Table of Contents
Vicodin Addiction, Abuse, and Symptoms


The Basics

This guide explains the effects, trends, and dangers of Vicodin use, as well as an unbiased analysis of the medicinal and behavioral treatment methods for Vicodin addiction based on current research and publicly available statistics. In some cases, usage statistics are derived from general prescription opioid use, which includes hydrocodone with acetaminophen, morphine, hydromorphone, and oxycodone.

Primary Vicodin Dangers

  • Addictiveness: Illicit drugs and some prescription medications have varying levels of addictiveness. In 2007, a group of researchers led by Professor David Nutt released a report summarizing the results of the study they conducted to determine the potential for addiction associated with 20 substances. Several of the substances studied were illicit drugs, including cocaine and heroin. The study also included legal substances such as alcohol, tobacco, and barbiturates. Vicodin was not tested, but it is in the same class of drugs of heroin. Nutt and his colleagues found that heroin had the highest potential for addiction, which highlights the dangers of long-term use of Vicodin and other opioids.
  • Risk of overdose: The main ingredients in Vicodin, hydrocodone and acetaminophen, can both be dangerous if an individual takes large doses or uses Vicodin for longer than recommended. Opioids in general are also associated with the potential for overdose. According to the Centers for Disease Control and Prevention (CDC), opioids were involved in 68% of the drug overdoses that occurred between 1999 and 2017. Approximately 702,000 people died of drug overdoses during this period, which means that nearly 500,000 deaths involved some type of opioid.
  • Unintended side effects: Vicodin can have serious side effects, especially when it is misused or abused. Some of the most serious side effects include chest tightness, irregular breathing, slowed respiratory rate, confusion, severe muscle twitching or stiffness, hallucinations, and loss of coordination.
  • Legal risks: Vicodin is considered a hydrocodone combination product, which makes it a Schedule II substance under the guidelines set forth by the United States Drug Enforcement Agency (DEA). Possession of Vicodin without a valid prescription is usually charged as a misdemeanor, with penalties for a first offense ranging from monetary fines to up to one year in a city or county jail. The penalties may be harsher if an individual has previously been convicted of possessing a controlled substance without a valid prescription.

Vicodin Background Information

Derived From Hydrocodone is synthesized from codeine, another opioid medication.
Ways Used Ingesting, snorting, injecting
Scientific Name Hydrocodone bitartrate with acetaminophen
Slang/Street Names for Vicodin Scratch, Fluff, Vikes, Vicos, Idiot Pills, Watsons, Tabs, Vics, Lorris, Hydros, 357s
How Long in Bodily System Half-life: 3.8 hours

Approximately 85% of Vicodin is eliminated within 24 hours, but it may remain in the body for several days, especially in chronic users.

Punitive Legal Measures: Using/Possession Vicodin is listed as a Schedule II controlled substance due to its high potential for abuse. Possessing Vicodin without a prescription is considered a criminal offense, and a first-time conviction is likely to result in a fine and up to one year in a city or county jail. Penalties are typically harsher for subsequent convictions.
Punitive Legal Measures: Selling/Distributing The penalties for selling or attempting to sell Vicodin are much harsher than the penalties for merely possessing it. An individual convicted of one of these offenses may be sentenced to anywhere from 10 to 20 years in prison. In some cases, the fine for selling Vicodin is as much as $1 million. Enhanced penalties are sometimes applied for offenses committed near schools or government buildings.
DEA Drug Rating Schedule II

Signs of Abuse

Behavioral Symptoms of Vicodin Usage and Abuse

How Vicodin affects the brain

Experts from the National Institute of Drug Abuse explain that Vicodin and other opioids affect the nerve cells in the brain. When an individual takes Vicodin, the amount of dopamine in the brain increases, producing a pleasurable sensation. The extra dopamine affects the brain’s reward center, which makes some individuals continue taking Vicodin so they can keep experiencing a “high” or a sense of euphoria.

