Lortab (Hydrocodone) Addiction: Signs and Side Effects of Lortab Abuse

Lortab is a brand-name, prescription pain medication that contains hydrocodone, an opioid, and acetaminophen, the active ingredient in Tylenol. Street names commonly used for hydrocodone include hydros, vikes, tabs and perks. Even when prescribed, hydrocodone can be addictive, especially when abused.

Because Lortab contains acetaminophen, it offers a unique risk profile compared to other hydrocodone products, such as Norco and Vicodin. High doses of Lortab can increase the risk of liver damage, even if the opioid effects feel manageable.

This comprehensive guide explores the signs and side effects of Lortab misuse, including why it can lead to addiction and how to get diagnosed. Because it focuses solely on the health effects and signs of Lortab addiction, it doesn’t discuss rehab or other treatment options.

For some people, taking Lortab can lead to addiction, especially with misuse. Opioids such as hydrocodone directly interact with the central nervous system, which is made up of the brain and spinal cord.

More specifically, hydrocodone activates opioid receptors in the brain to reduce pain. However, opioid receptor activation can have secondary effects, such as euphoria, relaxation and emotional relief, as dopamine levels increase.

When used as prescribed, these effects can be therapeutic, but they can also reinforce repeated use. Having access to quick pain and stress relief can encourage people to use Lortab more frequently or at higher doses than recommended.

Increased Lortab tolerance can also lead to addiction. Over time, your body adapts to the effects of hydrocodone, and you’ll need more of it to feel the same relief. Increasing tolerance can make people take unsafe doses of the drug, which can eventually lead to addiction.

For some people, the discomfort of hydrocodone withdrawal can push ongoing use. Eventually, this can create a cycle of using Lortab to avoid feeling sick.

Certain routes of use can also increase addiction risk. Snorting pills and mixing Lortab with alcohol or benzodiazepines can lead to loss of control, making it easier to fall into risky routines.

Lortab is linked to abuse and addiction, which are separate conditions with key differences. Abuse is any Lortab use outside of medical guidance.

Examples of Lortab misuse include:

• Taking it without a prescription
• Taking higher doses than prescribed
• Using it longer than directed
• Using someone else’s prescription
• Taking it to get high

Addiction is defined by compulsive, habitual Lortab use. Key characteristics include impaired control, cravings and continued use despite harm.

Although misuse and addiction aren’t the same, there’s a significant link between the two. Many people may start abusing Lortab for pain relief but progress into taking it for their mood, stress or to avoid withdrawal. Over time, these behaviors can lead to opioid use disorder (OUD).

When using Lortab, it’s essential to watch for early warning signs of addiction, such as:

• Running out of your prescription early
• Taking extra doses “just in case”
• Hiding pills
• Seeking multiple refills

While laypeople often use the terms “abuse” and “addiction,” clinicians have replaced those terms with “misuse” and “substance use disorder” to reflect that addiction is a treatable brain disease and not a personal choice.

Some people can develop a physical or psychological dependence on Lortab. Physical dependence develops when the body becomes reliant on hydrocodone to function and can lead to withdrawal symptoms when use stops or drops.

When someone starts to rely on Lortab to feel calm, emotionally steady or to function in their day-to-day life, they may be psychologically dependent on the drug. Psychological dependence can often cause compulsive drug use. Not everyone who uses Lortab will become dependent.

Factors that can lead to dependence include:

• Taking higher doses
• Frequent use
• Long-term use
• Taking it for emotional coping

Dependence isn’t the same as addiction, so not everyone dependent on Lortab is necessarily addicted to it. However, dependence is often an early sign that use patterns are escalating and may need attention.

Signs of Lortab addiction can present differently in each individual, but becoming familiar with common signs can help identify a need for professional help. Behavioral, physical, mental and social signs are all possible. If your behaviors related to hydrocodone use suddenly shift, it may be a sign of addiction.

Behavioral addiction signs include:

• Taking more Lortab than prescribed
• Seeking early refills
• Visiting multiple prescribers
• Hiding Lortab use
• Buying pills from nonmedical sources

Physical signs are sometimes easier to identify, especially in others, and include:

• Pinpoint pupils
• Drowsiness
• Slowed breathing
• Itching
• Nausea
• Constipation

Lortab addiction can also impact your mood and cognitive function. Psychological signs of OUD may include confusion, mood swings, anxiety between doses and strong hydromorphone cravings.

Some people with Lortab addictions find that their social behaviors change. For example, sudden isolation, out-of-character financial or legal issues, relationship conflict and performance decline at work or school can occur with OUD.

You should also keep an eye out for a few safety red flags regarding hydrocodone use. Taking Lortab while alone, mixing it with alcohol or benzodiazepines and escalating doses after building a tolerance indicate a need for professional treatment.

Lortab is known to cause withdrawal symptoms when use stops or drops — particularly in those physically dependent on the medication. When your body adapts to having hydrocodone in your system, it can react with withdrawal symptoms when the opioid is no longer there.

