Norco Overdose: Dangers, Death, and Addiction Treatment
Is Norco Dangerous?
What Is Norco?
Norco is the brand name for a prescription painkiller medication containing the opioid hydrocodone and a widely-available, over-the-counter (OTC) pain reliever and fever reducer, acetaminophen. Norco is prescribed to treat significantly severe pain, but some people abuse this medication merely to get the hydrocodone high, a practice that can quickly lead to addiction.
Abusing Norco encompasses taking it outside prescription guidelines. This can mean taking it more often than prescribed, in higher doses than prescribed, in a way other than intended (for example, crushing and snorting it), or without a prescription altogether. By abusing Norco, a person puts themselves at a high risk of severe negative consequences, including addiction and overdose death.
What Are the Effects?
The intended medicinal effect of Norco is pain management. The combination of an opioid painkiller and the analgesic acetaminophen helps to provide vital pain management for people facing moderately severe, short-term pain, with relatively few dangers or risks when taken as prescribed.
Various health issues may arise when a person starts misusing Norco. Hydrocodone interacts with certain opioid receptors in our brains in a manner that diminishes our perception of pain, but it may also have other physiological effects such as slowed breathing and heart rate. Hydrocodone use is also associated with increased dopamine activity in our brain’s reward center. The combination of these various processes can result in the typical opioid high when taken in high doses: reduced sensation of pain, euphoria, extreme relaxation, and drowsiness.1 Unfortunately, these pleasurable effects can come with a high cost.
Side effects of Norco abuse include:1,2
- Slowed or stopped breathing.
- Slowed or stopped heart rate.
- Low body temperature.
- Overdose, which can be deadly.
On top of these hydrocodone-specific side effects, there are the dangers associated with high doses of acetaminophen. When a person abuses Norco for the opioid high, they are also dosing their body with high levels of acetaminophen, which can cause extensive damage to the liver.3 This and many other Norco-related health risks may be further compounded by any concurrent alcohol use.
Prescription opioid abuse has become a serious problem and one of the primary contributors to the current opioid overdose epidemic.
Prescription Drug Abuse
Misuse and abuse of Norco can start due to many different reasons. Nearly 7 million people reported misusing hydrocodone medications like Norco in 2016.4 For many, an opioid addiction starts with attempts to manage pain. Some people may find that the prescribed dose is not enough to manage their pain and decide to self-select their dose rather than talking to their doctor about adjusting the prescription. Others may find that they enjoy the Norco high, using increasing doses to compensate for their developed tolerance.
This pattern of prescription-to-addiction is not uncommon. Prescription opioid abuse has become a serious problem and one of the primary contributors to the current opioid overdose epidemic. In 2015 alone, more than 22,000 people died because of an overdose of a prescription opioid painkiller, which is more than double the number of fatalities from only 10 years earlier.5 This escalating pattern of abuse, addiction, and overdose demonstrates some very problematic trends.
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Risks and Consequences
Norco abuse can wreak havoc on the user’s brain and body, resulting in long-term changes that can affect the rest of their life. Abusing Norco can cause serious damage to the user, but the good news is that a lot of the damage incurred can be improved or even reversed with sustained abstinence. Potential health problems related to Norco abuse include:3,6,7
- Severe breathing problems.
- Hypoxia, or dangerous lack of oxygen.
- Neonatal abstinence syndrome in infants born to mothers who used Norco during pregnancy.
- Liver damage.
- Hearing loss.
- Chronic constipation.
- Frequent episodes of nausea and vomiting.
Just because these drugs come from a doctor does not make them safe to abuse. Prescription opioids like Norco have undeniable abuse potential, which is why they come with strict dosing limits and short-term intended courses to help guarantee user safety.
On top of physical health issues, Norco abuse and addiction can have an extensive impact on the person’s life. Norco addiction can cause or contribute significantly to financial problems, legal troubles, low self-esteem, job loss, poor school performance, neglect of self or family, and even social isolation. All of these can affect a person’s mental health in negative ways.
Can You Overdose?
Abuse of prescription opioids like Norco comes with a very high risk of life-threatening overdose. The risk of overdosing on Norco is increased if the person is taking Norco with other drugs that may accentuate the opioid effects.
