Even when taken as prescribed hydrocodone has the potential to cause anxiety. For this reason, doctors should practice extra caution when writing prescriptions for patients with co-occurring mental health conditions.

Hydrocodone is the active ingredient in several prescription medications including Vicodin. Typically prescribed for pain, hydrocodone can be highly addictive. Potential substance dependence isn’t the only negative side effect of hydrocodone. Even when taken as prescribed hydrocodone has the potential to cause anxiety. When misused or abused hydrocodone is even more likely to cause anxiety and other mood-related side effects.

Studies have found that approximately half of all prescriptions for opioids are written for people who have a mental health condition like anxiety. The high number of opioid prescriptions is even more concerning when the increased susceptibility to substance use disorders by the population is considered. Researchers have examined the link between the use of hydrocodone and anxiety disorders. Some key questions researchers have attempted to answer include:

  • “Why does hydrocodone cause anxiety?”
  • “Does hydrocodone make anxiety worse for people with anxiety disorders?”
  • “Why do doctors prescribe hydrocodone for anxiety disorder patients?”

Article at a Glance:

  • Typically prescribed for pain, hydrocodone can be highly addictive.
  • Even when taken as prescribed, hydrocodone has the potential to cause anxiety.
  • Approximately half of all prescriptions for opioids are written for people who have a mental health condition like anxiety.
  • Hydrocodone anxiety is particularly severe during withdrawal. If someone  has been taking hydrocodone to avoid anxiety, the more overwhelming this rebound anxiety may seem.
  • Treatment for hydrocodone with a co-occurring anxiety disorder is available.

Why Does Hydrocodone Cause Anxiety?

When asking “Does hydrocodone cause anxiety?” the answer is a simple, “yes.” One of the known side effects of hydrocodone, when taken as prescribed, is anxiety. However, this does not explain why this happens. Hydrocodone, like other opiates, changes the brain’s chemical levels. For some people, these changes may cause anxiety or depression. For other people, hydrocodone may numb their feelings of anxiety and depression decreasing their ability to cope with these feelings naturally. Hydrocodone anxiety is particularly severe during withdrawal. If someone has been taking hydrocodone to avoid anxiety, the more overwhelming this rebound anxiety may seem.

Does Hydrocodone Make Anxiety Worse for People with Anxiety Disorders?

Some people who self-medicate may have the false belief that hydrocodone can help mitigate their symptoms of anxiety. However, they may be shocked to learn that their substance use may be creating anxiety worse than it was prior to beginning to use hydrocodone.

Hydrocodone has the potential to create anxiety in anyone who uses it, however, this may not always be the case. The side effect of anxiety may not affect everyone who uses hydrocodone.

Why Do Doctors Prescribe Hydrocodone for Anxiety Disorder Patients?

People with mental health conditions are more likely to receive prescriptions for opiates, like hydrocodone. It is unsure why exactly this occurs but there are several viable theories.

Someone with an anxiety or mood disorder is more likely to experience chronic pain. This higher rate of chronic pain may lead to more people with these disorders seeking relief. Another possible reason these patients receive more opiate prescriptions is the increased empathy of doctors for patients with pre-existing conditions. While no hard evidence of this is available, it has been suggested that stronger medications, such as opiates, are overprescribed for this reason. While doctors statistically prescribe a disproportionate amount of opiates, like hydrocodone, for patients with anxiety disorders, this is not considered best practice.

Not only are people with mental health conditions more likely to be prescribed opiates but they are also more likely to misuse or abuse them. Given this information, it can be expected that when prescribed, hydrocodone is frequently misused or abused. For this reason, doctors should practice extra caution when writing prescriptions for patients with co-occurring mental health conditions.

Hydrocodone and Co-Occurring Anxiety Treatment

Treatment for hydrocodone addiction with a co-occurring anxiety disorder is available. Whether someone uses hydrocodone to self-medicate anxiety symptoms or develops anxiety following hydrocodone use, recovery is possible. An individualized treatment plan addressing both disorders concurrently will provide the best chance for recovery. Whether someone  seeks inpatient or outpatient treatment, an effective treatment plan should include:

  • Peer support
  • Individual counseling
  • Medication management for opiate and depression treatment
  • Medical support during detoxification
  • Family education and counseling
  • Step-down and transitional services
  • Follow-up and ongoing support

If you or someone you know is exhibiting signs and symptoms of a hydrocodone use disorder, take this self-assessment to help get more answers. Whether anxiety or hydrocodone use comes first, treating an anxiety disorder and co-occurring substance use disorder requires a medical professional.

Denise-Marie Griswold
Medically Reviewed By – Denise-Marie Griswold, LCAS
Denise-Marie Griswold is a Licensed Clinical Addictions Specialist. She earned her Master's Degree in Substance Abuse and Clinical Counseling from East Carolina University in 2014. Read more

Caruso, C. “Most Opioid Prescriptions Are for People with Depression, Other Mood Disorders.” Scientific American, Published June 26, 2017. Accessed January 30, 2019.

Kosten, T. R., & George, T. P. “The neurobiology of opioid dependence: Implications for treatment.” National Center for Biotechnology Information, Published July 2002. Accessed January 30, 2019.

Motaghinejad, M., Fatima, S., Banifazl, S., Bangash, M.Y., & Karimian, M. “Study of the effects of controlled morphine administration for treatment of anxiety, depression, and cognition impairment in morphine-addicted rats.” National Center for Biotechnology Information, Published November 28, 2016. Accessed January 30, 2019.

National Institute on Drug Abuse. “Opioids.” Accessed January 30, 2019

Wightman, R., Perrone, J., Protelli, I., & Nelson, L. “Likeability and abuse liability of commonly prescribed opioids.” National Center for Biotechnology Information, Published December 1, 2012. Accessed January 30, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.