Vicodin contains two active ingredients – hydrocodone, a Schedule II opioid, and acetaminophen, the same pain reliever found in Tylenol. It’s prescribed for moderate to severe pain and carries a significant risk of dependence, misuse, and addiction.
Though the Vicodin brand was discontinued, the generic form, hydrocodone/acetaminophen, remains one of the most prescribed and misused opioids in the United States. According to SAMHSA’s 2024 National Survey on Drug Use and Health, an estimated 8.0 million Americans aged 12 and older misused prescription pain relievers in the past year – a category that includes hydrocodone (Vicodin), oxycodone, and other prescription opioids.
This guide covers what Vicodin contains, how it works, the signs of misuse and addiction, withdrawal symptoms, and treatment options available for people who want to stop.
What Are the Active Ingredients in Vicodin?
Vicodin contains two active ingredients that work together to relieve moderate to severe pain.
Hydrocodone
Hydrocodone is a semisynthetic opioid analgesic derived from codeine and thebaine - natural alkaloids found in the opium poppy. It works by binding to mu-opioid receptors in the central nervous system, blocking pain signals and triggering a release of dopamine. This dopamine response produces pain relief but also euphoria, which is the primary driver of its addiction potential. Hydrocodone is classified as a Schedule II controlled substance by the DEA, reflecting its high potential for abuse and dependence. It was rescheduled from Schedule III to Schedule II in 2014 in response to rising rates of misuse and addiction.
Acetaminophen
Acetaminophen is a widely available non-opioid analgesic sold over the counter as Tylenol. In Vicodin, acetaminophen adds to hydrocodone’s pain relief by working through a different pathway. Acetaminophen is though to block pain-signaling chemicals in the brain and spinal cord, while hydrocodone acts on opioid receptors. The combination creates an additive analgesic effect, making Vicodin more effective than either ingredient alone. However, acetaminophen also introduces the risk of serious liver damage if taken at high doses or combined with alcohol. For most adults, the maximum daily dose of acetaminophen from all sources is 4,000 mg, and many product labels now advise a lower limit of about 3,000 mg a day.
Vicodin Dosage Strengths
Before the brand was discontinued, Vicodin tablets came in these strengths. Generic hydrocodone/acetaminophen is still sold in similar strengths.
| Formulation | Hydrocodone | Acetaminophen |
| Vicodin | 5 mg | 300 mg |
| Vicodin ES | 7.5 mg | 300 mg |
| Vicodin HP | 10 mg | 300 mg |
Generic equivalents are also available in 2.5 mg, 5 mg, 7.5 mg, and 10 mg hydrocodone doses, paired with either 300 mg or 325 mg of acetaminophen.
Inactive Ingredients
In addition to its active components, Vicodin tablets contain inactive excipients: colloidal silicon dioxide, crospovidone, magnesium stearate, microcrystalline cellulose, povidone, pregelatinized starch, and stearic acid. These ingredients stabilize the tablet but have no therapeutic effect.
What Is Vicodin Called on the Street?
Vicodin and other hydrocodone/acetaminophen combination products go by a number of street names, including Vikes, Vics, Hydros, Watsons, and Tabs, according to the DEA’s Slang Terms and Code Words reference for law enforcement. Parents and family members who come across these terms in conversation, texts, or social media may not realize they refer to a prescription opioid rather than something harmless.
How Does Vicodin Work?
Vicodin works by targeting opioid receptors in the brain and spinal cord to suppress the perception of pain. Hydrocodone binds to mu-opioid receptors, the same receptors activated by heroin and other opioids. This binding suppresses pain signals and simultaneously stimulates the brain’s reward system by releasing dopamine. The resulting euphoria is what makes opioids like Vicodin habit-forming. Acetaminophen works through a different pathway, inhibiting prostaglandin synthesis in the central nervous system. This mechanism reduces pain intensity and can lower fever. The two ingredients together offer stronger, more reliable pain control than either drug taken alone.
Medical Uses of Vicodin
Vicodin is FDA-approved for the management of pain severe enough to require an opioid analgesic when non-opioid alternatives are inadequate. Common prescribed uses include:
- Post-surgical pain (including dental surgery and orthopedic procedures)
- Injury-related acute pain
- Cancer-related pain, including nerve pain
- Chronic pain in patients who have not responded to non-opioid therapies
Historically, hydrocodone/acetaminophen was among the most frequently prescribed opioids following wisdom tooth removal – though current dental guidelines increasingly favor non-opioid alternatives such as NSAIDs combined with acetaminophen as first-line post-extraction pain management. Hydrocodone/acetaminophen is usually prescribed for a few days of acute pain, such as after surgery or an injury, at the lowest dose that works.
