Once one of the most widely-prescribed drugs in the U.S., Vicodin was a fixed-dose combination analgesic containing hydrocodone bitartrate and acetaminophen. Then in 2011, the Food and Drug Administration put new restrictions on its formulation, along with that of Vicodin ES and Vicodin HP, and those three particular brands were discontinued.
However, there’s still a generic hydrocodone and acetaminophen medication on the market commonly referred to as Vicodin, although not usually prescribed under that brand name. Because generic Vicodin is manufactured with a synthetic opiate, it has a high rate of dependency.
Why the Change in Formula?
Surprisingly, it wasn’t that the drug was an opioid, but because it contained high levels of acetaminophen. Original Vicodin products, initially manufactured by Knoll in 1978, featured 5–10 mg of hydrocodone bitartrate and approximately 500–750 mg of acetaminophen. At that time, the U.S. Drug Enforcement Administration (DEA) considered Vicodin a Schedule III drug, defined as having “a moderate to low potential for physical and psychological dependence.”
However, many patients on Vicodin experienced severe liver damage, typically the result of eight or more Vicodin doses daily, which amounted to more than 4,000 mg of acetaminophen. So by 2014, as per the FDA, the primary manufacturer of Vicodin, AbbVie (formerly Abbott) ceased developing and marketing hydrocodone and acetaminophen products with more than 325 mg of acetaminophen, and switched to generic versions.
The National Library of Medicine (NLM) outlines the new formulas for tablets and oral solutions (as of 2022), which we provide verbatim:
- Hydrocodone bitartrate 5 mg / acetaminophen 300 mg
- Hydrocodone bitartrate 5 mg / acetaminophen 325 mg
- Hydrocodone bitartrate 7.5 mg / acetaminophen 300 mg
- Hydrocodone bitartrate 7.5 mg / acetaminophen 325 mg
- Hydrocodone bitartrate 10 mg / acetaminophen 300 mg
- Hydrocodone bitartrate 10 mg / acetaminophen 325 mg
- Hydrocodone bitartrate 7.5 mg / acetaminophen 325 mg per 15 mL oral solution
The Danger With Vicodin
Also in 2014, the DEA reclassified generic Vicodin, considered a “combination product with less than 15 milligrams of hydrocodone per dosage unit”, as a Schedule II narcotic, meaning it has “a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous.”
This, along with the massive opioid crisis of recent years, changed the way healthcare professionals prescribe the generic to manage moderate-to-severe post-surgical pain, chronic pain, and cancer. The NLM notes that “hydrocodone is one of the most common pain medications prescribed by clinicians and one of the most abused by patients.”
Hydrocodone acts as a sedative, prompting some individuals to experience deep relaxation or euphoria. Because of the combined formulation with acetaminophen, generic Vicodin targets two pain mechanisms, making it one of the most effective pain relievers, but also one with great potential for abuse. Patients also develop more tolerance to the drug, especially if used repeatedly, thus requiring more frequent or higher doses to get the same effect.
Additionally, almost any type of pharmaceutical opiate can become an illicit drug. In a 2019 report, the DEA indicated that “hydrocodone tablets with the co-ingredient, acetaminophen, is the most frequently encountered form. Hydrocodone is not typically found to be clandestinely produced; diverted pharmaceuticals are the primary source of the drug for abuse purposes. Doctor shopping, altered or fraudulent prescriptions, bogus call-in prescriptions, diversion by some physicians and pharmacists, and drug theft are also major sources of the diverted drug.”
Street names include hydros, vic, and vike.
Symptoms of Vicodin Addiction
People suffering with generic Vicodin addiction often have the same symptoms as hydrocodone addiction or addiction to any other opiates, such as fentanyl and oxycodone. Symptoms include, but aren’t limited to:
- Agitation and irritability
- Anxiety
- Behavioral changes, such as becoming obsessed with having the drug, withdrawing from people and activities to continue to use it, and lying to physicians about the need for it
- Blurred vision
- Chronic constipation and trouble urinating
- Constant itching
- Depression
- Excessive drowsiness or lethargy
- Headaches and ringing in the ears
- Mental confusion and disorientation
- Muscle aches, stiffness, and twitching
- Nausea and vomiting
- Needing more of the drug to achieve the same effects
- Paranoia
- Seizures
- Slowed respiratory rate and other breathing problems
- Skin rash
Some individuals also mix generic Vicodin with alcohol, which is dangerous, as it might cause respiratory distress, coma, or accidental overdose death.
Treating Vicodin Addiction Effectively at Willingway
One of the most troubling outcomes of the opioid crisis is many individuals became addicted to generic Vicodin and other opiates out of a genuine need to manage— and hopefully eliminate— chronic pain.
So when choosing an inpatient addiction rehabilitation center in Georgia, it’s critical to find a treatment program that implements a whole-person continuum of care plan. This approach ensures that the root cause of the addiction will be discovered and addressed on multiple levels: not only physically, but also emotionally, mentally, and spiritually.
The board-certified team at Willingway integrates progressive techniques such as medically managed detoxification, opioid pain management alternatives, and evidence-based pain recovery tools to ensure an easier generic Vicodin withdrawal process and a healthier state of being in recovery. Ask a member of our admissions team for more information.