How to Taper off Hydrocodone

As a detox method, tapering off hydrocodone allows users to recondition themselves — mind, body and spirit — to life without opioids.

Hydrocodone is in a category of prescription pain medications known as opioids and opiates. When you take hydrocodone regularly over the long term, your body becomes used to it, meaning that suddenly stopping the drug can cause withdrawal symptoms as your body struggles to readjust. Instead of simply abruptly quitting hydrocodone, your doctor may instead recommend a hydrocodone taper, slowly lowering your hydrocodone dose over time.

Tapering off Hydrocodone

Tapering off hydrocodone allows the body to gradually adapt to smaller amounts of the drug. It also helps make withdrawal symptoms that emerge during detox more manageable, easing or enabling you to skip them altogether. Some of the most common signs and symptoms of hydrocodone withdrawal include:

• Sweating
• Watery eyes
• Runny nose
• Headaches
• Nausea and vomiting
• Muscle aches
• Diarrhea
• Insomnia
• Abdominal cramps
• Goosebumps
• Anxiety
• Agitation

How to Taper off Hydrocodone

There is no scientific support for quitting opioids cold turkey. Going cold turkey is a centuries-old practice of stopping drug or alcohol use outright. Though it does achieve the goal of quitting in the short-term, withdrawal symptoms may lead people to use hydrocodone again before detox is complete, increasing the risk of overdose.

Slow, medically supervised tapers are the best course of action for people addicted to hydrocodone. Experts recommend:

• Reducing the dose by 10% per month if you have been taking hydrocodone for over a year.
• Reducing the dose by 10% per week if you have been taking hydrocodone for less than a year.

If withdrawal symptoms occur using this tapering schedule, the taper can be paused or slowed until symptoms subside.

Types of Hydrocodone Tapering Methods

Different tapering methods exist and can include direct tapering, substitute tapering and titration tapering. For legally prescribed opioids like hydrocodone, the Centers for Disease Control and Prevention (CDC) only recommends direct tapers.

Direct Tapering

In direct tapering, the hydrocodone dose is slowly reduced over months. The CDC specifically recommends direct tapers for prescription opioids like hydrocodone. If you have taken hydrocodone for over a year, the dose should be reduced by 10% a month or 10% a week if you have taken hydrocodone for less than a year.

Substitute Tapering

Substitute tapering is generally reserved for illicit opioids like heroin because doctors can’t prescribe heroin, and illicit drugs differ vastly in potency. In substitute tapering, the illicit opioid is converted to a legal opioid like methadone, and the dose of that drug is slowly reduced over time, like a direct taper.

Titration Tapering

Titration tapering is not recommended. This type of taper occurs when you attempt to dissolve hydrocodone in water to dilute it and take progressively smaller amounts daily. This type of taper is dangerous no matter the drug, as insolubility and inaccurate measurements are risks. Titration tapering should not be attempted with hydrocodone, which is not completely soluble in water.

Why Consider Tapering vs. Stop Hydrocodone Opioids Cold Turkey?

Tapering — specifically direct tapering — is much safer than stopping hydrocodone cold turkey. This is because a taper can help you avoid withdrawal symptoms, which can be severe and may put you at risk for relapse. A medically supervised taper, on the other hand, can help you achieve your goals of becoming hydrocodone-free as you are slowly weaned from the drug.

Common Hydrocodone Withdrawal Symptoms

Hydrocodone withdrawal symptoms commonly occur in those who quit the drug cold turkey, especially if they take it regularly. Withdrawal symptoms include:

• Muscle pain
• Runny nose and eyes
• Enlarged pupils
• Trouble sleeping
• Sweating
• Yawning
• Goosebumps
• Abdominal cramps
• Nausea and vomiting
• Diarrhea
• Agitation
• Anxiety

Side Effects of Hydrocodone Tapering

Tapering hydrocodone instead of quitting the drug cold turkey can eliminate or minimize the risk of withdrawal symptoms and side effects. If withdrawal symptoms occur, experts recommend pausing or slowing the taper to avoid further withdrawal symptoms. Easing the withdrawal process is the entire goal of a hydrocodone taper.

Hydrocodone Withdrawal Timeline

The timeline of withdrawal symptoms can differ depending on if a person takes a short or long-acting opioid. Hydrocodone comes in a short-acting dosage form combined with acetaminophen and a long-acting dosage form on its own. For this reason, the withdrawal timeline can vary depending on the exact product you take:

• Short-acting hydrocodone (Vicodin, Norco): Withdrawal symptoms start within 12 hours of the last dose, peak within 24–48 hours and improve over the next three to five days. 
• Long-acting hydrocodone (Hysingla ER, Zohydro ER): Withdrawal symptoms start within 30 hours of the last dose, can peak within three to eight days and can last around 10 days but may last a few weeks.

Even after acute withdrawal is complete, protracted withdrawal symptoms are also possible regardless of whether you take the short or long-acting form of the drug. Symptoms may last a few additional months during this process and can include: 

• Anxiety
• Depression
• Insomnia 
• Concentration problems 

Medications Used When Tapering off Opioids

Medications are sometimes used when helping you taper off opioids as a part of medication-assisted treatment (MAT). In MAT, these medications are prescribed to help ease withdrawal symptoms and prevent cravings, reducing the risk of relapse. MAT medications may be continued over the long term if medically appropriate to help you maintain sobriety.

Methadone

Methadone is a gold-standard medication to prevent opioid withdrawal symptoms. In some cases, if medically appropriate, hydrocodone may be converted to methadone, which may then be slowly tapered in a substitute taper.

Buprenorphine (Sublocade, Suboxone)

Buprenorphine is another gold-standard medication to prevent opioid withdrawal symptoms and is available in several oral (Suboxone) and injectable (Sublocade) dosage forms. Similar to methadone, if medically appropriate, hydrocodone may be converted to buprenorphine, which may then be slowly tapered in a substitute taper.

Naloxone (Narcan) 

Naloxone is rarely used during the tapering process, as it works by completely blocking opioid receptors and can therefore worsen withdrawal. However, your doctor may prescribe naloxone to help you avoid overdose in case of relapse after your hydrocodone taper is complete. In addition, naloxone is an ingredient in Suboxone, which is sometimes prescribed as part of a substitute taper for hydrocodone.

Naltrexone (Vivitrol)

Naltrexone is an opioid blocker generally not used during tapering as it can worsen withdrawal symptoms. However, the drug may be prescribed as an alternative to methadone or buprenorphine to help you maintain sobriety and avoid relapse after a hydrocodone taper is complete.

Can Tapering Your Hydrocodone Opioids Intake Reduce Withdrawal Symptoms?

A taper schedule is specifically designed to help you avoid or reduce withdrawal symptoms. Because you slowly reduce your hydrocodone dose over time, your body can adjust to decreasing hydrocodone doses. Since you are not suddenly significantly reducing your hydrocodone dose, your brain has a chance to acclimate to progressively lower hydrocodone doses, avoiding or minimizing the risk of withdrawal symptoms.

How The Recovery Village Uses Hydrocodone Tapering

If medically appropriate, The Recovery Village can taper your hydrocodone or convert you to a MAT regimen with an alternative medication like buprenorphine. We realize that a successful medical detox process will gently wean you from hydrocodone, setting you up for success in maintaining your sobriety in rehab and beyond. Don’t wait: contact us today to see how we can help.

Editor – Theresa Valenzky

Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more