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Shooting Hydrocodone, Lortabs or Vicodin Dangers and Side Effects

Misusing prescription drugs or taking them without a prescription altogether is always dangerous.

It can lead to addiction, overdose and other major complications.

Sometimes, the method by which you use the medication can hold its own special kind of dangers – above and beyond the risks represented by the active ingredient in the drugs.

If you are addicted to prescription pills like hydrocodone (the opioid drug contained in Lortab and Vicodin), and if you use needles to shoot or inject these drugs – you could experience a number of devastating consequences.

What Is Hydrocodone?

Syringe and pillsHydrocodone is a semisynthetic opioid and a strong pain reliever. Hydrocodone is often combined with the following over-the-counter drugs to relieve pain:

  • Acetaminophen.
  • Ibuprofen.
  • Aspirin.

Hydrocodone is available through hundreds of prescription formulas – including generic and brand name drugs. The most frequently prescribed hydrocodone products are:

  • Lortab.
  • Norco.
  • Vicodin.

All of these drugs are combination analgesics – formulated with both hydrocodone and acetaminophen.1

Widespread Use and Abuse of Hydrocodone

Hydrocodone is the most frequently prescribed opioid in the U.S. Unfortunately, this prescription drug is also heavily abused by its users – much to the detriment of their own health and lives.

Consider the alarming facts about widespread hydrocodone use and abuse in the U.S.1-3:

  • In 2013, doctors wrote more than 136 million prescriptions for hydrocodone and hydrocodone combination products (HCPs).
  • Everyday, roughly 1,000 people visit the emergency room due to misusing prescription opioids.
  • In 2011, an estimated 82,480 emergency department visits were associated with hydrocodone use.

While the FDA has approved hydrocodone products that attempt to deter abuse of these drugs – including new formulations that are difficult to crush, break or dissolve – people have found ways to circumnavigate the safeguards and, in doing so, place themselves at great risk.4

Where Do People Get Hydrocodone?

Prescription drugsHydrocodone users are relatively less likely to obtain the drug from street dealers. Instead, their compulsive use is often fueled by a supply of hydrocodone obtained by using a prescription – either real or forged.5

Still, although roughly 20% of users report they received a prescription for these drugs from a doctor, tablets are also sold on the street and traded among friends and family. According to the National Survey on Drug Use and Health (NSDUH), 50.5% of people who misused all types of painkillers reported that they got the drugs for free from a friend or relative.6

How Is Hydrocodone Abused?

The way that you take a drug into your body plays a role in how quickly it is absorbed into the bloodstream. Hydrocodone is most often taken orally. Some people choose to alternatively inhale or inject the drug into their system for a quicker “high.”

Below are some common methods in which hydrocodone, Lortab, and Vicodin are administered into the body by those who abuse this drug:

  1. Shooting. Some people choose to “shoot” hydrocodone. These individuals crush the pills, dissolve them in water, and then inject the resulting hydrocodone solution into a vein, muscle, or just below the skin. Injecting hydrocodone is an incredibly dangerous mode of ingestion. Dissolving multiple hydrocodone tablets can result in an immediately delivered, potentially fatal dose of the drug. And when taken in large doses, the acetaminophen often found in combination with hydrocodone formulations can cause severe liver damage.7
  2. Swallowing tablets. Hydrocodone, Lortab, and Vicodin are all prescribed in tablet form, and many individuals choose to abuse the drug in its original pill form, often by taking much more than indicated by the prescription.
  3. Snorting. Some hydrocodone users crush the tablets and inhale or snort the drug. One study of prescription opioid use found that among rural drug users, snorting was the most frequent route of administration for hydrocodone.8 Another study found that men were much more likely than women to crush and snort opioids.9

In a nationwide survey of opioid drug abusers, researchers found that hydrocodone users were more likely to take hydrocodone and HCPs orally and less likely to inject or snort the drugs, with roughly5:

  • 95% of users reporting that they swallowed the pills.
  • 26% of users reporting that they crushed the tablets and inhaled them.
  • Less than 5% of users reporting they dissolved the drug in water and injected the substance intravenously.

What Are the Health Effects of Hydrocodone?