Is Vicodin Still Available? (Brand vs. Generic)
The Vicodin brand name was discontinued in the United States. The generic form, hydrocodone bitartrate and acetaminophen, remains widely available under various formulations. Other familiar names for the same combination include Norco, Lortab and Lorcet. Today, most prescriptions are filled with generic hydrocodone bitartrate and acetaminophen.
Signs of Vicodin Misuse and Addiction
Misuse is defined as taking Vicodin in any way other than prescribed - at higher doses, more frequently, for longer than intended, or without a prescription. Misuse significantly increases the risk of dependence and vicodin addiction.
Behavioral Signs of Vicodin Addiction
Recognizing Vicodin addiction - formally diagnosed as opioid use disorder (OUD) using DSM-5 criteria - involves watching for changes in behavior, physical health, and daily functioning. Common signs include:
- Taking larger doses than prescribed or taking doses more frequently
- Continuing use despite negative consequences (relationship problems, job loss, legal issues)
- Doctor shopping or seeking Vicodin from multiple prescribers
- Obtaining Vicodin from friends, family, or illegal sources
- Spending significant time obtaining, using, or recovering from Vicodin
- Giving up activities previously valued in favor of drug use
- Inability to stop or reduce use despite wanting to
Physical Signs of Vicodin Misuse
- Persistent drowsiness or sedation
- Pinpoint (very small) pupils
- Slowed breathing
- Nausea, vomiting, or constipation
- Mood swings, irritability, or confusion
- Tolerance - needing increasingly higher doses to achieve the same effect
Many people who misuse prescription opioids first got them through a legitimate prescription, either their own or one belonging to a friend or family member. This is why careful monitoring matters even for people taking the medication exactly as directed.
Vicodin Withdrawal Symptoms
When someone who has developed physical dependence on Vicodin stops taking it suddenly, withdrawal symptoms typically begin within about 8 to 24 hours of the last dose. Hydrocodone’s short half-life of approximately 4 hours means it clears the body quickly. Longer-acting opioids like methadone leave the body more slowly, so withdrawal from them usually starts later.
Common Withdrawal Symptoms
- Intense drug cravings
- Anxiety, restlessness, and irritability
- Muscle aches and joint pain
- Sweating, chills, and goosebumps
- Nausea, vomiting, and diarrhea
- Insomnia and yawning
- Runny nose and teary eyes
Vicodin Withdrawal Timeline
| Phase | Timeframe | What to Expect |
| Early withdrawal | 8–24 hours after last dose | Anxiety, cravings, muscle aches, sweating |
| Peak symptoms | 24–72 hours | Most intense symptoms; vomiting, diarrhea, insomnia |
| Tapering off | Days 4–7 | Symptoms begin to subside |
| Post-acute phase | Weeks to months | Mood swings, cravings, low energy may persist |
This extended phase is sometimes called post-acute withdrawal syndrome (PAWS) and can last weeks to months after physical detox is complete. Opioid withdrawal can be dangerous, especially without medical care. Severe vomiting and diarrhea can lead to dehydration, and many people start using again to stop the symptoms. That is when overdose risk is highest: after withdrawal, tolerance drops, so a dose a person use to take can stop their breathing. Quitting “cold turkey” without support raises both risks. Medical detox, supervised withdrawal in a clinical setting, is the safest and most effective way to manage Vicodin withdrawal. Discover Recovery offers medical detox at our Camas, WA facility, with 24/7 monitoring and medication-assisted support to help manage symptoms safely.
How Long Does Vicodin Stay in Your System?
Hydrocodone has an immediate-release half-life of approximately 4 hours, meaning the body clears half the dose in that time. However, drug tests can detect Vicodin well beyond when its effects wear off.
| Test Type | Detection Window |
| Urine | Up to 3–4 days |
| Blood | Up to 24 hours |
| Saliva | Up to 36 hours |
| Hair | Up to 90 days |
Detection times vary based on factors including the dose taken, frequency of use, metabolism, age, body weight, and kidney and liver health. For a full breakdown, see our detailed guide: How Long Does Hydrocodone Stay in Your System?