Vicodin affects several parts of the brain, including the basal ganglia and the prefrontal cortex. The basal ganglia are an important part of the brain’s reward center. They reinforce certain behaviors that are considered pleasurable to humans, such as eating and socializing with other people. When an individual first starts using Vicodin, it does not take much of the substance to produce a euphoric sensation. Over time, however, the basal ganglia get used to the effects of Vicodin. As a result, more Vicodin is needed to produce the same pleasurable effects. The prefrontal cortex is involved in impulse control. In people who misuse Vicodin, it becomes difficult to control impulsive behavior. Some individuals develop a compulsive need to take Vicodin and other substances.

Behavioral signs of Vicodin usage and abuse

It’s not always apparent when someone starts misusing Vicodin, but some behavioral changes are likely to occur over time, signaling to others that the individual has a problem with substance abuse. Some people engage in doctor shopping, which is the practice of visiting multiple health care professionals to obtain additional Vicodin prescriptions.

Users may also engage in drug-seeking behavior when they visit their doctors. Drug-seeking behavior is an attempt to manipulate a prescriber into giving out a prescription for Vicodin even if it’s not warranted by the individual’s condition. Users who engage in these behaviors may exaggerate their symptoms or state that other, less addictive medications do not control their pain. If these tactics don’t work, someone who abuses Vicodin may start to engage in criminal behaviors such as forging prescriptions or stealing Vicodin and other opioids from friends and family members.

Individuals who abuse Vicodin may also engage in deceptive behaviors to cover up the fact that they are using Vicodin or to prevent other people from finding out how much Vicodin they are taking. For example, some users hide Vicodin in their cars to prevent family members from finding it in their homes. When people misuse Vicodin, they may also engage in risky behaviors or start neglecting their responsibilities. Adolescent users may skip school or start getting bad grades. Adult users may miss work, have trouble arriving to work on time, or start having performance problems.

Physical Symptoms of Vicodin Abuse

How Vicodin affects the body

Vicodin is classified as an opioid, a type of drug that works on the opioid receptors in the brain and other parts of the nervous system. When Vicodin attaches to opioid receptors, it blocks pain signals, relaxing the body and relieving pain caused by surgery, serious injuries, and chronic illnesses. Because Vicodin contains acetaminophen, taking too much of it can have serious effects on the liver, with some people experiencing liver failure as a result of Vicodin abuse. In some individuals, long-term Vicodin use may even cause seizures, irregular heartbeat, fainting, and changes in heart rate.

Early physical effects of Vicodin

Due to its short half-life, Vicodin typically starts producing physical effects within 20 minutes of taking a dose. Some of the early physical effects of this substance are unpleasant. In users who take other medications or have a history of chronic health conditions, these effects can even be dangerous.

This table illustrates the possible short-term physical effects associated with Vicodin.
Short-Term Physical Symptoms
Initial (direct effects of drug, 20 – 60 min.) Dizziness
Lingering (within an hour of taking the drug) Abdominal pain
Loss of appetite
Slow heart rate
Shallow breathing
Post-Use (several hours to days after use) Fatigue
Dark urine
Clay-colored stools
Dependence (more likely in higher doses)

Severe and long-term physical effects of Vicodin

Acetaminophen is hepatotoxic when used for longer than recommended or in larger doses than recommended, which means that it can destroy liver cells. As a result, long-term use of Vicodin and other hydrocodone combination products (HCPs) is associated with an increased risk of liver damage.

Vicodin can affect the heart and respiratory system, making Vicodin misuse especially dangerous for people who have medical conditions involving the heart and lungs. In one study, researchers found that people taking opioids like Vicodin were much more likely to die within six months of starting the medication than people who were taking other types of medications to relieve pain. Because Vicodin slows a person’s breathing rate, it can worsen the symptoms of sleep apnea, increasing the risk for heart attack and sudden death.

The harmful physical effects of Vicodin are even more pronounced when the substance is combined with alcohol. Like alcohol, Vicodin depresses the user’s central nervous system, which slows down breathing and heart rate. When both substances are taken together, the user’s breathing rate and heart rate may get even slower, increasing the risk for sudden death. Vicodin is also dangerous when combined with illicit drugs such as cocaine and heroin, especially in people with a history of chronic heart and lung conditions.

This table illustrates the possible long-term physical effects associated with Vicodin.
Long-Term Physical Symptoms
Casual Nausea

Including all of the above effects for casual use

Abdominal pain
Liver damage
Fuzzy thinking
Clay-colored stools
Dark urine
Dry throat
Withdrawal Runny nose
Muscle aches
Abdominal cramps
Bone pain
Muscle pain

Further Resources

Both the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer in-depth information on the symptoms and treatment of prescription stimulant addiction.

