Managing Norco Cravings
Norco is a prescription medication used to manage pain. It can be addictive, and suddenly discontinuing it can cause strong cravings. If these cravings are not effectively managed, they can lead to relapse.
Norco Cravings Signs and Symptoms
Norco (a combination of hydrocodone and acetaminophen) is a type of prescription medication in the opioid class of drugs. Prolonged abuse of Norco can lead to cravings after you stop usingor a strong urge to continue using – both of which are symptoms of addiction (known clinically as an opioid use disorder). 1
Each person experiences cravings differently, though cravings tend to be either physical and/or psychological.
Signs of physical cravings may include:
- Feeling “butterflies” or a “knot” in the stomach.
- Increased heart rate.
- Believing that you can “smell” the drug. 2
Symptoms of psychological cravings may include:
- Having trouble focusing on anything other than the substance or craving.
- Being nervous or bored.
- Persistent thoughts of using or that one needs the substance right now. 2
Cravings will pass. But when someone is in the grip of a strong craving, it may seem like the only way to get rid of it is to use.
Onset and Duration of Cravings
Cravings generally begin during withdrawal. They can continue for months or years after physical dependence has ended, but they become less frequent and less intense over time. 3
Cravings can also be triggered by certain things. With prolonged use of opioids, including Norco, the brain begins to create associations between the use of Norco and certain emotions, settings, people, or things, leading to cravings whenever one “encounters any of these triggers.” 4
Cravings usually last between 10 to 30 minutes, though they can vary widely. Some people may experience brief, fainter cravings, while others report experiencing stronger, more drawn-out cravings. Others experience both types.
Treatments for Cravings
Many effective techniques have been developed to help those in recovery manage their cravings.
Cognitive behavioral therapy (CBT) is a highly effective treatment for many issues, especially substance use disorders. Other well-documented techniques that can be helpful in managing cravings include consequential thinking, mindfulness, urge surfing, relaxation techniques, and distraction techniques.
- Cognitive behavioral therapy is based on the idea that addiction is a learned behavior, and that a thought leads to an emotion, which ultimately dictates action. 5 If the thought process can be altered, then a person can learn new, healthy behaviors and avoid relapse. CBT uses various techniques, such as identifying the pros and cons of substance use and increasing awareness of situations that increase the risk of relapse and avoiding them. 6 Once distorted thought patterns are identified, they are tested and replaced with more realistic thoughts. 7, Positive self-talk, or more realistic statements, can help a person get through a craving, and it is especially effective when a person can list the positive achievements made in recovery. 2
- Consequential thinking involves the person listing all of the negative consequences he or she has experienced and is likely to experience again as a result of Norco addiction. This exercise can help to increase the person’s motivation to change by helping him or her question mistaken beliefs, such as “one pill can’t hurt.” 8
- Mindfulness is a form of meditation that is based on staying in the moment and monitoring one’s thoughts without judging them. Mindfulness can allow one to observe the experience of a craving without becoming worried about relapsing or “having to use.” It also allows the person to relax enough to examine the thoughts and situations that may have triggered the craving.
- Urge surfing is another useful technique for managing cravings and preventing relapse. The person “rides out” the urge and focuses on where it occurs in the body and in the mind. In addition, the person describes the feeling of the craving, noting how strong it is and if it changes. 2 In so doing, the person can distance himself or herself from the craving and observe it non-judgmentally.
- Managing stressful situations, such as conflict with others, social functions, working, driving, or difficulty sleeping can be accomplished with relaxation techniques. 8 Commonly used relaxation techniques can be done at any time, in nearly any setting, and include deep breathing, progressive muscle relaxation, and guided imagery.
- Meditation can reduce stress and promote relaxation, as well as increase one’s ability to deal with commonly encountered daily stressors.
- Distraction techniques simply distract a person from a craving. Reading a book, journaling or writing, listening to music, watching TV, exercising, or participating in hobbies can all distract a person from his or her cravings. Exercise also provides many other benefits, such as improved self-esteem, reduction in boredom, improvement in mood, and improvement in the quality and quantity of sleep, which is often an issue for people in early recovery. 2
- Support systems. Relying on supportive family members or peers can also be extremely helpful in managing cravings. They can help the person realize that cravings are a normal part of recovery and that they will not last forever. 2
While these techniques are helpful for many in recovery, others may fear relapsing, or need additional supports, including professional services. These supports can range from self-help meetings, to inpatient or outpatient treatment, to group or individual counseling sessions. They provide additional help while the person is developing and practicing relapse prevention techniques. 8
- Inpatient rehab programs. Many people recovering from Norco addiction can benefit from an inpatient or residential treatment that is free of triggers. These programs offer detox, individual and group therapy, medical care, and aftercare planning. Inpatient is especially well-suited for people with strong cravings, longstanding addictions, and co-occurring mental health problems.
- Outpatient rehab programs. Outpatient treatment is provided on a part-time basis and usually includes group and/or individual therapy. People who are not able to take time away from day-to-day responsibilities may find this option more convenient. However, it does not offer the focused, intensive treatment of inpatient.