There are a number of dangerous and unpleasant side effects you can expect from using hydrocodone:

  • Depressant activity. Opioids work in the central nervous system to elicit depressant effects. Depressants are known to slow down heart rate, breathing rate, and brain activity of the user. The severity of respiratory depression experienced depends on the amount of drugs used.
  • Decreased sex drive and appetite. Side effects from opiates can also include a reduction in sex drive and appetite.
  • Nausea and vomiting. Hydrocodone, Lortab, and Vicodin are known to cause nausea in the user. The drugs activate the chemoreceptor trigger zone (CTZ), which sends signals to the body’s vomiting center and triggers a vomiting reflex.10
  • Constipation. Constipation is also a common side effect of opioid use since opioid receptors are located along the gastrointestinal (GI) tract in the body.
  • Drowsiness. People often experience varying degrees of drowsiness, sleepiness, and feelings of relaxation when taking hydrocodone.11

Long-term Abuse of Hydrocodone

Long-term use of hydrocodone and HCPs can cause more serious side effects.


If you use these drugs on a regular basis, your body’s tolerance to these drugs will increase – meaning that you would have to take more and more of these drugs to feel the same desired effects you felt the first time you used them.

Taking increasing amounts to overcome tolerance can lead to a tenacious physical dependence. Once an opioid dependence has been established, the user will experience an onset of unpleasant withdrawal symptoms when the drug hasn’t been taken recently – which often serves to reinforce continued, compulsive use.

Long-term Effects

Long-term effects of hydrocodone and some HCPs can include12-14:

  • Loss of hearing.
  • Sleep disorders.
  • Osteoporosis.
  • Chronic constipation and dysfunctional bowels.
  • Irregular heart rhythms.
  • Slowed breathing and low oxygen levels.
  • Coma.
  • Permanent brain damage.

Dangers of Hydrocodone with Acetaminophen

Abusing the drug combination of both hydrocodone and acetaminophen poses severe health risks. Hydrocodone and HCPs can vary with regards to the amount of acetaminophen in each pill. Typical amounts of acetaminophen per pill usually range from 300-325mg.

If adults take a high dose of Lortab or Vicodin in one sitting or over the course of a day, the dosage could push them over the body’s maximum daily acetaminophen limit (4 grams) and put them at an increased risk for liver toxicity. Consuming alcohol concurrently with these drugs can heighten this risk.

Risky Behavior

Regrets from risky behaviorGeneric hydrocodone and its trade formulations Lortab and Vicodin are all opioids. Opioid drugs are abused by some individuals because of the perception that they may make you feel relaxed and at ease. When you inject these drugs – and you feel the impact of the drugs all at once – you may be coaxed into doing things and making choices you might never make while sober.

Shared Needles & Casual Sex

In one study published in the journal Addiction15:

  • 29% of people who injected opioids used shared needles.
  • 20.7% of opioid abusing people had casual sex without a condom within the prior month.

Both of these risky behaviors could lead to infections with HIV/AIDS and other viral and bacterial illnesses, such as hepatitis, gonorrhea, or syphilis.

Gateway Drug to Heroin Abuse

Shooting hydrocodone may also make you more comfortable with the concept of injecting other drugs – including heroin.

This transition from opioid pain meds to heroin appears to be a common transition. A study in the journal Drug and Alcohol Dependence found that 24% of people who abused prescription opioids also abused heroin later in life.16

Special Risks from Shooting Hydrocodone

If you choose to abuse hydrocodone or HCPs by injecting the drugs into your system, you additionally increase your risks of:

  • Developing blood vessel damage and skin infections – such as abscesses – to the injection site.
  • Acquiring an infectious disease – such as HIV, hepatitis B, or hepatitis C – from sharing needles.

Addiction Treatment Facilities

When you are ready to get your life back on track and want to start considering your treatment options, it will be helpful for you to be aware of a few of the different treatment facility types that are available to you.

  • Luxury treatment facilities provide residential addiction treatment in addition to an array of plush, resort-like amenities that can make your recovery process extra comfortable.
  • Executive treatment facilities also offer residential addiction treatment alongside high-end amenities – but these facilities also provide the resources and structure that allow busy professionals to maintain an active involvement in the workplace throughout the recovery process.
  • Standard treatment facilities offer quality addiction treatment in both residential (“inpatient”) and non-residential (“outpatient”) settings. While these facilities do not offer the same variety of high-end amenities as do luxury and executive programs, they do come at lower, more affordable prices for those on more of a limited budget.

Find Help for Your Addiction

Each time you inject drugs, and each time you become a little more comfortable with a needle – you make that transition to a dangerous addiction just a little easier to accomplish. If you’d like to break the cycle, please call us at 1-888-744-0789 Who Answers?. We would love to help you find a treatment program for your addiction and help you learn how to maintain your sobriety for the rest of your life.

