Lortab is a prescription pain management medication that contains hydrocodone bitartrate and acetaminophen. Hydrocodone works to lessen pain by affecting the central nervous system; however, it is an opioid drug that can be very addictive.
The U.S. National Library of Medicine reports that maximum concentration of hydrocodone within the bloodstream typically occurs approximately 1.5 hours after administration of the drug. Half-life of the drug is about 4 hours. Lortab can be found in tablet, capsule, syrup, and suspension form.
Effects of Hydrocodone
Long-term use of hydrocodone, in any form, leads to serious effects on both the body and the mind. As with other opiates, abuse can quickly lead to addiction.
Effects on the Mind
Opioids like hydrocodone work by attaching to opioid receptors in the brain. This reduces or blocks the pain signals the brain receives. This can also produce a sense of euphoria or wellbeing by affecting the areas of the brain responsible for reward. NIDA warns that people who are addicted to hydrocodone may try to intensify this euphoric feeling by using the drug in ways other than how it is prescribed, such as crushing the pills to snort or inject the drug, or taking a larger dose.
Hydrocodone can be highly addictive. Addiction is defined by NIDA as compulsive drug-seeking behavior and continued use despite negative consequences. Contributing causes of addiction include individual biology and genetics, as well as social and environmental factors. As addiction is a chronic disease, it often requires long-term professional treatment.
Repeated use of hydrocodone typically leads to increased tolerance. Over time, the brain and body become accustomed to the presence of the drug, and changes occur within the brain. Increased doses of the drug are required to achieve the same effects that were once felt from a small dose. This can increase the risk of overdose, especially if a person uses hydrocodone after a period of abstinence from the drug; tolerance decreases after a period of abstinence, so a dose that was once well tolerated can prove dangerous. Because of this, risk of overdose can increase after receiving treatment for addiction.
Opioid drugs can have many neuropsychological effects, which may be short- and long-term. A recent study found that use of this type of drug caused lower performance in attention, concentration, memory, spatial reasoning, and psychomotor function. Long-term use of opioids had the most serious consequences, including poorer reasoning skills and less impulse control.
Effects on the Body
One of the many effects of hydrocodone abuse on the body is physical dependence. Over time, the body can become dependent on the presence of hydrocodone to function properly. Stopping or decreasing the drug can lead to withdrawal.
Hydrocodone use can cause many physical side effects. Most are not life-threatening. They may include:
- Nausea or vomiting
- Dry mouth and throat
- Rash or itching
- Dizziness or lightheadedness
- Narrowed pupils
- Changes in mood or anxiety levels
Hydrocodone can also cause more dangerous side effects. Potentially life-threatening effects of this drug include slow, irregular breathing and chest tightness. An overdose of hydrocodone is very serious. Symptoms of overdose include:
- Slow, shallow breathing
- Slowed heartbeat
- Cold, clammy skin
- Loss of consciousness
Abuse of hydrocodone or Lortab is especially dangerous for pregnant women. This drug can cause many problems in newborns, including neonatal abstinence syndrome. Babies exposed to opioids in the womb can be born addicted to the drug. Once they are no longer receiving the drug through the womb, symptoms of withdrawal appear. Withdrawal can be dangerous for newborns and can have significant negative impacts on their health and development.
Health Effects Associated with Acetaminophen
While hydrocodone is the truly addictive portion of Lortab, the other component in the medication – acetaminophen – carries serious health risks as well. Taking too much acetaminophen in any form can lead to liver damage, and over time, this liver damage can lead to death.
Those who abuse Lortab can easily and quickly exceed the maximum daily amount of acetaminophen that one should take in a day. The ill health effects of acetaminophen are also compounded by alcohol consumption. Those who abuse prescription painkillers often combine their use with alcohol in an effort to increase the pleasant effects of the drug. The result can be deadly.
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Effects of Addiction
The CDC reports that 44 people die every day from the misuse of prescription painkillers. In 2012, 2.1 million people in the United States met the criteria for substance use disorders related to prescription opioid drugs, according to the National Institute on Drug Abuse (NIDA).
Hydrocodone addiction can have many negative effects on behavior, mental wellbeing, and physical health. Since addiction involves compulsively seeking out and using the drug, it can impact virtually all areas of a person’s life.
Mayo Clinic reports that addiction to prescription drugs can lead to the following behaviors:
- Stealing or forging prescriptions
- Seeing more than one doctor in order to receive multiple prescriptions
- Taking higher doses than prescribed
- Disturbances in sleep patterns
- Mood swings or hostility
- Poor decision-making and dangerous behavior
Other signs of addiction may include:
- Chronic drowsiness and lack of energy
- Lack of participation in activities previously enjoyed
- Increased isolation or a change in friend groups
- Increased secrecy
Choosing a Treatment Program
In 2009, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that 9.3 percent of people aged 12 or older in the US needed treatment for an illicit drug problem. Only 11.2 percent of those who needed treatment received it at a facility specializing in drug addiction. Addiction to opioids is one of the largest contributors to drug treatment facility admissions.