Taken with another central nervous system depressant, like alcohol or benzodiazepines, a person may experience dangerous slowing of vital life functions such as breathing and heart rate. Combining substances is always risky, but when it comes to opioids like Norco, the consequences can include death.
Norco overdose symptoms include:8
- Weak heartbeat.
- Shallow or stopped breathing.
- Pinpoint pupils.
- Blue color to lips and fingernails.
Beyond the risks associated with hydrocodone overdose, a Norco user also faces the potentially life-threatening effects of taking a high dose of acetaminophen. Acetaminophen can have toxic, damaging effects on the liver in high doses.3 The simultaneous consumption of alcohol additionally lowers the threshold for acetaminophen-related liver injury.
Combining substances is always risky, but when it comes to opioids like Norco, the consequences can include death.If you suspect that you or somebody near you may be experiencing a Norco overdose, call 911 right away. Getting immediate emergency medical help is the best way to help an overdosing individual. Report the drug(s) and dose taken, if possible. Medical professionals know how to handle Norco overdoses, and many emergency responders now carry Narcan (naloxone), which can immediately reverse the effects of an opioid overdose and may save the person’s life.9
In some states, naloxone is available at certain pharmacies for people to keep at home for opioid overdose emergencies. If you live in an area where naloxone is available and have it on hand during the overdose, you should closely follow the instructions to administer the medicine.
Administering naloxone is not always enough to help an overdosing person, so it is extremely important that you call for emergency medical help even if you have administered the medicine. Naloxone can only help with stopping overdose symptoms related to the hydrocodone in Norco. Acetaminophen overdose is still a major threat during a Norco overdose, and medical help should be sought right away.
The Opioid Epidemic
More than 33,000 people died of an opioid overdose (including heroin and prescription painkillers) in the U.S. in 2015, a drastic increase from previous years.5 The United States is in the middle of an opioid overdose epidemic, with more and more people dying from opioid-related deaths each year. Some major contributing factors include overprescribing practices among the medical community and the influx of street heroin cut with super potent opioids like fentanyl and carfentanil.
Abusing prescription opioids is an undeniable risk factor for subsequent heroin addiction.10 In fact, one study looked at national-level data and found that heroin users were almost 4 times more likely to have used prescription opioids in the year before the study than people who did not report heroin use.10
Once a person develops an addiction to opioids, they may find that obtaining prescription pills is difficult and expensive. Heroin is frequently much cheaper, easier to obtain, and, in many cases, elicits an inherently more intense high (especially when injected).
As people addicted to prescription painkillers fall into the throes of heroin addiction, they face another major threat: street heroin cut with extremely potent, often deadly, synthetic opioids. These undoubtedly contributed to the recent increase in heroin-related deaths. Heroin overdose deaths rose from a little over 3,000 in 2010 to almost 13,000 in 2015.5 Deaths attributed specifically to synthetic opioids (other than methadone) rose from 3,000 in 2010 to 9,500 in 2015.5 As the rates of opioid-related overdose deaths skyrocket, the U.S. must scramble to find ways to help alleviate this crisis.
What Is Addiction?
Using or abusing a drug once does not mean a person is addicted. Addiction develops amidst long-standing, maladaptive patterns of substance abuse behavior, and many criteria factor into an official medical diagnosis of an opioid use disorder.
As a person’s Norco abuse escalates into higher or more frequent doses, they may start to notice that the same dose doesn’t provide the same high. In order to achieve the desired drug effect, they need increasingly large doses. This is known as tolerance, and it can set the stage for addiction.
Tolerance, and the ensuing increase in drug use to overcome it, can kick start the development of significant physical dependence, which is when the person’s body is so used to the presence of Norco in its system that it struggles to function normally without it. When a person is physically dependent on Norco, they will start to experience withdrawal symptoms when they don’t use it and may even be taking Norco just to avoid the unpleasant withdrawal syndrome.
Tolerance and dependence can lead a person down the path to compulsive drug use and increasingly negative consequences. Addiction encompasses a set of behaviors surrounding drug use, and tolerance and dependence are certainly a big part, though not the only factors to consider when trying to determine if a person is addicted.
