Drug and Alcohol - Opioid Addiction

What's The Difference: Oxycodone vs Hydrocodone?

Oxycodone and hydrocodone seem like the same drug, but there's notable differences between these two opioid painkillers. Learn more in our blog.

What's The Difference: Oxycodone vs Hydrocodone?

Table of Contents

Written by

Brian MooreBrian Moore

Content Writer

Reviewed by

Jeremy ArztJeremy Arzt

Chief Clinical Officer

March 30, 2023

The Edge Treatment Center

Many people are curious about whether oxycodone and hydrocodone are any different from each other.

Such doubts about substances that have a reputation for being addictive are common as both these opioid drugs relieve pain. However, there are many distinctions between the two drugs. Knowing about these differences is important for anybody who feels that there is a growing case of prescription drug abuse within the family or if a person is increasingly experiencing a craving for such painkillers without a real cause.

By the Numbers:

Up to 92% of opioid abusers use prescription opioids at least once in a year. Prescription opioid abuse costs $78.5 billion annually in the form of healthcare, legal programs, and lost productivity - NCDAS

Opioid abuse is a significant concern for the American public health system. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2018, more than 10 million individuals aged 12 or older abused opioids in some form.

Oxycodone versus Hydrocodone: Both Are Synthetic Opioids

Synthetic opioids are drugs that are created in laboratories to mimic the chemical structure of opioids naturally derived from the opium poppy. While they share a similar chemical makeup to natural opioids like prescription painkillers, synthetic opioids are entirely man-made compounds that are typically manufactured in pharmaceutical laboratories.

This is in contrast to non-synthetic opioids like morphine and codeine which are essentially an extract from the naturally occurring chemicals found in opium pods. When extracted and refined, these substances can be used as a part of medications, and they have a high potential to be abused. Synthetic opioids are often used as adulterants in other drugs, particularly heroin & cocaine, or are manufactured into pills and sold on the streets as spurious painkillers.

Due to their uncontrolled potency, accidental overdosing is a common risk associated with synthetic opioids.

What Is Oxycodone?

Oxycodone is a prescription opioid pain medication, similar to other opioids like morphine, codeine, and methadone. OxyContin, also known as oxy, was introduced in 1995 as a controlled-release form of oxycodone, designed to provide extended pain relief for people with severe pain, so they wouldn't have to take pills as frequently.

However, OxyContin became associated with abuse and addiction problems, particularly when the tablets were crushed, releasing the drug more rapidly and increasing its effects. Using oxycodone regularly for recreational purposes can lead to tolerance, where the pleasure experienced by a drug decreases over time. Stopping the use can result in opioid withdrawal symptoms that can make a person feel ill, and eventually, their life can revolve around obtaining the drug via any means.

The time it takes for addiction to occur varies from person to person, but it can happen quickly. Injecting oxycodone carries the same risks as injecting heroin, including contracting HIV, hepatitis, and other potentially fatal infections. Using oxycodone to self-medicate pain or numb emotions may seem beneficial initially, but addiction can lead to significant problems. Like other opioid drugs, oxycodone can mask a person's emotions and prevent them from addressing their underlying issues.

Strength of Oxycodone

Oxycodone is available in capsules, tablets, and an oral solution. Their strengths vary:

Oxycodone Capsules

Available in 5 mg strength

Oxycodone Tablets

Available in 5 mg, 10 mg, 15 mg, 20 mg, 30 mg

Oxycodone Oral Solution

Available in 5 mg / 5 ml strength. Additionally, a concentrated form is available in 100mg / 5 ml strength

What Is Hydrocodone?

Medications like hydrocodone have therapeutic benefits and still, they have a big reputation for being abused. Hydrocodone is an opioid pain reliever. It is used as an active ingredient in many branded medications. This includes pain-relieving formulas of Lortab and Lorcet but most of these meds have been discontinued in the US.

This underlines how Hydrocodone presents a serious addiction risk. It is usually prescribed for moderate to severe pain relief. However, individuals who use this drug regularly can quickly become addicted to this substance. Individuals who have been prescribed hydrocodone by their physician, as part of a medically supervised pain management plan, are at a lower level of risk of addiction but if the dosing continues for a longer period, the risks seem to rise. Hydrocodone addiction is only one aspect of the prescription painkiller epidemic in the United States.

