How Long Does Hydrocodone Stay In Your System? Drug Facts, Timelines, and Treatment

Hydrocodone Drug Facts

Hydrocodone is a powerful semi-synthetic opioid with both analgesic and antitussive properties. It’s derived from natural alkaloids within the resin of poppy seeds.[1]

The painkiller is a Schedule II controlled substance, indicating it has a high potential for abuse and limited approved medical uses. Currently, it is used to manage chronic pain for which other non-opioid painkillers are ineffective or as a cough suppressant in advanced-stage cancer patients.

Invented in Germany in the 1920s, hydrocodone was finally approved by the FDA for use with acetaminophen in the United States in 1998.[2] It has since become a cultural flashpoint in the opioid crisis that has developed in the US since the early 2000s.

Hydrocodone Mechanism of Action

Hydrocodone primarily acts on the mu-opioid receptors in your central nervous system. However, if the dosage exceeds common therapeutic levels, it can also act upon delta and kappa-opioid receptors.[3]

Mu-opioid receptors signal the brain to release dopamine. Part of the brain’s reward system, dopamine, produces the feeling of pleasure, which is meant to reward certain healthy activities like eating, drinking, working out, and sex.

Hydrocodone is an opioid agonist, which means it initiates a physiological response if it attaches to your opioid receptor. In this case, hydrocodone has the effects of a depressant, as it decreases both neuronal excitability and respiration rate.

Because it depresses your respiration rate, hydrocodone is particularly dangerous if combined with alcohol or other depressants. If the respiration rate declines too low, oxygenated blood will stop flowing to the brain, which can cause coma, seizures, or death.[4]

Metabolism and Metabolites

Hydrocodone is metabolized by the liver and excreted by the kidneys. When hydrocodone is metabolized, the metabolites hydromorphone and norhydrocodone are formed.[5]

While hydrocodone itself has analgesic properties, its metabolite hydromorphone is also a potent analgesic, though the correlation between their plasma concentrations and analgesic effects may vary.

How Long Does Hydrocodone Stay In Your System?

Hydrocodone comes in two different kinds of dosage capsules: Immediate Release (IR) and Extended Release (ER). ER capsules take longer to be eliminated from the body than IR capsules because they remain longer in the blood.

The prescribed dosage amount for IR and ER hydrocodone may differ depending on the patient’s medical condition, pain severity, and other medications being taken. Single-entity hydrocodone (rather than in combination with acetaminophen) is only available in ER formulation.[6]

How Long Does Hydrocodone Take to Kick In?

Immediate-release hydrocodone reaches peak plasma concentration within 1 hour, whereas extended-release hydrocodone reaches peak plasma concentration in 14-16 hours.[7]

What Is The Half-Life of Hydrocodone?

The time it takes for 50% of a given substance to be eliminated from your body is the elimination half-life. It takes 4 to 5 consecutive elimination half-lives to statistically eliminate a given substance from your body.

The elimination half-life of hydrocodone is approximately 4 to 9 hours, which means that it will be statistically eliminated from your body anywhere from 16-20 to 36-45 hours after initial ingestion.

Methods of Hydrocodone Drug Testing

Effects of Long-Term Hydrocodone Use

The most widely abused prescription opioid in the United States, long-term hydrocodone use has potentially serious complications.

Chronic hydrocodone use can lead to tolerance, incapacitation, overdose, and death, especially if ingested with other addictive substances. Alcohol use combined with hydrocodone use has a high potential for irreparable harm due to the heightened risk of fatal respiratory depression.

Common Side Effects of Hydrocodone

The most common side effects of hydrocodone are constipation and nausea.[8]

Even when taken as prescribed by your doctor, the risk of side effects and developing a chemical dependency on hydrocodone is lower than if taken illicitly.

If you have liver or kidney impairment, you should only take a 50% dose of hydrocodone. Because your organs for metabolizing and eliminating are impaired, less of the drug should be ingested.

If you are pregnant, breastfeeding, or have significant genetic polymorphisms (such as CYP2D6), you should avoid taking hydrocodone.[9] The drug can be passed through the placenta and breast milk and could cause respiratory depression or death in newborns.

Serious Side Effects of Hydrocodone

While less likely, there are serious–and potentially lethal–side effects of hydrocodone use.[10] These include:

• Breathing problems like severe respiratory depression, shortness of breath, and respiratory tract infection.
• Circulation problems include low blood pressure, slowed heartbeat, and retained fluid in the legs.
• Neurological problems like headaches, anxiety, dizziness, insomnia, and fatigue.
• Skin problems like persistent itching, uncontrollable sweating, and spreading rash.
• Gastrointestinal problems like vomiting, upset stomach, inflammation, and unexplained abdominal pain.
• Urinary problems include urinary tract infections or the inability to fully empty the bladder.
• Hearing problems like tinnitus or hearing loss.
• Endocrine issues like secondary adrenal insufficiency.

Some symptoms of acute hydrocodone toxicity include apnea, slowed heartbeat, pinpoint pupils, clammy and blue skin, low blood pressure, unconsciousness, and shortness of breath.

The respiratory depression caused by hydrocodone administration can increase the risks of respiratory acidosis.[11] As the lungs slow, less oxygen enters the body. And, when less oxygen is entering the body, less carbon dioxide can be filtered out of it.

Acute hydrocodone toxicity shares remarkably similar symptoms to respiratory acidosis. Oftentimes, respiratory acidosis is the cause of the symptoms of acute hydrocodone toxicity.

Treatment For Hydrocodone Addiction

If you are addicted to hydrocodone, seek treatment immediately. The most effective treatment option for recovering from opioid addiction is to find a treatment center and begin detox.

Detoxification is a time set aside to eliminate hydrocodone from your body. Chemical detox is most effectively pursued in a clinically controlled environment with medication-assisted treatment. These drugs are compassionately administered to make the transition to sobriety as painless as humanly possible.

At Epiphany Wellness, it’s our mission to help families recover from alcohol and drug addictions. In both our New Jersey drug rehab as well as our Tennessee addiction treatment center, we provide evidence-based treatment and dedicated support to help individuals embark on a journey toward a revitalized and transformed life. Contact our admissions today to find out if we can help you or a loved one suffering from hydrocodone addiction.