Do I Need Treatment?
Addiction looks different for every person, and it can be difficult to recognize when you need help. If you’re questioning whether or not you’re addicted to Norco, a problem may already be present. Here are some helpful statements you may identify with:11
- I am taking Norco in higher amounts or for longer periods of time than I intended.
- I want to quit or cut back my use but haven’t been able to yet.
- I spend a lot of time trying to get, use, or recover from Norco.
- I crave Norco, or I have a strong desire to use it.
- I have repeatedly been unable to fulfill major obligations at work, home, or school because of my Norco use.
- I still use despite social or interpersonal problems related to my Norco use.
- I have stopped or reduced social, recreational, or job-related activities because of my Norco use.
- I have repeatedly used Norco in physically dangerous situations, like driving.
- I continue to use Norco despite knowing that my use has caused or exacerbated psychological or physical problems for myself.
- I have a tolerance to Norco’s effects.
- I experience withdrawal when I do not use Norco, or I take Norco to avoid withdrawal.
If you identify with even 2 of these statements within the past year, you may want to seek professional help. Norco addiction can be a very difficult habit to break, and having the help of an experienced treatment team can make a huge difference in your recovery.
Detoxing from Norco can be a major challenge for the recovering user as withdrawal symptoms begin. Many people who have worked through withdrawal from opioids like Norco have described it as the worst flu imaginable.
Norco withdrawal syndrome may not be deadly, but it can be extremely uncomfortable. Trying to detox on your own could tempt you to relapse because using Norco again will quickly reduce the uncomfortable symptoms. Getting professional care can help ensure that you make it through detox and withdrawal as safely and comfortably as possible and reduce your risk of relapsing.
Norco withdrawal symptoms can begin anywhere between 8 and 48 hours after your last dose.12 Withdrawal symptoms can include:12
- High body temperature.
- Rapid breathing.
- Rapid heart rate.
- High blood pressure.
- Extreme headaches.
- Runny nose.
- Sweaty or clammy skin.
- Muscle spasms.
- Muscle and bone pain.
- Abdominal cramping.
Treatment professionals can help you work through Norco recovery in many ways. During detox, they can prescribe medications like clonidine that will help you cope with physical withdrawal symptoms like vomiting, diarrhea, insomnia, muscle and bone pain, headaches, and stomach cramps.12 Alleviating these symptoms can make withdrawal and detox more comfortable, but it doesn’t address one of the most challenging aspects of detox: cravings. Fortunately, there are a handful of medications that treatment professionals can prescribe to help with Norco cravings:12
- Methadone, which activates the opioid receptors in the brain like Norco but without the extreme rush or high.
- Buprenorphine, which activates opioid receptors but to a much lesser extent than Norco.
Every person is different, and a medication that works for one person during Norco detox may not necessarily work for another. Addiction treatment professionals can help you safely work out the most helpful medicine profile to get your through detox.
Substance Abuse Treatment
The first step in the treatment journey is detoxification, or detox. This involves extended abstinence to help clear all the Norco from your body so that you can begin treatment with a clear, sober head. Many people face challenging withdrawal symptoms during this time, but a professional program will know how to help you manage them.
Once detox is complete, formal treatment can begin. In an inpatient program, you would stay at a treatment facility for the duration of the program. This offers you an escape from the original abuse environment in a 100% sober center with few external relapse triggers. Some inpatient programs offer around-the-clock medical and psychological care, which can make a huge difference for you as you work through the program.
In an outpatient program, you would continue to live and sleep at home for the duration of the program. You would check in with the program on a regular basis for treatment and therapy sessions, and some programs will even offer medical check-ups as well. This can be comforting for people who have a very hard time being away from familiar environments, but can also be an extreme challenge for those who do not have strong internal motivation for getting clean.
No matter which setting you choose, therapy and counseling will be a major part of treatment, and every program has a different approach. Group and individual therapy sessions are important during recovery, and throughout the program you will learn and develop skills to help you maintain sobriety after treatment ends. Some common therapeutic approaches for treating addiction to opioids like Norco include:
- Contingency management, which is also called motivational incentives, involves earning rewards for meeting recovery and treatment goals.
