Hydrocodone and Oxycodone: How They're Different, How They're the Same, and Why It Matters

While it's not as common as it was 10 or 20 years ago due to changes in the law and rising awareness around opioid abuse, doctors still prescribe narcotic painkillers for patients. While they can potentially lead to drug abuse and misuse, for people battling cancer, experiencing chronic pain, or recovering from major surgery, narcotics can provide pain relief that other pain medications cannot.

Still, the high potential of developing a substance abuse problem should not be ignored. If a doctor prescribes hydrocodone or oxycodone to you or a loved one, we can help you understand the differences and similarities between the two.

What is an Opioid?

Opioids, also known as narcotics, are a class of drugs that include codeine, fentanyl, hydrocodone, morphine, oxycodone, buprenorphine, methadone, and heroin. Prescription opioid medications are intended to treat severe pain, whereas illicit narcotics, like heroin, are used for the pleasurable rush and sedation effects.

All opioids act on the central nervous system, binding to opioid receptors to block pain signals between the brain and the body. In addition to providing relief for acute pain and chronic pain, opioids also slow down breathing, heart rate, and mental functions.

While opioids work well as pain relievers or analgesics, while also bringing feelings of extreme relaxation and euphoria, they also have significant dangers of addiction and death.

The side effects can be highly unpleasant as well.

Side Effects of Opioids

For people in severe pain, opioids can work wonders. However, the side effects should not be ignored. Common side effects of opioid use and abuse include nausea, constipation, mental confusion, stomach pain, dry mouth, extreme drowsiness, slowed breathing, addiction, and even death.

How Are Hydrocodone and Oxycodone Similar?

Hydrocodone and oxycodone are both Schedule II semi-synthetic opioids prescribed to relieve moderate to severe pain, and chemically, they are very similar. They work by binding to opioid receptors in the brain to disrupt pain signals. Each drug slows down breathing and digestion. Both are highly addictive and should only be taken exactly as prescribed by a healthcare professional.

In addition to what are considered positive side effects to taking oxycodone and hydrocodone like pain relief and a "high" feeling, possible negative side effects of each include:

  • Heartbeat irregularities

  • Hives

  • Dry mouth

  • Nausea

  • Vomiting

  • Swelling about the face, including lips and tongue

  • Difficulty breathing

Adding Acetaminophen to Hydrocodone and Oxycodone

Both hydrocodone and oxycodone are sometimes combined with acetaminophen, an over-the-counter pain reliever. In the case of oxycodone acetaminophen, it is commonly known by its brand name Percocet®. Hydrocodone acetaminophen is commonly known by brand names Lortab®, Norco®, and Vicodin®.

According to the FDA, hydrocodone and/or oxycodone combined with acetaminophen presents a higher risk of liver damage and overdose than when each opioid is taken alone.

How Are Hydrocodone and Oxycodone Different?

One primary difference between hydrocodone use and oxycodone use is the side effects. Tiredness is a more common effect of taking hydrocodone, and constipation is a more common effect of taking oxycodone.

As for which is more effective in providing pain management or at providing feelings of euphoria and pleasure, the two drugs are remarkably similar. In truth, factors like a person's substance use and substance abuse history, their weight, the release form of the hydrocodone or oxycodone (i.e. instant-release or time-release tablets), and the dosage have more to do with how the drug is experienced than a strict difference between the two. That being said, individuals who misuse opioid medications generally prefer formulations of oxycodone such as Oxycontin, Roxicet, and Percocet.

For someone with acute pain following surgery, then, taking hydrocodone rather than oxycodone may be a slightly less risky choice.

What Does Addiction to Hydrocodone or Oxycodone Look Like?

Dependency on oxycodone and hydrocodone is often both psychological and physical. Signs of dependency or addiction to opioids include:

  • Preoccupation with finding and taking the drug

  • Profuse sweating

  • Increased heart rate

  • Insomnia

  • Anxiety

  • An inability to stop using the drug

  • Seeking other, more powerful opioids out

Treatment Options for Hydrocodone and/or Oxycodone Use Disorders

Treatment for individuals with opioid use disorder can include Medication-Assisted Treatment (MAT), non-opioid pain management, therapy, resiliency training through yoga, meditation, and more.

We have world-class staff with unparalleled expertise for handling everything from withdrawal symptoms to co-occurring disorders and more.

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