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Hydrocodone vs Oxycodone – What are the Differences?


Opioid addiction, including addiction to prescription painkillers like hydrocodone and oxycodone, has led to a staggering loss of life and widespread suffering. Those living with addiction to one of these substances, long-term use or otherwise, are inherently more likely to forgo addiction treatment and ultimately lose the battle for their lives. Consider this fact. More than 111,000 people have lost their lives due to drug overdose in the US as of the most recent data from the Centers for Disease Control and Prevention. Meanwhile, approximately 3.8% of US adults live the struggle of opioid addiction, including hydrocodone and oxycodone, reports the National Center for Drug Abuse Statistics.

These drugs sound similar and carry many similarities, but the difference between oxycodone and norco can easily be confused with the difference between OxyContin and Hydrocodone or a myriad of other names and brands. Remember that there are always many different names for every medication and its potential combinations. Regardless, the risk of addiction is still present and can also lead to physical dependence, addiction, and a range of adverse effects.

At the root of the issue, they are different and are independently responsible for destroying whole lives. Both have similar effects and it’s inaccurate to describe one as the solution to the question, “which is stronger- oxycodone or hydrocodone?” Rather than getting into the weeds of nuanced names, let’s take a closer look at what these medications are and their role in the ongoing opioid epidemic.

What Are Hydrocodone and Oxycodone?

Hydrocodone and oxycodone are prescription opioid drugs used to treat moderate-to-severe pain. They’re so named because they mimic the effects of the natural compounds within the opium poppy plants. Some are synthetic, while others are made from opium itself. Both drugs in this comparison come from parts of the opium plant, but they don’t necessarily occur naturally. These drugs target specific opioid receptors in the brain and nervous system, which is why they are effective in managing pain but also carry a high risk of addiction.

For example, oxycodone is made from a chemist-induced reaction with thebaine, and as a result, its effects on the body mimic a state of euphoria stronger than that of the opium plant. Hydrocodone on the other hand is made from codeine, which is another compound within the opium plant, but its side effects are slightly less than that of oxycodone, albeit very minor.

Oxycodone was built to be a replacement with a low-risk profile compared to hydrocodone, but obviously, we know a different truth exists today. They are most often prescribed to manage acute pain or chronic pain in patients who need to take pain medication over a long period of time. They are generally prescribed only after other pain medications have proven ineffective in managing their severe pain.

Hydrocodone Versus Oxycodone: Two Medications With a Major Impact

Hydrocodone impacts the central nervous system and prevents pain signals from reaching the brain. It can be found as a single-ingredient substance or a combination drug—it’s most commonly prescribed as a mixture of hydrocodone combined with acetaminophen. It is the active ingredient in the well-known painkillers Vicodin, Norco, and Lortab and can be combined with ibuprofen to manage pain and reduce fever and inflammation. It can also be combined with a decongestant to manage differing ailments.

Oxycodone changes how your brain and body respond to and perceive pain. Like hydrocodone, it is available in a single-ingredient substance or combination medicine. It is the active ingredient in OxyContin and Percocet. It also appears to have a stronger impact on the perception of the mind of the person taking the drug compared to hydrocodone. Yet, hydrocodone is more readily accessible than oxycodone.

Further, a core difference between hydrocodone and oxycodone is that oxycodone is more potent than hydrocodone, so a lower oxycodone dose is needed to produce the same effects as hydrocodone. Due to that fact, it’s essential to recognize that treatment for such an addiction, but in particular an oxycodone addiction, warrants medical intervention. Moreover, treatment may be covered under your existing insurance coverage too, but before we dig much further, let’s consider the side effects of using either of these medications inappropriately.

