy sessions as their main therapeutic approach.
Partial hospitalization. Partial hospitalization or day treatment programs are a form of outpatient care. These programs may also offer detox and usually include medical care, group therapy, family therapy, and individual counseling. They require more of a time commitment than basic outpatient programs.

Medication for Withdrawal

Medication-assisted treatment (MAT) for opioid withdrawal can include the use of medications approved for the treatment of opioid dependence or focus on a taper approach, in which a physician will slowly decrease the dose of Vicodin over time to minimize withdrawal symptoms.

MAT is most effective when paired with some form of behavioral therapy and should be only be administered by a medical professional.

Types of medications used in MAT include:

Buprenorphine – treats the symptoms of detoxification, suppresses cravings, and blocks the effects of other opioids such as Vicodin. It can only be prescribed by physicians who have met certain requirements outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Methadone – a long-acting opioid that can lessen withdrawal symptoms and help stabilize people in withdrawal from Vicodin. Users are often tapered off of methadone after detox, but may continue to take it beyond the withdrawal phase. Methadone is only available at SAMHSA-certified methadone clinics.
Clonidine – helps reduce anxiety and agitation as well as muscle spasms, aches, and increased sweating.⁴

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Vicodin Withdrawal