What is Hydrocodone?

Hydrocodone is a semi-synthetic opioid used for pain relief and sometimes for cough suppression. It is a full opioid agonist, similar to oxycodone and morphine, but generally considered slightly weaker than oxycodone milligram for milligram.

It is not commonly prescribed in Canada, but is widely used in the United States.

What Hydrocodone Is

• An opioid analgesic (pain medication)

• Typically combined with acetaminophen (Tylenol)

• Also used in some cough syrups in the U.S.

• Classified as a controlled substance

Common brand names:

• Vicodin

• Norco

• Lortab

• Hycodan (cough syrup)

How It Works

Hydrocodone binds to mu-opioid receptors in the brain and spinal cord to:

• reduce pain

• decrease cough reflex

• produce sedation

• create mild euphoria (in some users)

How It Compares to Other Opioids

Hydrocodone falls between morphine and codeine, slightly weaker than oxycodone.

Availability

Canada

• Hydrocodone products are rare.

• Some cough syrups used to exist, but most have been discontinued.

• It is not part of pain management or OAT programs in Canada.

United States

Very common:

• Hydrocodone/acetaminophen (Vicodin, Norco)

• Hydrocodone/ibuprofen (Vicoprofen)

• Pure hydrocodone ER (Hysingla ER, Zohydro ER)

Withdrawal

Hydrocodone withdrawal resembles oxycodone IR:

• Onset: 8–12 hours after last dose

• Peak: 36–72 hours

• Duration: 4–6 days

• Symptoms: chills, diarrhea, sweating, anxiety, restless legs, insomnia, cravings

Why People Misuse Hydrocodone

• Readily prescribed in U.S.

• Causes euphoria at high doses

• Users often transition to oxycodone or fentanyl due to tolerance