Hydrocodone Versus Oxycodone Side Effects

Both medications, because they derive from similar forms and substances, have similar common side effects. The effects of hydrocodone may appear less severe than the effects of oxycodone, but again, every person may respond differently to the drug. In general, both affect opioid receptors in the brain to treat and block moderate to severe pain. However, they do come with some side effects, including:

  • Dry mouth
  • Swelling
  • Muscle spasms
  • Tremor
  • Tachycardia
  • Chills
  • Fatigue
  • Anxiety
  • Confusion
  • Depression
  • Agitation
  • Seizures

This isn’t a complete list. For instance, some may experience sudden increases or decreases in blood pressure, while others only notice some side effects. But, the latter half of the list tends to be associated more with oxycodone dependence and opioid use disorder. Still, it all is subject to the person’s metabolism, history with the prescription, and whether opioid medications are being used for pain relief or another habit forming intent.

Once a person has developed a physical dependence on hydrocodone, or oxycodone for that matter, they often turn to non-prescription drugs like heroin as a substitute after their prescription runs out. Heroin is cheaper and often more accessible–significantly as authorities have increased the conditions under which a doctor prescribes these prescriptions due to the risk of opioid abuse itself.

Hydrocodone vs Oxycodone: Similarities

Hydrocodone and oxycodone are both labeled as Schedule II drugs, which means they are considered dangerous and addictive and are therefore regulated by the DEA. A Schedule II substance is just one step below illegal drugs.

Both hydrocodone and oxycodone are very similar and effective in how they treat pain. However, some believe that oxycodone is a bit stronger. Both drugs are highly addictive, even when taking the correct, prescribed dosage. Most narcotics have the same side effects: lightheadedness, dizziness, sedation, nausea, and vomiting. They also both create a sense of euphoria, which triggers the reward system in the brain. Each time this happens, the brain starts to rewire itself to want more of whatever is creating the sense of pleasure, even if it causes long-term problems for the person. As a result, they seek stronger medications, such as extended-release tablets or extended-release formulations, that usually have a higher concentration of the active ingredient.

These opioid analgesics amplify the effects of other medications that slow brain function. For example, if opioids are combined with alcohol, barbiturates, or muscle relaxants, brain function will be restricted to such a degree that it could lead to impairment of breathing. Mixing oxycodone or hydrocodone with alcohol is especially dangerous.

Hydrocodone vs Oxycodone: Differences

Both Hydrocodone and Oxycodone work in similar ways, but it’s not a simple question of Oxy vs Norco for an ailment. Plus, the ability to understand what type of drug is oxycodone and its impact means you have first to recognize that while similar, they have different properties.

Yes, they both stimulate the opioid receptors in the brain to increase pain tolerance and reduce the perception of pain. They aren’t technically capable of activating on the pain itself, but the person thinks the medication relieves it. This is a Catch-22 situation because it’s not the same as resolving the pain. Instead, being under the influence of such medications increases the risk of dangerous behaviors, including causing additional injury to the problem that precipitated the pain and need for the prescription in the first place.

Oxycodone is available as both immediate and time-release narcotic painkillers. Hydrocodone is an instant-release painkiller when in its most common form (mixed with acetaminophen). However, when it is prescribed by itself it also has a time-release formula. Another difference between the two is that hydrocodone has a higher chance of producing the negative side effects of stomach pain and constipation.

Hydrocodone vs Oxycodone: Addiction and When to Get Help

Doctors generally prescribe these two drugs as a last resort when other drugs do not keep the pain under control. They do this because, even when taken as prescribed, they pose a high risk of dependence and addiction. However, there is some debate about which causes a more severe dependency. For instance, the internet is littered with questions along the lines of “Which is stronger, oxycodone or hydrocodone,” or “What are the differences between Oxy and Norco.”

Still, both mean that a person has likely already gone past the point of dependency. And the most frightening factor is knowing that this could happen with little to no warning or visible signs of a problem. As a result, there are few things all people and caregivers should do to reduce their risk of developing an addiction to opioid medications, including:

  • To be a responsible patient and avoid addiction, only take these drugs as prescribed.
  • Keep an open and honest dialogue with your doctor while taking these (or any other) prescribed medications.
  • Don’t suddenly stop taking them, as that will likely result in you experiencing withdrawal symptoms.
  • Don’t crush, snort, or inject any substance containing hydrocodone or oxycodone.
  • If you feel as though you are starting to become dependent on any substance, contact your doctor right away.

