Zohydro ER, a long-acting version of the opioid hydrocodone, is classified as a Schedule II substance by the Food and Drug Administration. People who take Zohydro ER may develop a tolerance or an addiction due to the addictive nature of opioids. Opioids can be particularly addictive because of the euphoric effects they produce and the tolerance they induce when taken.

Article at a Glance:

  • Hydrocodone, the active ingredient in Zohydro ER, is the most commonly prescribed opioid in the United States.
  • As a Schedule II controlled substance, Zohydro ER has a high risk of abuse and dependence.
  • Common side effects of Zohydro ER include constipation, nausea and sedation.
  • Medical detox followed by rehab can wean you off Zohydro ER and start you on the path to a drug-free life.

What is Zohydro ER?

Zohydro ER is an extended-release formula of the opioid hydrocodone. The drug is FDA-approved for people with severe ongoing pain, such as pain due to cancer. Hydrocodone is the most commonly prescribed opioid in the US. More than 83 million hydrocodone prescriptions were written for hydrocodone in 2017.

Often, extended-release versions of opioids contain larger quantities of the drug than immediate-release versions. This is because extended-release versions are designed to be released gradually into the system over an extended period. However, this time-release mechanism can be bypassed by crushing the pill in preparation for ingestion, snorting, or injection. This kind of recreational use is very dangerous because a large amount of hydrocodone can be released all at once into the body, putting the person at risk for overdose and life-threatening complications.

Zohydro ER Addiction

Opioids are highly addictive because they trigger the brain’s reward system. As a result, those prescribed Zohydro ER and take the medication responsibly are still at risk of developing an addiction or dependence on the medication. Sometimes, people trying to get high on Zohydro ER will mix it with other opioids or central nervous system depressants. This is dangerous. Mixing these substances can cause a person to stop breathing and can easily be fatal.

If you think that you or someone you know is struggling with Zohydro ER, seek help as soon as possible. Signs that may point to addiction can include:

  • Becoming obsessed with finding and taking Zohydro ER
  • Losing interest in the hobbies you once enjoyed
  • Performing poorly at work or school
  • Suffering from financial problems because you spent money obtaining Zohydro ER or other opioids

Signs, Symptoms & Side Effects of Abuse

Some of the most common side effects of taking Zohydro ER as prescribed include:

  • Constipation
  • Nausea
  • Sedation
  • Fatigue
  • Headache
  • Dizziness
  • Dry mouth
  • Itchy skin

Long-Term Consequences

Even if someone is taking Zohydro ER as prescribed over the long-term, the risk of addiction and dependence remains high. Further, chronically taking opioids can cause hormonal issues that result in medical problems like:

  • Low libido
  • Impotence or erectile dysfunction
  • Menstrual irregularities
  • Infertility

Zohydro ER Overdose

Zohydro ER is a central nervous system depressant that acts directly on the brain stem. In an overdose, the drug slows breathing as it depresses the automatic urge to breathe. Other symptoms of an overdose can include:

  • Cold/clammy skin
  • Extreme sedation
  • Flaccid muscles
  • Constricted pupils
  • Severely slowed breathing

Opioids have an especially high overdose risk when taken with benzodiazepines like Xanax. For this reason, the FDA has a Black Box Warning against taking benzodiazepines and opioids like Zohydro ER at the same time.

Zohydro ER and Alcohol

You should not drink if you take Zohydro ER. Alcohol causes your body to absorb more Zohydro ER more quickly than it is supposed to, which increases overdose chances. Mixing the substance can be fatal and may lead to:

  • Severe drowsiness
  • Severe sedation
  • Problems breathing

Zohydro ER Withdrawal

If you no longer wish to take Zohydro ER, you should talk to your doctor before adjusting your dose. This type of medication should never be stopped suddenly or “cold turkey.” Abruptly stopping your treatment will greatly increase your risk of experiencing severe withdrawal symptoms.

Common withdrawal symptoms include:

  • Nausea and vomiting
  • Anxiety
  • Hot and cold flashes
  • Poor sleep, difficulty falling asleep or excessive sleepiness
  • Extreme cravings
  • Diarrhea
  • Stomach cramps
  • Runny nose
  • Watery eyes
  • Sweating

Poorly managed withdrawal symptoms can reduce your chances of staying sober. To avoid withdrawal symptoms, it can be helpful to take part in a medically-assisted detoxification program. In a medical detox program, you can safely wean from Zohydro ER with medically-trained professionals who can address any withdrawal symptoms that may occur.

Withdrawal Timeline and Symptom Duration

Zohydro ER withdrawal symptoms may become noticeable within 12 to 48 hours after the last dose was taken. Withdrawal symptoms can last as long as 20 days in some cases. Everyone experiences Zohydro ER withdrawal differently, so these timelines may vary.

Zohydro ER Addiction Treatment & Detox

Recovering from opioids like Zohydro ER is a multi-step process. The first step is getting Zohydro ER out of your system. This can occur at home under a doctor’s supervision or in an inpatient medical detox. In some cases, medication-assisted treatment, or MAT, with methadone or buprenorphine is available. These drugs are long-acting opioids that help reduce cravings for Zohydro ER, increasing your chances of staying sober. After you are detoxed from Zohydro ER, you can choose between inpatient and outpatient rehab treatment options.

Inpatient Rehab

In inpatient rehab, you live at a treatment center while you recover from Zohydro ER. Individual and group therapies play a core role during inpatient rehab as you explore the reasons you began to rely on Zohydro ER. Inpatient rehab can be particularly beneficial for those who suffer from severe addiction, have poor support at home or find recovery too difficult in the outside world.

Outpatient Rehab

Outpatient rehab often follows inpatient rehab. Here, you live at home while attending scheduled therapy appointments. People with less severe addictions can sometimes start in outpatient rehab if an inpatient stay is not needed. Teletherapy is also available for these clients.

Choosing a Zohydro ER Rehab Center

Every rehab center is different, and finding the center that suits your recovery needs is an important step in living a life free of Zohydro ER. Your doctor can help you understand your recovery needs and what to look for in a rehab center.

If you or someone you know is struggling with Zohydro ER or another hydrocodone product, do not delay getting help. Our compassionate staff at The Recovery Village can help you find resources and programs to fit your needs. Contact us today.

Melissa Carmona
Editor – Melissa Carmona
As the content manager at Advanced Recovery Systems, Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
Jessica Pyhtila
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
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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.