- 12-step meetings. Self-help meetings are free and include Alcoholics Anonymous, Narcotics Anonymous, or SMART Recovery. People recovering from Norco addiction can receive support and feedback from other people. These groups also offer a recovery program that has helped many people get sober. They tend to be more effective when paired with formal treatment. 9
- Individual therapy. Some people choose to continue seeing a therapist or counselor one-on-one after completing a treatment program. Therapists can help you gain insight into your addiction, work on relapse prevention techniques, and offer ongoing support for your recovery.
- Group therapy. Group therapy is another form of ongoing support after treatment. You meet with a small group of other people who are also in recovery. Hearing from other people can give you the sense that you are not alone in your recovery, and you can receive advice from those who have successfully managed cravings.
Finally, opioid use often damages many areas of one’s life, including relationships, housing, and work. It can leave those in early recovery with unstable or unsafe housing situations. For these people, sober housing may be an option while participating in treatment.
Medications Used to Curb Norco Cravings
Helpline Information to talk to a recovery support specialist about Norco rehabilitation programs in your area.
Medication-assisted treatment helps people manage their cravings and maintain sobriety. A physician will replace Norco with a less potent, or longer-acting opioid medication and gradually reduce the dose over time or maintain the person on a certain dose, depending on the circumstances.
These medications include:
- Methadone. Methadone is a long-acting opioid medication. Its effects can last for days. It can produce dependence, but it leads to a lower level of tolerance and can reduce cravings.
- Suboxone. Suboxone is a combination of buprenorphine and naloxone, which blocks the effects of other opioids. At low doses, buprenorphine produces effects similar to methadone. At high doses, it blocks the effects of other opioids and can lead to withdrawal in users who are still dependent on Norco.
- Naltrexone. Naltrexone can help people avoid relapse after they have gone through Norco withdrawal. It binds to the same receptors as Norco, but does not produce the pleasurable effects of the drug. It also blocks the effects of other opioids. 4
Each of these medications functions differently. But when taken consistently, they can help reduce the intensity and frequency of cravings and help a person safely withdraw from Norco. 10 They can also help a person engage in therapy and help rebuild his or her life without the distractions of cravings or withdrawal symptoms.
Be aware that methadone and Suboxone are potentially addictive and may lead to opioid withdrawal symptoms when abruptly stopped. Talk to your physician about any concerns you have and do not try to stop using these medications on your own.
How to Stop Urges Naturally
Natural techniques include distraction, exercise, relaxation, and healthy eating.
Cravings can be reduced or managed with techniques that require little or no training. However, maintaining sobriety often requires the help and support of a treatment program or a therapist. Think of these as ways to manage your cravings in between individual or group therapy sessions or support group meetings.
- Distraction techniques can shift the focus from the craving to a different activity, such as a hobby or listening to music.
- A consistent exercise regimen can help keep your stress level low and activate endorphins or “feel good” chemicals in the brain.
- Relaxation techniques, such as deep breathing or meditation, can reduce some of the anxiety associated with cravings and allow you step back and observe the craving without acting on it.
- Following a balanced, healthy diet can help to reduce cravings, improve mood, boost energy, and promote overall health.
Cravings and Relapse
In addition to practicing techniques to manage cravings, it can help to be aware of relapse warning signs. Relapse is a slow process with many “red flags” that can alert a person to an impending relapse.
Relapse Warning Signs
Some of these red flags could include:
- Reducing or stopping self-help meeting attendance.
- Getting involved with people, places, or things associated with substance use.
- Being in stressful situations.
- Experiencing life-altering changes, mood swings, and changes in eating or sleeping patterns.
- Thinking or talking about prior substance use in a glamorous way.
Relapse Prevention Strategies
Relapse is not inevitable. It can be prevented with the right techniques and supports, including:
- Participating in support groups, outpatient treatment, therapy, self-help meetings, and sponsorship. 8,9
- Surrounding yourself with a strong support group of other individuals in recovery.
- Becoming involved in positive activities, such as finding hobbies, exercising, socializing with other people in recovery, and volunteering.
- Staying away from people, places, and things that can trigger cravings.
Find a Recovery Center for Norco Treatment
If you need help with Norco addiction or learning how to manage cravings, call 1-888-319-2606 Helpline Information . A treatment support representative can answer questions about insurance and payment and offer options based on your coverage.
. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
. National Institute on Drug Abuse. (1998). Topic 1: Coping with craving.
. Drug Enforcement Agency. (2015). Drugs of abuse.
. Kosten, T.R. & George, T.P. (2002) The neurobiology of opioid dependence: implications for treatment. Science & Practice Perspectives, 1(1), 13-20.
. World Health Organization (2007). Psychosocial interventions in pharmacotherapy of opioid dependence: a literature review.
. National Institute on Drug Abuse. (2012). Cognitive-Behavioral Therapy.
. McHugh, R.K., Hearon, B.A., & Otto, M.W. (2010). Cognitive-behavioral therapy for substance use disorders. The Psychiatric Clinics of North America, 33(3), 511-525.
. Harvard Health Publications (2009). Treating opiate addiction, part II: alternatives to maintenance.
. U.S. National Library of Medicine. (2016). Opiate withdrawal.
. Center for Substance Abuse Treatment. (2005). Medication-assisted treatment for opioid addiction in opioid treatment programs. Rockville, MD: Substance Abuse and Mental Health Services Administration. Treatment Improvement Protocol (TIP) Series, No. 43.