Treatment for Opioid Dependency of Hydrocodone or Oxycodone

The treatment options for hydrocodone versus oxycodone vary, but both begin with recognizing a need for professional intervention. As highly addictive opioids that impact basic neural function, withdrawals from these medications without supervision can be life-threatening.
Initial treatment begins with detoxification, or detox, and is a medically assisted process to minimize side effects and maintain the body’s equilibrium with a safe and effective process. Next, a residential treatment stay may be necessary to continue rebuilding equilibrium and providing healthy coping skills to overcome the triggers that result in a desire to abuse prescription painkillers. After residential treatment, continuous outpatient rehabilitation can help people maintain sobriety, and over time, they’ll be able to help others themselves as part of an effective alumni program, much like that of New Choices Treatment Centers.

For some individuals, medication-assisted treatment using drugs like buprenorphine or methadone may be recommended to manage cravings and withdrawal symptoms as part of a comprehensive opioid addiction treatment plan.

Overcome Hydrocodone or Oxycodone Addiction With New Choices Treatment Centers

Addiction to hydrocodone versus oxycodone isn’t all that different, but both cause irreparable harm to your psyche, physical health, and life. When you are dependent on the drug, your body has become so used to the drug that it can no longer function normally without it. Unfortunately, addiction to either hydrocodone or oxycodone only worsens when left untreated. Start by realizing there is no such things as the lesser of two evils in this conversation. Both require treatment. Also, realize that no matter what point you may find yourself at or a loved one living with addiction experiencing, seek help. There is no shame in seeking help. At New Choices, our caring team of professionals are ready and willing to help you at every step. Speak with a New Choices admissions team member to learn more about how we can help you begin the journey toward sobriety.

Frequently Asked Questions (FAQ)

What are hydrocodone and oxycodone?

Hydrocodone and oxycodone are prescription opioid painkillers used to treat moderate to severe pain. They work by binding to opioid receptors in the brain and reducing the perception of pain.

What’s the difference between hydrocodone and oxycodone?

The main differences between hydrocodone and oxycodone are their potency and source. Oxycodone is more potent than hydrocodone and is derived from thebaine, while hydrocodone is derived from codeine. They also have different brand names and may vary in their side effects.

Are hydrocodone and oxycodone addictive?

Yes, both hydrocodone and oxycodone have a high potential for abuse and addiction, even when taken as prescribed. They can cause physical dependence, meaning that the body adapts to the presence of the drug and experiences withdrawal symptoms when the drug is stopped.

What are the signs of hydrocodone or oxycodone addiction?

Signs of addiction may include taking larger doses than prescribed, craving the drug, spending significant time obtaining and using the drug, neglecting responsibilities, and continuing to use despite negative consequences.

How long do hydrocodone and oxycodone stay in your system?

The length of time hydrocodone and oxycodone stay in your system depends on factors such as dosage, frequency of use, and individual metabolism. Generally, they can be detected in urine for 2-4 days, in saliva for 1-4 days, and in hair for up to 90 days.

What are the treatment options for hydrocodone or oxycodone addiction?

Treatment for hydrocodone or oxycodone addiction typically involves a combination of detoxification, behavioral therapy, and medication-assisted treatment. Professional treatment programs, such as those offered by New Choices Treatment Centers, can provide comprehensive care tailored to individual needs.

Can I quit hydrocodone or oxycodone cold turkey?

Quitting hydrocodone or oxycodone abruptly can be dangerous and lead to severe withdrawal symptoms. It is essential to seek professional help and undergo a medically-supervised detoxification process to ensure safety and comfort. Text us now for help.

How can I support a loved one struggling with hydrocodone or oxycodone addiction?

Supporting a loved one with addiction involves encouraging them to seek professional help, offering emotional support, and creating a safe, drug-free environment. Educate yourself about addiction and treatment options, and consider joining a support group for families of individuals with addiction.

Still have questions? Text us or submit a comment.