Treatment of hydrocodone addiction must address several factors, including the individual needs of the person receiving treatment, and social and familial factors that may contribute to the addiction or recovery. Relapse is common, and many individuals require multiple rounds of treatment before long-term sobriety is achieved.
Treatment may involve medical detox, behavioral therapy, and medications. Behavioral therapy addresses the thoughts and behaviors that contribute to the addiction and help the affected individual establish new patterns, so the urge to use drugs can be better resisted. Therapy can also improve life circumstances, such as family relationships and functioning within the community, which also contribute to recovery from addiction. Medication may be prescribed in combination with therapy to treat withdrawal or to assist in maintaining sobriety. Research has shown that a combination of behavioral therapy and medications tends to be the most effective treatment approach.
Withdrawal and Detox
Dependence is a common component of addiction. Once the body becomes physically dependent on hydrocodone, stopping or lessening use of the drug will lead to withdrawal. Withdrawal is the body’s natural period of adjustment, as it becomes accustomed to functioning without the drug. Symptoms can be very unpleasant, but are not usually life-threatening. The initial symptoms of withdrawal may include:
- Anxiety and agitation
- Trouble sleeping
- Muscle aches
- Watery eyes and runny nose
Later symptoms of withdrawal may include:
- Abdominal cramps
- Nausea and vomiting
- Dilated pupils
Detox is typically the first phase of treatment for hydrocodone addiction, and it addresses this period of withdrawal. NIDA defines detox as the process by which the body rids itself of the addictive substance. For addiction to Lortab and hydrocodone, medical detox in an inpatient setting is recommended. Since opiate detox can be intense, 24-hour medical supervision is required. In addition, relapse is more likely to occur if patients detox in an outpatient setting, because of easier access to the drug.
Various medications can be used to treat hydrocodone or Lortab addiction. The three medications most commonly prescribed for this purpose are naltrexone, methadone, and buprenorphine.
Naltrexone blocks opioids from activating opioid receptors within the body. This prevents Lortab from having an effect if taken. Naltrexone can be used to treat overdose on an as-needed basis or as part of an ongoing addiction treatment program. This drug is not well tolerated by everyone, but can last for several weeks, so it can be a convenient medication for patients without regular access to healthcare.
Methadone is an opioid that has similar effects as hydrocodone, so it can be used to treat withdrawal or to reduce cravings. It has been used to treat addiction for several decades, but it is a carefully controlled substance. Methadone can only be dispensed through licensed treatment programs, so it is not available on an outpatient basis.
Buprenorphine is also used to reduce cravings and withdrawal symptoms. This drug can be prescribed by physicians in an office setting, so it is more readily available than methadone. It is typically well tolerated and has a low risk of abuse.
Individual and group counseling is frequently used to tread addiction to hydrocodone and other opioid drugs like Lortab. Therapy may be provided in an inpatient or outpatient setting. Common forms of therapy to treat addiction include the following:
- Cognitive Behavioral Therapy helps the individual address patterns of unhelpful thoughts and behaviors that may be perpetuating the addiction. New patterns are formed, so the individual can better respond to stressful feelings and situations that may trigger drug use.
- Contingency Management provides incentives as rewards for positive behaviors. Abstaining from drug use is reinforced through rewards that are received after reaching certain milestones.
- Motivational Enhancement Therapy is commonly used early in addiction treatment to encourage the individual to participate in treatment and abstain from drug use. This approach builds motivation and commitment to the treatment plan.
- Twelve-Step programs offer ongoing peer support to those in recovery from hydrocodone addiction. Individuals have various groups to choose from, such as Narcotics Anonymous and Pills Anonymous.
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Treatment for hydrocodone addiction typically involves an initial period of more intense treatment, at whatever level is most appropriate for the individual. As the individual progresses in recovery, the hours spent in treatment are gradually decreased. Continued long-term treatment is an important component of sustained sobriety.
Therapy may be provided through outpatient programs, partial hospitalization or intensive outpatient programs, or inpatient programs. Each level of treatment varies in intensity and level of care provided. Long-term inpatient treatment programs may last several months and offer a highly structured environment in which to receive treatment. Short-term residential programs are more common and may last a few weeks. These programs focus on detox and initial intensive treatment; after inpatient care, clients are generally transitioned outpatient care.
Inpatient treatment is more expensive and time-intensive than outpatient programs, but it offers certain advantages. A study published by the U.S. National Library of Medicine found that participants in outpatient treatment were four times more likely to relapse during the course of treatment than those in inpatient programs.
Partial hospitalization or intensive outpatient programs are programs that provide regular treatment sessions multiple days a week on an outpatient basis. These programs offer comparable treatment to what is found in inpatient programs, but they are usually much less expensive.
Group counseling is frequently employed in the treatment of addiction. Group therapy provides social support and a network of resources, which can be very helpful in maintaining sobriety. NIDA has found that group counseling increases the likelihood of positive outcomes from addiction treatment, especially when used in combination with individual therapy.