Managing Hydrocodone Cravings
Hydrocodone, one of the main ingredients in combination painkiller medications such as Vicodin or Norco, can be a highly addictive drug. Often used for moderate to severe pain, hydrocodone is the most commonly prescribed and most frequently abused painkiller in the United States. 1
A hydrocodone addiction can lead to cravings when use is stopped or reduced. These cravings can be overwhelming and hard to manage without some form of professional help or support. Learn more about hydrocodone cravings and how to deal with them.
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Hydrocodone Cravings Signs and Symptoms
Cravings are strong urges to usehydrocodone. They can be very difficult to endure and can lead to relapse.
Some of the common signs and symptoms of cravings include:
- Feeling a strong physical urge to take the drug (feeling shaky or anxious without it).
- An intense psychological need to take the drug (difficulty thinking about anything else).
- Clammy hands.
- Increased heart rate and breathing.
Like other opioids, hydrocodone affects opioid receptors in the brain, a certain portion of which are responsible for triggering feelings of pleasure, euphoria, and reward. 3
Over time, your brain creates a lasting memory of these feelings and associates them with the specific circumstances in which they are felt, such as certain places or with certain people. 3 After you stop using hydrocodone, you may still experience cravings when you encounter those circumstances again – such as when you meet someone with whom you once used. This can make abstinence difficult and challenging.
If you’ve developed an addiction to hydrocodone, you may also experience cravings and withdrawal symptoms when you suddenly stop using hydrocodone or when the amount that you’ve been using is reduced. 2Many people continue using hydrocodone-containing products because they fear the intensity of cravings and withdrawal symptoms.
Cravings can be very distressing for someone trying to quit hydrocodone. However, they are a normal part of the recovery process and do not necessarily mean the person wants to use hydrocodone again. They will also typically peak in intensity and subside within an hour if the person does not give in to them. 5 Most people find that their cravings become less intense over time.
Therapies and Treatments for Hydrocodone Cravings
Fortunately, a number of therapies can be used to help reduce and treat cravings These therapeutic approaches are used in inpatient, outpatient, group therapy, and individual therapy settings and include:
- Cognitive behavioral interventions: Also referred to as CBT, cognitive behavioral therapy is a form of psychotherapy that helps people identify triggers and teaches strategies for coping with cravings, including distraction, talking about the craving, recalling the negative consequences of drug use, and using positive self-talk. 5
- Contingency management:Contingency management rewards people who resist a craving. Many programs use vouchers or other incentives to encourage participants to stay clean from drugs and alcohol. For example, someone who resists a craving and submits a clean urine drug screen would receive a voucher that can be exchanged for food, movie tickets, or other items.
- Mindfulness: Mindfulness involves using techniques such as meditation to help people withstand cravings by accepting the present moment and relating differently to their thoughts and feelings. 4
- Urge surfing: Similar to mindfulness, this technique teaches people to “ride the wave” of a craving. Many users who practice this technique begin to realize that cravings are a physical sensation that rises, peaks, and eventually subsides.
It’s normal to fear relapse, especially when you’re faced with cravings. Professional treatment programs are available if you feel like you can’t handle the craving on your own. Some common options include:
- Inpatient treatment: This is an intensive, residential form of treatment that provides 24/7 monitoring and support. People who attend inpatient programs often stay for several weeks to months, depending on their recovery needs. Inpatient treatment usually includes components such as detox, individual therapy, group counseling, 12-step meetings, and other forms of therapy. Relapse prevention techniques and ways to manage cravings may be taught at these programs.
- Outpatient treatment: Outpatient can also be a beneficial alternative option for people who cannot devote the time or resources required for inpatient treatment. Often composed of the same components as inpatient treatment but on a less intensive scale, outpatient treatment usually requires attendance at a recovery center several times a week.
- 12-step meetings: Many people in recovery benefit from the support and guidance of others who are walking the same path. Twelve-step meetings are based on the 12 steps of recovery outlined by Alcoholics Anonymous. Participants attend meetings as often as they wish and work one-on-one with a sponsor to help maintain sobriety. A sponsor is also available to call if a participant is having a craving.
- Individual therapy: Individual therapy involves one-on-one psychotherapy with a licensed counselor. People generally attend individual therapy once a week, but treatment can occur on a more frequent basis in some cases. This form of treatment offers a focused setting to discuss cravings or other issues related to recovery.
- Group counseling: Often a component of both inpatient and outpatient treatment, group counseling sessions are led by qualified substance abuse specialists who help lead participants through the recovery process. Participants can discuss cravings with other group members and the therapist and receive advice from others based on their experiences.
Medications Used to Curb Hydrocodone Cravings
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Your doctor or treating physician may prescribe certain medications to help reduce cravings and assist you during the detox and recovery process. These medications should be combined with behavioral therapies or some other form of treatment, such as a 12-step program.
Methadone and buprenorphine also present risks for dependence, and they should only be used under the supervision of a physician.