Opioid withdrawal can be very uncomfortable and unpleasant. For some, it can feel like a severe flu, with intense restlessness and cravings.

Common Lortab withdrawal symptoms include:

• Anxiety
• Sweating
• Yawning
• Runny nose
• Watery eyes
• Muscle aches
• Insomnia
• Agitation

Late symptoms of Lortab withdrawal include:

• Nausea
• Vomiting
• Diarrhea
• Abdominal cramps
• Chills
• Goosebumps
• Dilated pupils

Opioid withdrawal is different for everyone, meaning the severity and duration of your symptoms can vary.

The length of your withdrawal period can be impacted by:

• Typical dose
• Duration of use
• Frequency of use
• Overall health
• Using it with other substances

For most people, withdrawal symptoms appear within 6 to 12 hours after their last dose. Symptoms can peak in intensity by the second or third day of withdrawal and last about a week. In some cases, certain withdrawal symptoms can linger for weeks.

Misusing Lortab can lead to a wide range of short- and long-term side effects. Short-term side effects occur shortly after using hydrocodone. They tend to resolve within a couple of days after use.

Short-term opioid effects include:

• Sedation
• Dizziness
• Impaired judgment
• Slowed breathing
• Euphoria
• Lightheadedness
• Nausea
• Vomiting
• Constipation

Long-term side effects are more common with repeated use over an extended period of time.

Long-term opioid risks include:

• Tolerance
• Dependence
• Chronic constipation
• Increased overdose risk
• Depression
• Heart attack
• Sexual dysfunction
• Sleep disorders
• Compromised immune system
• Hyperalgesia (severe pain)

Lortab also contains acetaminophen, giving it a unique side effect risk profile. If your total daily acetaminophen intake is too high, side effects can include liver damage and liver failure. Because other medications contain acetaminophen, such as cold and pain medications, it’s crucial to be mindful of daily intake when using Lortab.

Different routes of use can also have unique side effects. For example, snorting Lortab can cause nasal damage, and injecting it can increase your risk of infections and bloodborne diseases.

Lortab misuse and addiction greatly increase the risk of opioid overdose, which is a medical emergency that can cause irreversible damage, including death. If you notice signs of overdose, call 911 immediately.

Signs of overdose include:

• Respiratory depression
• Unconsciousness
• Slow heartbeat
• Cold and clammy skin
• Pale or blue lips

While anyone who uses Lortab has the potential to become addicted, not everyone will. Some medical factors can increase your risk of hydrocodone addiction. For example, having a long-term opioid prescription, taking higher doses and having limited supervision surrounding your Lortab use can lead some people to addiction.

Increased risk is also seen in people with pain and stress disorders. Chronic pain, repeated injuries, high stress and sleep disruption can encourage opioid use that becomes cyclical.

People with a history of mental health conditions, such as anxiety, depression, trauma and trouble with emotional regulation, are also more prone to addiction. Some individuals may use opioids, such as Lortab, to cope with the symptoms of their mental health disorder.

If you have a history of substance abuse, you may be more likely to become addicted to Lortab. Prior misuse of alcohol, opioids, benzodiazepines and other drugs can indicate a predisposition.

Ease of access may impact your risk of addiction. People with leftover medication at home, shared pills or easy access through social networks may be more likely to misuse hydrocodone and become addicted over time.

Environmental factors can also increase risk. If you were exposed to substances at an early age or have a family history of substance addiction, you may be more likely to become addicted to Lortab.

Certain signs can sometimes identify Lortab addiction, but a proper diagnosis must be made by a medical professional. Clinicians diagnose OUD using established criteria focused on patterns over time.

During an evaluation for OUD, you can expect to answer questions about your Lortab use and behaviors, such as:

• Cravings
• Tolerance
• Withdrawal symptoms
• Loss of control
• Risky use
• Continued use despite harm

You may also receive a mental health screening and overdose risk evaluation during your assessment. Your doctor will refer to established criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to analyze your behavior.

Criteria used to diagnose OUD include:

• Taking larger doses or for longer than prescribed
• Inability to cut down on opioid use
• Spending a lot of time thinking about or getting opioids
• Craving opioids
• Neglecting work or school responsibilities
• Continued use despite consequences
• Giving up social activities or hobbies due to opioid use
• Developing a tolerance
• Experiencing withdrawal

While drug testing can confirm opioid exposure, it can’t diagnose addiction. Clinicians rely on assessments and look for patterns of use to make that distinction.

Lortab addiction is a serious condition that can happen to anyone. Having an OUD isn’t an indication of a personal failure, but it does indicate a need for professional support and treatment.

Even occasional hydrocodone abuse can have serious implications and be life-threatening. Overdose scares, escalating doses, withdrawal symptoms and combining Lortab with other depressants are warning signs that it’s time to take action.

Taking the first step toward recovery can be overwhelming, but it doesn’t need to be with the right resources. Help.org is a free, confidential tool that can help you and your loved ones find a rehab center for Lortab addiction based on your location, needs and preferences.