A Closer Look at Hydrocodone

In the U.S., there are five categories for controlled substances: Schedule I through Schedule V. The classification of drugs is determined by eight factors – including the drug’s potential for abuse or misuse, and whether the drug is used for medical purposes.

Hydrocodone, itself, is a Schedule II drug. In 2014, HCPs became labeled as Schedule II controlled substances as well.17

Hydrocodone is categorized as Schedule II because it has a high potential for misuse and can lead to drug dependence. In fact, hydrocodone and HCPs were involved in as many as 82,480 visits to the emergency room in 2011.18

Despite it’s potential for abuse, hydrocodone remains a useful drug to treat pain. When determining the scheduling of drugs such as hydrocodone, the medical benefits are weighed alongside the risk for abuse – allowing these drugs to remain at their Schedule II classification.

How Does Hydrocodone Work?

Hydrocodone is an opioid receptor activator – what’s known as an opioid agonist. When hydrocodone binds to the opioid receptor, it results in a chain of events that ultimately modifies an individuals perceived pain level.

There are a few different types of opioid receptors in the body, including:

  • Mu receptors.
  • Delta receptors.
  • Kappa receptors.

Hydrocodone works primarily on the mu receptor.

In addition to pain relief, opioid drugs can result in a number of other physical responses – sometimes leading to dangerous and uncomfortable side effects such as:

  • Respiratory arrest.
  • Constipation.
  • Jerking limb movements.
  • Depressed cognition.

How the Body Metabolizes Hydrocodone

Hydrocodone – like other opiates – is metabolized predominantly in the liver, but is also partially cleared by the kidneys.

As previously mentioned, if you drink alcohol while using hydrocodone and HCPs, you can decrease your body’s threshold for liver damage. Even a few drinks can alter the way your body responds to the drugs in the system and increase your risk of serious side effects.

Special Populations at Risk from Hydrocodone Abuse

Hydrocodone and HCPs can also impart specific risks to different groups of people.

Pregnant Women & Newborns

Among women, hydrocodone is the most frequently prescribed opioid.19 According to the CDC, an average of 25% of women enrolled in Medicaid had been given prescriptions for the drug at some point.

Pregnant women who abuse hydrocodone, Lortab, or Vicodin are at increased risk for causing adverse outcomes in the newborn, including20:

  • Prematurity
  • Low birth weight.
  • Higher mortality.
  • Birth defects.
  • Neonatal abstinence syndrome (NAS).

While studies have found that women can detox during pregnancy, relapse rates among these individuals are high.21

Newborn Abstinence Syndrome (NAS)

When newborns are exposed to opioids in utero, they can go through withdrawal shortly after birth. The effects of withdrawal on their systems include:

  1. Tremors.
  2. Excessive crying.
  3. Diarrhea.
  4. Sweating.

Collectively, these symptoms characterize NAS.

From a public health standpoint, NAS is a major issue due to the healthcare costs it may impart, and the majority of these hospital costs are paid for by the state through Medicaid programs.22

Elderly Populations

In 2010, it was reported that pain relievers such as Vicodin were the most commonly involved drugs in elderly adults’ visits to the emergency department – making up 43.5% of this population’s drug-related ER visits.23

On average, older Americans are more likely to go to the doctor with complaints of achy joints and muscle pain than other age groups. Hydrocodone, Lortab, and Vicodin are commonly prescribed to older individuals to help treat pain.

DESCRIPTION GOES HEREUse of opioids in this population can lead to24:

  • Increased sedation.
  • Respiratory depression.
  • Impaired vision.
  • Impaired coordination.
  • Increased falls.


Teens may be at an increased risk for developing an addiction to hydrocodone and HCPs. Prescription opioids are some of the most commonly abused drugs – second only to marijuana – among young people who initiate illicit drug use.25

According to the National Institute for Drug Abuse (NIDA), 4% of senior high school students reported using Vicodin in the past year.26 This figure is alarming when you consider that the use of opioids such as hydrocodone can quickly lead to dependence and overdose among teens.

In a nationally representative study of high school seniors, researchers found that opioid abusers were more likely to be27:

  • Male.
  • White.
  • Lower performers in school.

High Hepatitis C Risk Among Teenagers

The incidence rate of the hepatitis C virus is increasing among young injection drug users, with one 2011 study reporting 30.9% of young injection drug to be positive for HCV.28

Sharing non-sterile needles to inject hydrocodone and HCPs increases one’s risk of contracting HCV – a chronic, infectious disease that can potentially lead to life-threatening complications.