Some of the more common medications used to treat hydrocodone cravings include: 3
- Methadone – a long-acting medication that affects opioid receptors similarly to hydrocodone, but isn’t typically associated with the highs and lows associated with hydrocodone abuse. It can help users get through the withdrawal phase and engage in treatment. Methadone can only be prescribed in hospitals or clinics regulated by the Substance Abuse and Mental Health Services Administration (SAMHSA).
- Buprenorphine – another opioid medication that produces a weaker “high” than hydrocodone while blocking the effects of other opioids. Buprenorphine also has a ceiling effect, which means that after a certain point, a user cannot enhance the effects by taking more of the drug.
- Naltrexone – a medication used after detox that blocks the effects of opioids such as hydrocodone. Over time, the drug can help to reduce the rewarding effects of hydrocodone and prevent cravings.
How to Stop Cravings Naturally
Exercise can help distract you from cravings and reduce stress.
You may be able to curb cravings, or at least reduce their intensity, by using certain natural methods. However, these are most effective when combined with some form of professional treatment for relapse prevention.
- Exercising:Exercise encourages the release of endorphins, your body’s natural form of opioids. In addition, exercsising can help distract you from cravings, develop self-esteem, and manage stress.
- Meditating: Observing the thoughts you are having about cravings without acting on them may help you resist the urge to use.
- Engaging in hobbies: Try something new or something you’ve always wanted to learn. Cultivating a hobby helps you think about something other than using and gives you a goal to work toward.
- Spending time with supportive friends: Getting out of the house and being social can give you a much-needed mood boost, as well as distract you from cravings.
- Practicing breathing exercises: Not only do breathing exercises distract you from cravings, but deep, diaphragmatic breathing slows down the central nervous system and invokes your body’s natural “relaxation response.” Sit with your eyes closed and focus on taking slow, deep breaths. Inhale to a slow count of four, pause, then exhale to a count of five. Concentrate on making your exhalations slightly longer than your inhalations.
- Cultivating a relaxing sleep routine before bedtime: Sleep difficulties can be one of the most frustrating symptoms of cravings. Although it may not completely alleviate insomnia, creating a relaxing, regular sleep routine helps prepare your mind and body for bed and may make it easier for you to fall asleep. Try taking a warm bath or meditating with a free guided audio program.
Cravings and Relapse
Unfortunately, relapse is often part of the recovery process, and cravings are a common cause of relapse. Being aware of specific triggers and warning signs may help you avoid a relapse and keep you on the right path.
Some common relapse warning signs include:
- Associating with people who still use drugs: Even if you remember them fondly, it’s best to avoid these people. Being around them is a major trigger to use. Avoid “energy vampires,” or former friends or acquaintances who suck the life out of you and make you feel bad about yourself.
- Stopping attendance at recovery meetings: You might think you don’t need the support anymore, but there’s always a chance of relapse, no matter how long you’ve been clean and sober.
- Major life events, such as illness, divorce, or death of a loved one: The stress of these events can lead to relapse. Surround yourself with the support of those who love and care for you during these times.
- Isolating yourself: Stay connected to positive social supports and get involved in your community.
- Thinking you can use “just once” and be fine: Some people who have been sober for a period of time start to think that they can go back to occasional use. But this is a common cause of relapse and can reignite the spiral of addiction again.
Relapse isn’t inevitable – when you’re aware of your triggers, you can take action to prevent a relapse. Some of the ways of preventing relapse can include:
- Calling a sponsor or a supportive friend or loved one. Often, just talking about the craving with someone else can lessen the intensity of it.
- Sticking to your aftercare plan. A treatment team at a recovery center will usually work with you on an aftercare plan for when you discharge. Aftercare includes forms of ongoing care you receive after treatment, and it can help prevent a relapse. Types of aftercare include 12-step meetings, outpatient treatment, individual counseling, group counseling, and sober living.
- Cultivating a positive support system. Connect with people who care about you and support your recovery: friends, family, and others in recovery.
- Practicing self-care when you feel a craving. You don’t have to use to feel good. Do something nice for yourself instead. Get a massage, go for a walk in nature, or watch a funny movie.
- Identifying and avoiding your triggers. Make a list of the people, places, and things that make you want to use hydrocodone. Then write down ways you can avoid these things and how you can cope with them when you can’t avoid them.
If you do relapse, try to see it as a bump in the road that many people in recovery have had to face. They’ve gotten through it, and you will, too.
Find a Recovery Center for Hydrocodone Dependency
You don’t have to walk the path to recovery on your own. Call 1-888-319-2606 Who Answers? to speak to a treatment support specialist about finding the right treatment program for your needs and means.
. Drug Enforcement Administration. Drug Fact Sheet: Hydrocodone.
. Mayo Clinic. (2014). Drug addiction: Symptoms.
. Kosten, T. and George, T. (2002). The Neurobiology of Opioid Dependence: Implications for Treatment. Addiction Science and Clinical Practice. 1(1): 13-20.
. Nauman, E. (2014). Can Mindfulness Help Stop Substance Abuse? The Greater Good Science Center at the University of California, Berkeley.
. National Institute on Drug Abuse (2005).A Cognitive-Behavioral Approach: Treating Cocaine Addiction: Topic 1: Coping With Craving.
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