Norco Withdrawal: Symptoms and Treatment

Reading Time: 5 minutes

Doctors may prescribe Norco, a medication comprised of hydrocodone (an opioid) and acetaminophen, for the management of pain that is severe enough that non-opioid pain medications cannot manage it.¹ Using Norco can lead to a physiological dependence, which means you need to take Norco in order to avoid unpleasant and distressing withdrawal symptoms.² You can develop a dependence on Norco if you use this medication as prescribed, if you misuse it in a way other than directed, or if you abuse it without a prescription.

Though the withdrawal symptoms from Norco alone are rarely life-threatening, you may want to seek medical detoxification if you want to quit using Norco.³ Norco detox programs can help manage your unwanted withdrawal symptoms and medically stabilize you.

What Causes Norco Withdrawal?

The hydrocodone, which is an opioid painkiller, component of Norco constitutes a Schedule II controlled substance.¹ This classification indicates hydrocodone’s high potential for abuse, misuse, and addiction. These qualities increase the risk of becoming dependent upon this medication.¹

Norco withdrawal symptoms emerge when someone who is dependent on Norco abruptly quits using this opioid.⁴ Dependence occurs due to repeated exposure to higher and higher doses of Norco. People tend to take escalating doses of this opioid painkiller because they build a tolerance, which means more of the drug is needed to produce the same desired effect, such as pain relief or euphoria.^1,2 Once someone is tolerant to Norco, they will take higher doses, and this will ultimately speed up the development of a Norco dependence. Often, tolerance and dependence will contribute to the development of a Norco addiction, but addiction doesn’t need to be present for someone to experience Norco withdrawal symptoms.

Physiological dependence on Norco occurs because repeated exposure causes the body and brain to adapt to the presence of the opioid. Once adapted, the body requires the presence of Norco in order to function “normally.” Without Norco in your system, opioid withdrawal symptoms will emerge.

Additionally, using certain medications when Norco is in your system can trigger symptoms of withdrawal. These medications include:¹

Buprenorphine
Nalbuphine
Butorphanol
Pentazocine
Naloxone
Nalmefene

Norco Withdrawal Symptoms

If you suddenly quit using Norco, withdrawal symptoms may develop in the 8-24 hours following your last dose. These symptoms of Norco withdrawal may last from 4-10 days.⁵

Norco withdrawal symptoms may include:^1,2,3,5

Intensified physical pain
Backache
Joint pain
Muscle cramps
Stomach cramps
Restlessness
Increased heart rate, respiratory rate, or blood pressure
Tearing of the eyes
Runny nose
Excessive yawning
Sweating
Chills
Pupil dilation
Inability to sleep
Body temperature changes, hot or cold
Goosebumps
Nausea, vomiting, or diarrhea
Irritability
Anxiety
Anorexia

Norco withdrawal symptoms are often distressing enough that people will return to Norco use in order to relieve these symptoms. This can create a cycle of compulsive Norco use that ultimately leads to Norco addiction.

Factors Affecting Norco Withdrawal

Your particular Norco withdrawal symptoms and timeline may vary depending on:

Your individual physiology
How long you’ve been using Norco
The dose you’ve been using
Method of administration (e.g. snorting or injecting)
The severity of your Norco dependence
Whether you are using any other substances

Detox: Managing Norco Withdrawal Symptoms

If you are prescribed Norco and are worried about discontinuing use, talk to your doctor before you abruptly quit using Norco or any other opioid medication. Your doctor may recommend you engage in an opioid taper regimen.¹ When you taper off a substance, you reduce your use of it gradually instead of simply quitting all at once. That way, your body can slowly adjust to the lower doses of Norco.

If you received a prescription for Norco, your doctor may recommend alternative pain medications or therapies as you adjust to a reduction in this medication. Depending on the severity of dependence or Norco withdrawal symptoms, your doctor may recommend formal Norco detox treatment to manage withdrawal.^1,6

If your Norco withdrawal symptoms are extremely distressing, you may want to consider entering an inpatient detox facility where you will receive around-the-clock care to ensure your comfort and safety throughout the process. If your symptoms are milder, you may want to consider an outpatient program where you will attend visits that work with your schedule. Both inpatient and outpatient detox programs will likely administer opioid withdrawal medications, which can help ease your Norco withdrawal symptoms during detox.

Some opioid withdrawal medications used during Norco detox include:³

Methadone: Long-acting opioid agonist that mitigates withdrawal symptoms without causing a high.
Buprenorphine: Partial opioid agonist that eases withdrawal symptoms without producing euphoria.

Risk of Overdose After Norco Withdrawal

Following an episode of withdrawal from Norco, your tolerance to opioids may decrease.² As such, after you’ve detoxed from Norco, you are at an increased risk of experiencing an opioid overdose.² It’s extremely important to know this so that if you do return to Norco use after detoxing, you should take a smaller dose than you were using before you went through withdrawal.

Some signs of Norco overdose include:¹

Profound respiratory depression
Extreme sleepiness
Stupor
Coma
Cold and clammy skin
Pinpoint pupils
Reduced blood pressure and respiratory rate
Airway obstruction
Nausea and vomiting
Profound sweating

Norco overdose can be fatal—if you think you or someone else has overdosed on Norco, call 911 to receive emergency medical attention. If you have naloxone, the life-saving opioid overdose medication, administer it immediately.

Transition to Addiction Treatment

If you are addicted to Norco, detox treatment may not suffice for long-term recovery—this is because detoxification does not address the underlying problems that motivated you to misuse or abuse Norco in the first place. Once you detox from Norco, you may want to consider transitioning into a professional substance abuse treatment program, where you will receive various therapeutic interventions that can help you avoid relapse.

Treatment can take place at several levels of care depending on the challenges you face in recovery. Those with a mild Norco addiction may want to consider treatment on an outpatient basis, which ranges in intensity from a couple of hours of therapy per week to several hours each day of counseling. Cognitive-behavioral therapy, mindfulness interventions, and motivational interviewing techniques can help you challenge unhelpful thoughts, learn pain-management skills, and stay motivated throughout recovery.

If you have a more severe Norco addiction, are addicted to more than one substance, or have a co-occurring mental health condition, you may benefit from inpatient or residential treatment. These levels of care can offer medical supervision, structured routines, and frequent interventions to help you develop the coping skills you need in the long-term recovery process.6 The combination of medical interventions, medication management, talk therapy, and peer-led support groups in residential settings can introduce you to new ways of managing addiction.

Recovery does not end with withdrawal and detox. From inpatient to outpatient, treatment professionals can work with you to develop a treatment plan which promotes long-term wellness. Call 800-681-1058 (Who Answers?) today to speak with a treatment specialist about which treatment approach would best suit your needs.

Resources

Allergan USA, Inc. (2018, September). Norco.
Berger, Fred K. (2021, May 10). Opiate and opioid withdrawal. MedlinePlus.
Shah M., & Huecker, M.R. (2021, January 25). Opioid Withdrawal. [Internet]. StatPearls. StatPearls Publishing.
U.S. National Library of Medicine. (2021, January 15). Hydrocodone. MedlinePlus.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders(5th ed.). Arlington, VA: American Psychiatric Publishing.
Miller, W. R., Forcehimes, A. A., & Zweben, A. (2011). Treating addiction: A guide for professionals. The Guilford Press.