Hydrocodone vs Oxycodone (What's the Difference?)

Their names are similar. They’re in the same drug category, and they’re often used for similar purposes. Are there any significant differences between hydrocodone vs. oxycodone?

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Table of Contents

Understanding Hydrocodone and Oxycodone

Hydrocodone and oxycodone are semi-synthetic opioids.

“Semi-synthetic” means that the drugs are chemically altered versions of substances that are naturally produced by the opium poppy plant. Oxycodone is derived from thebaine, while hydrocodone may be derived from either thebaine or codeine.

Both are prescription medications that are typically used to treat moderate to severe pain:

Hydrocodone is sold under the brand names Vicodin and Lortab.
Oxycodone is sold as OxyContin.
Each drug is also available as a generic.

Hydrocodone and oxycodone can be sources of considerable relief when used as directed for a legitimate medical concern. Unfortunately, they are also highly addictive substances that can be deadly if misused.

Comparing Hydrocodone vs. Oxycodone

Though these two drugs are quite similar, there are a few minor differences between hydrocodone vs. oxycodone:

History: Though the use of both drugs can be traced to the early 1900s, oxycodone is slightly older. The first clinical use of oxycodone occurred in 1917, but hydrocodone wasn’t synthesized until 1920.
Strength: Oxycodone is a bit more potent than hydrocodone, so patients can take smaller doses to receive similar effects. From the perspective of those who use these substances for recreational purposes, oxycodone’s greater strength means that it may pose a slightly larger risk of both addiction and overdose.
Side effects: Both substances can cause the same side effects, but oxycodone is more likely to cause constipation, while hydrocodone is more likely to cause drowsiness.

One of the most significant similarities between oxycodone and hydrocodone is that they are both classified as Schedule II controlled substances. This means that experts have determined that they both have “a high potential for abuse, with use potentially leading to severe psychological or physical dependence.”

Opioid Addiction: Diagnostic Criteria & Warning Signs

Clinicians refer to the criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) when assessing patients for addictions to hydrocodone or oxycodone.

Nonprofessionals may want to keep any eye out for certain warning signs that could indicate a loved one has developed a problem.

Diagnostic Criteria for Opioid Use Disorder

The DSM-5 includes 11 criteria for opioid use disorder, which is the clinical term for addiction to hydrocodone or oxycodone.

To be accurately diagnosed with this condition, a person must meet two or more of the following:

Having powerful urges or cravings for opioids
Persistent desire, which may include multiple failed attempts, to stop using hydrocodone or oxycodone
Frequently using the drugs in a greater amount or for a longer period than they intended
Spending significant amounts of time in activities related to acquiring and using the drugs, and recovering from their effects
Continuing to use the drugs after having physical or psychological problems that were caused or worsened by prior use
Continuing to use oxycodone or hydrocodone after having personal or social problems that were caused or worsened by prior use
Repeatedly using hydrocodone, oxycodone, or other opioids in circumstances that pose an obvious physical hazard, such as by combining them with other drugs or driving while under their influence
Failing to pay bills, keep appointments, or fulfill other personal, academic, or work-related responsibilities because of their opioid use
Reducing or ending their participation in important social or work-related activities because of their opioid use
Developing tolerance, which means they have to use larger or more potent doses to feel the drugs’ effects
Experiencing withdrawal symptoms when they try to stop using opioids, or when they are prevented from acquiring and using the drugs

Warning Signs of Opioid Addiction

If someone in your life is addicted to hydrocodone or oxycodone, you should encourage them to talk with their doctor or schedule an assessment at a reputable addiction treatment center.

But how can you determine if your loved one needs help? Watch for warning signs such as:

Using the drugs in larger doses or for a longer period of time than directed by their doctor
Exaggerating their symptoms so they can get additional prescriptions
Borrowing, stealing, or offering to buy painkillers that were prescribed to someone else
Buying hydrocodone or oxycodone from street dealers or via illicit online sources
Lying about the amount and frequency of their opioid use
Having unexplained financial problems
Exhibiting dramatic shifts in mood, energy, and motivation
Unintentional weight loss
Frequent absenteeism and/or a drop in performance at work or in school

None of these warning signs are irrefutable proof that a person is addicted to opioids. But they can all be signs of a mental or behavioral health condition. Regardless of what type of problem a person has developed, being assessed by a qualified professional can help them understand the scope of the challenge, so they can find the most appropriate type of treatment.

Opioid Overdose: Symptoms & Response

Opioid overdose can occur the first time a person uses hydrocodone or oxycodone. If they become addicted, their risk can increase considerably.

Symptoms of Opioid Overdose

Overdose occurs when a person ingests more of a drug than their body can safely break down an eliminate.

In the case of hydrocodone and oxycodone, typical overdose signs include:

Disorientation
Loss of consciousness and inability to be awakened
Slow, shallow, or otherwise irregular breathing
Slow heart rate and faint pulse
Skin that is cool or clammy to the touch
Blue, purple, or grey coloring on skin near mouth and fingertips

How to Respond to an Opioid Overdose

If you are with someone who exhibits the signs listed above after using an opioid, your response can make a literal life-or-death difference. Here’s how you can help:

Call 911 and remain with them until help arrives.
Roll the person onto their side to prevent them from choking if they vomit.
Place a coat or blanket on them to keep them warm.
Be prepared to tell the emergency responders as much as you know about which drugs they had been using and how much they used.

If you have naloxone (Narcan), administer it either immediately before or directly after you call 911.

Even if the person is revived with Narcan, they still need to be evaluated by a trained professional for several reasons, including:

Narcan only works on opioid overdoses. If the person has other drugs in their system, those substances can still harm them.
Narcan is effective for about 30-90 minutes. Depending on how much hydrocodone or oxycodone the person took, they may still be in danger of overdose after the Narcan wears off.

If a person doesn’t get immediate effective care after overdosing, they may not survive the experience.

The National Institute on Drug Abuse (NIDA) has reported the following about overdose deaths in the U.S. involving hydrocodone, oxycodone, and other prescription opioids:

In 1999, these drugs contributed to 3,442 overdose deaths.
The annual number of overdose deaths involving prescription opioids peaked at 17,029 in 2017. This represented an increase of 394.7% from 1999.
In 2023, prescription opioids were involved in 13,026 overdose deaths. This was a 24% decrease from 2017, but it is still a 278% increase over 1999.

Find Treatment for Opioid Addiction in Northern California

Bright Future Recovery offers detox, residential, outpatient, and virtual programming for adults who have become addicted to opioids and other substances. We also serve clients who have anxiety, depression, and other co-occurring mental health concerns.

To learn more about how we can help you or a loved one, or to schedule a free assessment, please visit our Contact page or call us today.

Hydrocodone vs Oxycodone (What’s the Difference?)