Opioid medications are commonly used to treat post-surgery pain, chronic pain, and pain caused by injuries. Several prescription medications contain opioids, such as hydrocodone and oxycodone.
These drugs have shown to be effective in treating a wide variety of pain due to their ability to bind to opioid receptors throughout the body that mitigate the pain response. But when they are abused or used for too long, they also can cause addiction and dependence.
Hydrocodone and oxycodone are fairly similar, but they have a few differences worth noting, especially if you’re looking for a way to manage your pain symptoms with your doctor. But how are oxycodone and hydrocodone different? Is one stronger or safer than the other?
Learn more about the differences and similarities between hydrocodone and oxycodone.
What Is Oxycodone?
Oxycodone is an opioid that is an active ingredient in several prescription medications, including OxyContin and Percocet. It’s mainly used in prescription pain relievers and to manage moderate-to-severe pain caused by surgery, injuries, or disease. It is available in several forms, including tablets, capsules, and a liquid, with a prescription. Depending on the way you take the drug, it may only take 10 minutes to begin working as a pain reliever. It’s also sold in an extended-release formulation, which can take longer to work but works for much longer.
While oxycodone is a useful prescription drug, it is also commonly used as an illicit, recreational drug since it can cause feelings of euphoria. In addition to relieving pain, it can also cause sedation and constipation, as well as respiratory depression. It produces euphoric feelings, which are what makes it so appealing to recreational users and addictive. It is possible to abuse the drug either orally or intravenously, and the powder is often crushed and snorted by users.
A common opioid, oxycodone is prescribed to treat various pain sources, even routine uses like pain after a dental procedure. However, because the drug is so ubiquitous, it can be misused and abused easily. It’s possible to develop a chemical dependence or addiction to oxycodone through normal prescribed use that lasts for too long. But you are more likely to become addicted if you misuse or abuse the drug recreationally.
Prescription opioid misuse and abuse are risk factors for heroin use, according to the National Institute on Drug Abuse (NIDA). In fact, nearly 80% of heroin users reported using prescription opioids before switching to heroin.
What Is Hydrocodone?
The prescription opioid hydrocodone is another painkiller that inhibits coughing and relieves pain. It is usually taken orally, and it’s available in liquid or tablet form. The pain-relieving effects of hydrocodone can be enhanced when combined with drugs like ibuprofen, which have anti-inflammatory benefits. Hydrocodone works in the brain in a way that’s similar to other opioids, including oxycodone. It mimics your body’s natural endorphins and binds to their sites on opioid receptors.
Opioid receptors are designed to work with endorphins to medicate pain symptoms, but prescription opioids are more potent and block severe pain more effectively. Opioid receptors are located all over the brain and body, allowing hydrocodone to block pain signals at the site of pain and in the brain.
Hydrocodone is less commonly used than oxycodone, but it is also addictive with significant abuse potential. When abused, it can cause a similar euphoric high to oxycodone and other opioids of abuse. When you abuse opioids frequently or take high doses, your brain becomes dependent on them to keep its chemistry balanced. In the same way as oxycodone, hydrocodone alters the way your reward center interacts with opioids.
Developing an addiction to hydrocodone will result in an opioid use disorder, a disease that affects the reward center of the brain. Addiction can cause you to use drugs compulsively, even if drug use is causing serious problems in multiple aspects of your life.
How Are Hydrocodone and Oxycodone Similar?
Hydrocodone and oxycodone are both semi-synthetic opioids, which means that they are made by altering an opiate, which is a naturally occurring opioid. In fact, these drugs are both derived from the same opiate: codeine. Codeine is found in opium poppy plants, and it’s among the first opioids to be isolated, along with morphine. Since they are in the same drug category and even have the same parent opiate, they share many common effects.
Both have been shown to alleviate pain symptoms, which is their primary function in medical use. They can also cause sedation, itchiness, constipation, and other effects and side effects. They are also both addictive with a significant potential for abuse.
Oxycodone or Hydrocodone: Which Drug Is Stronger?
Hydrocodone and oxycodone are both used in similar applications when treating moderate to severe pain symptoms. But opioid medications can vary in potency. That means they may have different levels of strength. While one drug may produce significant effects at a relatively low dose, a similar drug may require a much higher dose to achieve the same effects. Measuring the potency of different prescription drugs helps medical professionals recommend safe doses.
By measuring a drug’s power, medical professionals can prescribe safe doses and understand which drugs will be the most effective in different situations. For example, opioids are known to cause pupillary contraction. One study that set out to measure the strength of different opioid prescriptions found the following:
The same effect of oxycodone on pupillary responses was achieved with 50% more hydromorphone. Nevertheless, they concluded that non-drug-abusing volunteers showed little difference in pharmacodynamic effects. Therefore, they affect the body in a very similar way and to a similar extent. According to a 2005 study, they are both effective in treating acute pain symptoms. Patients receiving oxycodone or hydrocodone did not experience a difference in pain relief when given oxycodone or hydrocodone in an emergency room setting. Within ten minutes, both drugs begin to work.
Both drugs seem to be equal in terms of addiction potential and strength. If one is truly stronger than the other, the differences are insignificant.
Which Drug Is More Effective?
Research has shown that both oxycodone and hydrocodone are equally effective at treating pain. The study above also found that participants felt equal pain relief 30 and 60 minutes after taking the medication. The hydrocodone group, however, experienced constipation more frequently than the oxycodone group. When taken at equal doses, oxycodone and acetaminophen combined had 1.5 times the potency of hydrocodone and acetaminophen.
Oxycodone vs. Hydrocodone: What's the Difference?
Despite the fact that hydrocodone and oxycodone have similar effects on the body, there are a few important differences that should be noted, like their abuse potential. In 2012, a review compared hydrocodone, oxycodone, and morphine for their abuse potential. In comparison to the other two drugs, oxycodone was found to have an elevated abuse liability profile. All three drugs can contribute to an addiction, but oxycodone is more likely to be abused and used recreationally, which can cause an opioid use disorder quickly.
There are similarities between these two drugs as far as their side effects are concerned, including vomiting, nausea, constipation, dizziness, itching, anxiety, and rash, but there are also some differences as well. Because hydrocodone may be ototoxic, it can damage parts of the ear, such as the cochlea and auditory nerve, causing bilateral hearing loss. Some researchers, however, note that the paracetamol that is often included with hydrocodone in analgesics may cause this toxicity.
What Is Involved in Opioid Addiction Treatment?
Addiction to hydrocodone or oxycodone often starts with medical detox, which involves medically managed care that helps you through the withdrawal phases of treatment. Detox addresses medical and psychological needs.
Unlike other substances, such as benzodiazepines, hydrocodone withdrawal symptoms are not nearly as dangerous or life-threatening.
In spite of this, hydrocodone detox should never be done alone without medical assistance in order to avoid a relapse or any possible health complications. Additionally, doctors can use methadone or buprenorphine as a substitute for hydrocodone and gradually taper those down. This is a therapeutic approach called medication-assisted treatment (MAT), and it is usually supplemental to other treatment options.
A hydrocodone addiction recovery program that offers ongoing care is the next step after detox has been completed and withdrawal symptoms have subsided. In order to successfully quit hydrocodone, detox alone is not sufficient.
The next step is either inpatient or outpatient treatment, addressing the psychological aspects of your addiction while equipping you with the important tools and coping skills to manage and address your substance use disorder. If you cut treatment short after detox, your risk for relapse is increased significantly.