In one study of 791 opioid abusers, young people ages 18-24 were much more likely than the general population to use dirty needles to inject opioids – putting this population at special risk for contracting HCV.29

Learn More and Find Treatment

If you’d like to learn more about hydrocodone addiction and treatment, call us at 1-888-744-0789 Who Answers?. We would love to help answer your questions and walk you through which treatment options might best suit your unique needs and circumstances.


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  2. Drug Abuse Warning Network. (2013). Highlights of the 2011 Drug Abuse Warning Network (DAWN) findings on drug-related emergency department visits. The DAWN Report. Substance Abuse and Mental Health Services Administration.
  3. Whistler, J. L. (2012). Examining the role of mu opioid receptor endocytosis in the beneficial and side-effects of prolonged opioid use: from a symposium on new concepts in mu-opioid pharmacology. Drug and alcohol dependence,121(3), 189-204.
  4. FDA approves extended-release, single-entity hydrocodone product with abuse-deterrent properities. (2014). U. S. Food and Drug Administration (FDA).
  5. Cicero, T. J., Ellis, M. S., Surratt, H. L., Kurtz, S. P. (2013). Factors influencing the selection of hydrocodone and oxycodone as primary opioids in substance abusers seeking treatment in the United States.Pain,154(12), 2639-2648.
  6. (2016). Substance Abuse and Mental Health Services Administration.
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  8. Young, A. M., Havens, J. R., Leukefeld, C. G. (2010). Route of administration for illicit prescription opioids: a comparison of rural and urban drug users. Harm reduction journal7(1), 1.
  9. Back, S. E., Lawson, K. M., Singleton, L. M., Brady, K. T. (2011). Characteristics and correlates of men and women with prescription opioid dependence.Addictive behaviors, 36(8), 829-834.
  10. Chau, D. L., Walker, V., Pai, L., Cho, L. M. (2008). Opiates and elderly: use and side effects. Clinical interventions in aging,3(2), 273.
  11. Hydrocodone and acetaminophen (oral route). (2016). Mayo Clinic.
  12. Ho, T., Vrabec, J. T., Burton, A. W. (2007). Hydrocodone use and sensorineural hearing loss. Pain Physician, 10(3), 467-72.
  13. Risks of long-term opioid use. University of Utah Health Care, Pain Center.
  14. What are the possible consequences of opioid use and abuse? (2014). National Institute on Drug Abuse.
  15. Darke, S., Hall, W., Carless, J. (2006). Drug use, injecting practices and sexual behavior of opioid users in Sydney, Australia. British Journal of Addiction, 85(12), 1603-09.
  16. Brands, B., Blake, J., Sproule, B., Gourlay, D., Busto, U. (2004). Prescription opioid abuse in patients presenting for methadone maintenance treatment. Drug and Alcohol Dependence, 73(2), 199-207.
  17. Coleman, J. Rescheduling hydrocodone combination products: addressing the abuse of America’s favorite opioid. (2015). American Society of Addiction Medicine (ASAM).
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  21. Bell, J., Towers, C. V., Hennessy, M. D., Heitzman, C., Smith, B., Chattin, K. (2016). Detoxification from opiate drugs during pregnancy. American Journal of Obstetrics & Gynecology, 214(1), S68.
  22. Patrick, S. W., Schumacher, R. E., Benneyworth, B. D., Krans, E. E., McAllister, J. M., Davis, M. M. (2012). Neonatal abstinence syndrome and associated health care expenditures. JAMA 307(18), 1934-40.
  23. Administration on Aging (AOA). (2012). Older Americans behavioral health – issue brief 5: prescription medication misuse and abuse among older adults. Substance Abuse and Mental Health Administration.
  24. Leipzig, R. M., Cumming, R.G., Tinetti, M.E. (1999). Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. Journal of the American Geriatrics Society, 47(1):30-39. 16
  25. DrugFacts: nationwide trends. (2015). National Institute on Drug Abuse (NIDA).
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  28. Lankenau, S. E., Kecojevic, A., Silva, K. (2015). Associations between prescription opioid injection and Hepatitis C virus among young injection drug users. Drugs (Abingdon Engl), 22(1), 35-42.
  29. Surratt, H., Kurtz, S. P., Cicero, T. J. (2011). Alternate routes of administration and risk for HIV among prescription opioid abusers. Journal of Addictive Diseases, 30(4), 334-341.