By Curtis Alexander, Pharm.D.
America’s Natural Pharmacist
Summary: Opiate withdrawal is a very real possibility when you have been taking opiates long term, especially one year or longer. While, the drug itself may no longer be in your system the receptors in your body will still be responding to the changes that the drug caused in them.
Dear Curtis: Could you please tell me how long Vicodin® stays in your system if you have been taking it for several years?
My Answer: There are actually two parts to your question. First, how long the Vicodin will stay in your system (i.e., how long you’ll show up with measurable blood levels). Secondly, and more importantly for someone in your position whose been taking a pain killer (called an opiate) for years like you have, is your risk of running across opiate withdrawal symptoms.
So, let’s tackle the blood level question.
When we are looking at any drugs we can calculate about how long the drug will be able to be measured in your blood. Pharmacists do this by using a property called half life. Essentially what this means is each and every substance has a half life. Now, Vicodin actually contains two drugs: hydrocodone (the pain killing opiate) and acetaminophen (or plain old Tylenol). For your question I’m only going to focus on the opiate part of Vicodin.
Hydrocodone has a half life of roughly four hours. So, in 4 hours roughly half of the drug has been eliminated from your system. As a general rule pharmacist and doctors consider the drug to be gone, or reach unmeasurable levels, within 5 half lives. So, if the half life is four hours the hydrocodone portion of Vicodin will be eliminated from your body within 20 hours. So, within a day, it should be out of your system. This is one of the reasons why you must dose Vicodin every 4 to 6 hours – because it’s half life is relatively short and if you didn’t you wouldn’t maintain high and level enough amounts of the drug in your blood to do it’s job.
Serious Concerns of Opiate Withdrawals
Withdrawal from opiates is a very real concern especially for someone who has been on them for years. Of course, the lower the dose the easier time you’ll have getting off them. But you do want to proceed slowly. Recently, I had a patient who was on extremely high doses of narcotics for years who was sick and tired of being on them. In a fit, she decided to go cold turkey. She basically went through two weeks of pure hell until she started feeling human again. Skin crawling, nausea, uncontrollable vomiting, sweating. You name it – she had it.
She’s thankful now and said that she will never go on another narcotic but doing what she did is something you should NEVER do – people have died from trying that. She’s fortunate she didn’t.
But, back to getting off your Vicodin. When you start taking a drug like Vicodin there is a phenomenon called neuroadaptation. This bascially means that your neurons and receptors get ‘numb’ to the effects of the drug. So, to get the same effect you may find you have to start increasing the dose.
Now, will you have withdrawal symptoms? It’s hard to tell because each person is different. But, from the fact that you’ve been taking it for years I would venture to guess that, Yes, you will. Obvisouly, this is something you have to talk to your doctor about but he/she will likely recommend a slow step down therapy. So, for example, if you have been taking 1-2 tablets every 4 to 6 hours he will likely have you cut that down to 1 tablet every 4 to 6 hours for a week or so then drop down to 1 tab every 8 hours or something similar.
This is much less of a shock to your system and is a lot more maneagable. Also, you should talk to your doctor about magnesium and zinc supplementation which will help as will avoiding alcohol and caffeine during this time which can make your symptoms worse.