Several opioids are available on both legal and illegal drug markets, and some individuals may choose hydrocodone as their primary drug of abuse. Recreational use of hydrocodone is a bad idea as it can easily lead to the development of an opioid use disorder. Individuals who use hydrocodone for pain management may develop a physical dependency on the drug within a short period. The fine line between hydrocodone addiction and dependence can seem very thin in such instances.

Strength of Hydrocodone

Hydrocodone is often mixed with the over-the-counter pain medication acetaminophen. In these medications, hydrocodone comes in various strengths and combinations:

  • 2.5 mg hydrocodone / 500 mg acetaminophen

  • 5 mg hydrocodone / 500 mg acetaminophen

  • 7.5 mg hydrocodone / 325 mg, 500 mg, 650 mg, 750 mg acetaminophen

  • 10 mg hydrocodone / 325 mg, 500 mg, 650 mg, 660 mg, 750 mg acetaminophen

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How Are Hydrocodone and Oxycodone Similar?

The FDA warns that taking hydrocodone and oxycodone with acetaminophen can increase the risk of liver damage and drug overdose, especially when compared to taking each opioid separately. In addition to this, there are some more similarities between these two highly addictive substances.

  • Both hydrocodone and oxycodone are generic names for commonly prescribed opioids.

  • These are classified as Schedule II semi-synthetic opioids.

  • Both prescription drugs are used for alleviating moderate to severe pain.

  • Chemically, they are similar, binding to opioid receptors in the brain to interrupt the signals that make a person experience trauma.

  • Both drugs slow down breathing and bodily functions like digestion.

  • It is important to note that both drugs are highly addictive and should only be taken as prescribed by a health professional.

When comparing oxycodone and hydrocodone, remember that while both drugs are effective in treating short-term pain but when used for long-term, both of these substances can lead to greater drug tolerance, which means the person constantly seeks higher doses to recreate the same level of relief or pleasure.

Basic Similarities Between Hydrocodone & Oxycodone 

Hydrocodone and oxycodone can be taken alone or in combination with other pain relievers like acetaminophen, aspirin, or ibuprofen. Both these prescription medications come in different forms, including the liquid form apart from being retailed as a tablet or capsule. There are also extended-release (or ER) versions available for reach, which release the drug slowly into the body to provide longer-lasting pain relief.

However, these ER versions are not meant to be used for short-term pain or episodes of acute pain, such as post-surgery pain. According to the Centers for Disease Control & Prevention (CDC), 1 in 4 people who receive long-term opioid treatment in a primary care setting is likely to develop opioid addiction in some form. As individuals develop a tolerance to the medication, they may require higher doses to achieve the same sense of relief. This can lead to misuse and abuse of the medication, which increases the risk of addiction among people using oxycodone or hydrocodone.

Some Close Similarities & Differences in Hydrocodone & Oxycodone

Prior to 2014, hydrocodone and oxycodone were classified in separate drug schedules. Drug schedules assign a number to a medicine, chemical, or substance based on its potential for misuse and accepted medical use. However, both hydrocodone and oxycodone are now classified as schedule II drugs, indicating their high potential for being misused. Oxycontin tablets are typically taken orally. The recommended dose for this pain-relieving medication is usually every 12 hours, and the tablets are available in various doses in a neighborhood pharmacy. The total dosage for the week or the day is decided by the physician, depending on the severity of pain.

Hydrocodone is more likely to be available in an extended-release form or a controlled-release formula. Here, the drug is designed to be released slowly during the day. This medication is sold under brand names like Zohydro ER. Just like Oxycodone, Hydrocodone medications are usually taken orally, every 12 hours.