- The community reinforcement approach is an intensive 24-week outpatient therapy that can help you recognize the value and satisfaction that comes with sobriety.
- 12-step facilitation is when a program supplements their therapies with 12-step meetings like Narcotics Anonymous, encouraging those in treatment to continue attending meetings and working the steps as part of long-term recovery once the initial treatment period has ended.
- Cognitive behavioral therapy involves looking into your reasoning for turning to Norco abuse in the first place, as well as practicing refusal and relapse prevention skills.
Once you complete the treatment program, you may want to look into aftercare options. Many people choose to continue attending therapy sessions to strengthen the skills they developed in treatment. In addition, many people opt to move into sober living communities, where all residents are in recovery. These kinds of communities can help you build a social network of sober-minded friends that can encourage your recovery.
Free support groups are another excellent aftercare option. 12-step groups like Narcotics Anonymous offer many people a free option for aftercare. There are also non-12-step options for recovery after Norco abuse, and your treatment program can help you get in touch with these valuable resources.
Another extremely valuable option for sobriety maintenance is ongoing medication-assisted treatment (MAT). For many people, medication is an important tool that they use to help them stay away from Norco after leaving treatment. Cravings can seem irresistible, and closely-monitored MAT can help alleviate these cravings and aid in long-term abstinence. In fact, medication in combination with therapy has demonstrated substantial effectiveness when it comes to addiction recovery.13
Some of the same medications used during Norco detox can also be used for MAT. Buprenorphine and methadone are common MAT medications that help many people in recovery. These medications help reduce cravings to a manageable level but, as opioid medications, they unfortunately have some abuse potential of their own. There are other options for people who have an especially hard time staying away from opioids after treatment:
- Naltrexone:14 This medication blocks opioid receptors, which prevents the user from getting the opioid high even if they relapse to using Norco again. It is available in pill form (Depade) and as a once-a-month injection (Vivitrol).
- Suboxone:15 This is a combination medication with buprenorphine, which helps reduce opioid cravings, and naloxone, which prevents the opioid high and discourages the user from abusing the drug.
MAT, though becoming an increasingly common standard of treatment, is not entirely without its detractors. There are some people who believe that MAT is simply substituting one addiction for another, but the truth is that every person is vastly different. Each recovering person has their own individual needs and circumstances that will necessitate different approaches to long-term recovery. Medication may not be necessary for one person’s recovery, but another may face near-irresistible cravings that only MAT can help with. The most important thing is that the recovering person stays safe and, for many, recovery includes carefully monitored MAT.
Norco addiction can be an incredible challenge to take on, but the outcome of getting help is always worth the effort. Getting clean can mean the difference between life and death, and there are thousands of treatment centers out there, ready to help you in your own recovery journey. Reach out for help and get started on the path to a satisfying sober life.
- Benyamin, R., Trescot, A., Datta, S., et. al. (2008). Opioid complications and side effects. Pain Physician, 11, S105-S120.
- National Center for Biotechnology Information. (2005). PubChem Compound Database; CID=5284569. Hydrocodone.
- U.S. National Library of Medicine. (2017). Hydrocodone/Acetaminophen (By mouth).
- Center for Behavioral Health Statistics and Quality. (2017). 2016 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD.
- National Institute on Drug Abuse. (2017). Overdose Death Rates.
- Connecticut Department of Consumer Protection. Prescription Monitoring Program: Hydrocodone and Acetaminophen.
- Patrick, S., Davis, M., Lehman, C., et. al. (2015). Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012. Journal of Perinatology, 35(8), 667.
- U.S. National Library of Medicine. (2015). Hydrocodone/oxycodone overdose. MedlinePlus.
- Substance Abuse and Mental Health Services Administration. (2016). Naloxone.
- Compton, W., Jones, C., Baldwin, G. (2016). Relationship between nonmedical prescription-opioid use and heroin use. New England Journal of Medicine, 374, 154–163.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 13–4131. Rockville, MD.
- Kleber, H.. (2007). Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Dialogues in Clinical Neuroscience, 9(4), 455–470.
- Substance Abuse and Mental Health Services Administration. (2016). Naltrexone.
- Substance Abuse and Mental Health Services Administration. (2016). Burprenorphine.