Prescription opioids like oxycodone and hydrocodone are a very significant topic of discussion in the U.S. today, as they’ve contributed to addiction throughout the country.

Two drugs at the center of the opioid epidemic are hydrocodone and oxycodone. Together, these two drugs were responsible for more than 44 million prescriptions in America in 2019 alone. Although hydrocodone and oxycodone are similar, they have several important differences. This is important to know if you or someone you love is prescribed one of these drugs.

What Is Oxycodone?

Oxycodone is a Schedule II opioid that changes how you feel and how your brain and body respond to and perceive pain. It’s considered a semi-synthetic opioid that is moderately potent, and it is commonly used for the treatment of pain that ranges from moderate to severe. Oxycodone is available as a single-ingredient pain-relieving prescription medicine, and there are also combination options. Some of the things oxycodone may be combined with for more effective pain relief include acetaminophen, also known as paracetamol, and nonsteroidal anti-inflammatories like aspirin and ibuprofen.

Oxycodone is intended for the treatment of short-term pain, but it is sometimes used for chronic pain. It’s the active ingredient in OxyContin and Percocet, which are commonly prescribed medications.

In the U.S., oxycodone is approved only for oral use in tablet and oral solution form, but in other countries, it’s also approved for intravenous administration. Because oxycodone has the potential to create a sense of euphoria when someone takes it, it is one of the most abused opioids in the country right now.

What Is Hydrocodone?

Hydrocodone is a Schedule II semi-synthetic opioid drug and a prescription painkiller. This narcotic pain medication binds to opioid receptors in the central nervous system and changes the way pain is perceived. Hydrocodone drug brand names include Hysingla ER and Zohydro ER, which are both extended-release medications. However, there are also several other drugs that contain hydrocodone mixed with analgesics like acetaminophen. 

The risks and side effects associated with most hydrocodone formulations come from the drug’s opioid and acetaminophen components. Hydrocodone slows the overall activity of the central nervous system (CNS), which includes respiration, heart rate, and blood pressure. This slowing of the CNS is why it’s particularly important for people to follow dosing instructions and take hydrocodone exactly as prescribed.

While hydrocodone does have benefits in a therapeutic sense, as with other opioids, there is also the risk of addiction and dependence. When people take opioids, particularly in high doses, it can create a euphoric high. This is something that can lead to addiction.

What Is the Difference Between Oxycodone and Hydrocodone?

Although oxycodone and hydrocodone have many similarities, there are some differences. One of the most important differences between the two drugs is their potency. Even though they are both Schedule II drugs, oxycodone is about 50% stronger than hydrocodone.

In addition, long-acting forms of hydrocodone can last longer than long-acting forms of oxycodone. The half-life of a drug refers to how long it takes your body to clear half of a single dose. Although the half-lives of short-acting oxycodone and hydrocodone are similar, the half-life of long-acting hydrocodone is seven to nine hours; for oxycodone, it is only 4.5 to 5.6 hours.

Oxycodone vs. Hydrocodone High

Unfortunately, people frequently abuse prescription pain relievers, leading them to wonder about the differences between a hydrocodone vs. oxycodone high. Because oxycodone is stronger than hydrocodone, it is possible the drug can lead to a more intense high for some people. However, this can vary based on the person.

Which Is Stronger: Hydrocodone or Oxycodone?

Both oxycodone and hydrocodone are powerful, but oxycodone is approximately 50% stronger than hydrocodone. Even so, this may not translate to better pain control. Some studies have shown that a combination of hydrocodone and acetaminophen is just as effective at treating pain as oxycodone with acetaminophen.

Oxycodone vs. Hydrocodone Side Effects

Oxycodone is stronger than hydrocodone, but these opioids have similar side effects to each other and to other opioids. Common side effects of both drugs include:

  • Constipation
  • Nausea or vomiting 
  • Sedation
  • Dizziness
  • Lightheadedness
  • Itching 
  • Headache 
  • Insomnia
  • Dry mouth
  • Sweating
  • Weakness

Oxycodone vs. Hydrocodone  Dependence and Addiction

Both oxycodone and hydrocodone have risks of addiction and dependence that come with using them, even when they are taken as prescribed. Taking an opioid medication creates a pleasurable response in the brain that triggers the reward system. When this happens, your brain starts to rewire itself to want to continue doing the activity that created that sense of pleasure. In this instance, that activity involves taking oxycodone or hydrocodone.

Dependence is different from addiction and can occur independently from it. Dependence occurs when your body becomes so used to taking a drug that it no longer feels normal without them. When you’re dependent on opioids and you stop taking them suddenly, it shocks your body in a way that results in withdrawal symptoms.

Oxycodone and hydrocodone are both classified as Schedule II drugs, meaning they both have a high abuse potential. It’s important for people to take these drugs exactly as instructed to avoid the risk of addiction, which can occur even when a person has a valid prescription.

Symptoms of Opioid Addiction

Opioid addiction is common, and it is important to be aware of its symptoms if you or someone you love takes an opioid. Signs that someone is struggling with opioids include:

  1. Taking more opioids than intended or over a longer period than intended.
  2. Previous unsuccessful attempts to cut back on opioids.
  3. Spending a lot of time obtaining, using or recovering from the opioid.
  4. Craving opioids.
  5. Opioid use causes problems keeping up with obligations at work, school or home.
  6. Opioid use causes social or interpersonal problems.
  7. Giving up social, occupational or recreational activities because of opioids.
  8. Taking opioids even when it is physically dangerous to do so.
  9. Using opioids despite knowledge of it causing recurrent problems.
  10. Needing higher opioid doses to achieve the same effects as before.
  11. Withdrawal symptoms when you try to cut back on or stop opioids.

If you believe you are experiencing at least two of these signs of opioid use disorder, you may have an opioid addiction. Fortunately, help is available at The Recovery Village. Our opioid experts can help you overcome opioid abuse and put you on the path to a healthier, opioid-free life. Contact us today to learn more about opioid addiction treatment programs that can work well for your situation.

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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
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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

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.