Vicodin Usage

Rates of opioid use have skyrocketed, especially in the United States

The International Narcotics Control Board reports that the United States had more than 47,000 daily doses of opioid medications available for every one million people between 2013 and 2015. Germany had just over 30,000 daily doses per one million people between 2013 and 2015. Japan, which ranked third on the list of most populous countries, only had 1,220 daily doses per one million people.

The use of Vicodin and other opioids is also fairly common in Australia and New Zealand. According to the 2019 World Drug Report, approximately 3.3% of the adult population in this region uses prescription opioids such as hydrocodone, tramadol, codeine, and oxycodone. Although Asia has a prevalence rate of only 1%, it also has a large population, which means that more than half of all global users of opioids reside in an Asian country. In Asia, the prevalence rate of opioid use varies by region. South-West Asia and the Middle East have the highest rates of opioid use at 2.3% of the population.

One of the reasons why Vicodin use has been increasing is because hydrocodone is sometimes used in place of medications with a higher potential for abuse and addiction. According to the 2019 World Drug Report, there has been a 300% increase in the amount of hydrocodone available for consumption. Some of the increase has been attributed to the need for pain relievers that can be substituted for other drugs.

Although there was a sharp increase in the hydrocodone supply between 1998 and 2012, data from the 2019 World Drug Report indicates that the supply is starting to go down. In 1998, approximately 12,000 kilograms of hydrocodone were available for medical use. The supply peaked at approximately 45,000 kilograms in 2012, and it declined to about 25,000 kilograms in 2016.

Prescription Opioid Use Throughout the World
Highest Second Third
Regions With the Highest Number of Prescription Opioid Users North America Australia and New Zealand South-West Asia/Middle East
Regions With the Highest Number of Daily Doses of Opioid Medications per One Million Inhabitants North America Oceania Western Europe/South-Eastern Europe

*This table includes data on the use of general prescription opioids, including hydrocodone, codeine, morphine, oxycodone, and hydromorphone.

Sources: 2019 World Drug Report (United Nations Office on Drugs and Crime)

Vicodin Usage Demographics in the United States

The United States is grappling with an opioid "epidemic" due to the large quantity of opioids available to Americans

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), nearly 12 million people aged 12 and older reported using an opioid like Vicodin within the previous year. This represents 4.4% of the American population, indicating the severity of the opioid epidemic in the United States.

Fortunately, the results of the Monitoring the Future Study indicate that young people are not using opioids at the same rate they were in 2016 and 2017. In 2018, only 3.4% of the 12th graders surveyed reported that they had used an opioid within the past year, a decrease from previous years. Furthermore, only 6% of the 12th graders surveyed indicated that they had used an opioid at any point in their lives, which was also a decrease from 2017 and 2018 rates of lifetime use.

Demographics of Prescription Usage
Past Year (2018) Lifetime
8th grade (14-15 yo) No data collected No data collected
10th grade (15-16 yo) No data collected No data collected
12th grade (17-18 yo) 3.4% 6.0%

How to Find Help

Vicodin affects the reward center of the brain, which makes some users crave more and more of the drug over time. Once the person develops a tolerance to Vicodin, it takes higher, more frequent doses to achieve the same pleasurable feelings that were once possible with a smaller dose. Even if the individual wants to stop using Vicodin, the unpleasant withdrawal effects can make it difficult to stay sober. Therefore, Vicodin treatment programs aim to help the individual taper off the substance instead of stopping it suddenly, which can ease some of the withdrawal symptoms and prevent relapse.

Learn about Vicodin reahabilition in our guide.

Staging an Intervention

If you have a loved one who’s struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it’s important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren’t handled correctly.

5 Tips for Staging an Intervention

1. Don’t Do It Alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially those who have a close relationship with you or the addict.
2. Research Ahead of Time. It’s best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for getting help.
3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it’s best to have a statement of how the person’s addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.
4. Offer Help. It’s important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.
5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it’s important that they understand that everyone present will end codependence and enabling behaviors.