Vicodin Overdose Warning Signs
Vicodin overdose is a medical emergency. Opioid overdose occurs when the drug suppresses the central nervous system to the point that breathing slows or stops entirely. Recognize these warning signs immediately:
- Extremely slow, shallow, or stopped breathing
- Unresponsiveness or unconsciousness
- Lips or fingernails turning blue (cyanosis)
- Gurgling or choking sounds
- Limp body
- Pinpoint pupils
What to Do in a Vicodin Overdose Emergency
Call 911 immediately. Do not wait. Administer naloxone (Narcan) if available. Naloxone is an opioid antagonist that rapidly reverses the effects of an opioid overdose. It is available without a prescription at most pharmacies. A single dose of Narcan may temporarily reverse the overdose, but medical care is still required - Vicodin’s effects can outlast naloxone. The risk of overdose increases substantially when Vicodin is combined with alcohol, benzodiazepines (such as Xanax or Valium), or other CNS depressants. Learn more about the dangers of mixing opioids with alcohol: The Dangers of Mixing Hydrocodone and Alcohol.
Vicodin vs. Other Opioids
Vicodin vs. Norco
Both Vicodin and Norco contain hydrocodone and acetaminophen and work the same way. The primary difference lies in the amount of acetaminophen in each tablet Vicodin is no longer sold under its brand name and both are widely prescribed as generic hyrdocodone/acetaminophen. Other familiar names for the same combination include Norco, Lortab and Lorcet.
Vicodin vs. Oxycodone (Percocet)
Oxycodone (sold as Percocet when combined with acetaminophen) is approximately 1.5 times more potent than hydrocodone. A study by Chang et al. published in Academic Emergency Medicine (2015) found that oxycodone/acetaminophen and hydrocodone/acetaminophen provide similar results for treating acute musculoskeletal pain, though oxycodone is generally considered a stronger analgesic. Both carry comparable risks of misuse and addiction.
Vicodin vs. Fentanyl
Fentanyl is 50–100 times more potent than morphine, making it dramatically stronger than hydrocodone. Fentanyl is responsible for the majority of opioid overdose deaths in the United States. DEA laboratory testing has repeatedly found that many fake prescription pills contain a potentially deadly dose of fentanyl, so taking any pill that did not come from a pharmacy carries a serious risk of fatal overdose.
Treatment Options for Vicodin Addiction
Evidence-based treatment for opioid use disorder works - and outcomes improve significantly when someone seeks help earlier in the course of addiction.
Medication-Assisted Treatment (MAT)
Medication-assisted treatment combines FDA-approved medications with counseling and behavioral therapies. For opioid use disorder, the primary MAT medications include:
- Buprenorphine (Suboxone) - a partial opioid agonist that reduces cravings and withdrawal symptoms without producing a full opioid high
- Methadone - a long-acting opioid agonist used in supervised clinical settings to reduce cravings and block the effects of other opioids
- Naltrexone (Vivitrol) - an opioid antagonist that blocks the euphoric effects of opioids, used after detox to prevent relapse
MAT is endorsed by SAMHSA, NIDA, and the American Society of Addiction Medicine as the most effective treatment for opioid use disorder when combined with counseling.
Medical Detox
Medical detox is typically the first step in treating Vicodin addiction. In a supervised detox setting, clinicians monitor withdrawal symptoms around the clock and administer comfort medications to manage the most severe effects. Detox alone is not treatment - it must be followed by a structured rehabilitation program.
Inpatient vs. Outpatient Rehab
Residential (inpatient) treatment provides 24/7 support in a structured environment, removing the patient from triggers and enabling intensive therapy. It is typically recommended for moderate to severe opioid use disorder. Intensive Outpatient Programs (IOP) and Partial Hospitalization Programs (PHP) offer structured therapy during the day while allowing patients to live at home or in sober living. These are appropriate for people with strong support systems and lower relapse risk. Aftercare and continuing care - including 12-step programs, ongoing therapy, and sober living - are critical components of long-term recovery. Discover Recovery offers a full continuum of care for Vicodin and opioid addiction. From medical detox and residential treatment to outpatient programs and aftercare, at our facilities in Camas, WA, Long Beach, WA, and Portland, OR. Call 866.719.2173 to speak with an admissions counselor, or verify your insurance online in minutes. Most major insurance plans are accepted.