West Virginia has the highest rate of neonatal opioid withdrawal (NOW) syndrome cases. Wyoming and Utah both have the highest rate of opioid overdose involving prescription opioids at 70% - NCDAS

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Opioid Side Effects Common to Oxycodone & Hydrocodone

Anyone abusing opioids is likely to have a disturbed heart rate and slow mental functions. While opioids like oxycodone and hydrocodone can effectively relieve pain by creating a feeling of relaxation and euphoria, this feeling can trigger an addiction. Prescription opioids are meant to alleviate different types of severe pain, from post-surgical trauma to burn injuries. They might be prescribed for short-term pain management or as a part of daily use in people with chronically painful health conditions like arthritis. In comparison, illegal drugs like heroin are consumed for the typical rush and their stronger sedative effects. All opioids affect the central nervous system by binding to opioid receptors. This mechanism is common to nearly all types of opioids as the opioid obstructs pain signals between the brain and body. Besides providing relief for acute & chronic pain, opioids also have the potential to slow the breathing rate, leading to respiratory distress.

The list of most commonly abused opioids includes:

Some common side effects of both oxycodone and hydrocodone use and abuse include:

  • Nausea

  • Hives

  • Dry mouth

  • Extreme drowsiness

  • Slowed breathing

  • Mental confusion

  • Stomach pain

  • Constipation

  • Heartbeat irregularities

  • Swelling around the face, including lips and tongue

How Are Hydrocodone and Oxycodone Different?

The primary difference between using hydrocodone and oxycodone is the side effects these substances might cause. Hydrocodone is more likely to cause tiredness or a feeling of day-long malaise while oxycodone side effects are more about digestive problems in the form of constipation.

When it comes to delivering pain relief or creating short-lived feelings of euphoria, the two drugs are similar. However, factors such as a person's history of substance use, the form of drug used (instant-release or controlled-release), and the strength of dosage can influence how the drug affects a person.

Overall, it has been seen that Oxycodone use is more commonly associated with side effects of dizziness and drowsiness apart from fatigue and migraine-like headaches.

Minor Differences Between Hydrocodone & Oxycodone 

Many people believe that oxycodone is a more effective pain reliever than hydrocodone. However, a study conducted in 2016 that compared the effectiveness of drug combinations, clarified that there is little difference in the effectiveness of oxycodone and acetaminophen & hydrocodone and acetaminophen drug combinations. The study found no significant differences between the two drug combinations in treating acute musculoskeletal pain. In both groups, a large percentage of the participants reported a nearly 50% pain reduction.

Both oxycodone and hydrocodone can effectively reduce pain sensations and the results are almost similar for people suffering from chronically painful conditions. However, it is important to note that they do not address the underlying cause of the pain—the cause of pain is not affected by such potent painkillers.

Additionally, due to the risks of dependence and addiction, many experts recommend exploring other pain relief options before considering the use of opioids.

Drug Interactions Common to Hydrocodone and Oxycodone 

It is important to inform your doctor about all the medications and supplements you are taking when using hydrocodone or oxycodone, as taking other drugs with these opioids can increase your risk for serious side effects. The combination of opioids with certain drugs that depress the central nervous system can lead to dangerous outcomes, including a significant decrease in breathing and heart rate, and even coma. These drug interactions include interacting with the following:

  • Muscle relaxants

  • Parkinson’s disease drugs

  • Anti-anxiety drugs

  • Antihistamines

  • Anti-seizure drugs

  • Benzodiazepines and other sedatives

  • Sleep aids

  • Anti-nausea drugs

  • Antipsychotic drugs

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Substance Interactions Common to Hydrocodone & Oxycodone 

Using hydrocodone or oxycodone along with other antidepressants can lead to a dangerous situation. When there is a buildup of serotonin in the brain due to the use of different psychoactive substances and medications like synthetic opioids, the overall functioning of the brain can be affected. Consuming too many of these medications together can bring about acute side effects.

Some of the other non-prescription drugs or supplements that you should avoid to keep away from such problems include:

  • Marijuana and cannabis products

  • St. John’s Wort

  • Alcohol

  • Kava-kava

Oxycodone Abuse & Hydrocodone Abuse Are Treatable. The Edge Treatment Center Can Help

If you or someone you love seems to have developed an addiction to prescription opioids like oxycodone and hydrocodone, don’t hesitate in seeking help. The Edge Treatment Center has a specialized opioid drug treatment program that has helped many leave prescription opioids behind.

Oxycodone abuse and hydrocodone abuse have something in common: fatal overdose. Don't risk addiction to opioids. Reach out to The Edge Treatment Center for help today.

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