Oxycodone and Hydrocodone: What’s the Difference?

Oxycodone and hydrocodone have much in common. Both are powerful opioid medications prescribed for pain and both present a significant risk of dependence and addiction. The misuse of both drugs has risen dramatically in the past few years.

However, in spite of their many similarities, there are significant differences between oxycodone and hydrocodone.

How they are Prescribed?


Oxycodone is prescribed for people with moderate to severe pain. It generally isn’t taken on an as-needed basis like aspirin or ibuprofen, but is used every few hours around the clock.

Oxycodone is sold under a number of brand names, including OxyContin, and Roxicodone, although it is commonly known as “oxy.” When combined with acetaminophen, hydrocodone is sold by brand names such as Percocet, Endocet or Narvox. A similar drug known as OxyNorm is sold in Europe.


Hydrocodone is known by a number of brand names, including Vicodin, Lortab and Hycodan. The pure form of hydrocodone is known by the brand name Zyhydro. Hydrocodone is usually taken every 12 hours. Like oxycodone, it is used to treat long-term pain.

When hydrocodone is combined with ibuprofen, it is sold as Reprexain or Vicoprofen. Hydrocodone is tightly controlled and rarely prescribed in most European countries.

In the United States, hydrocodone is prescribed for moderate to severe pain, usually caused by chronic or long-term conditions or following surgery or an injury. A syrup form of hydrocodone is prescribed to treat severe coughs.

It appears that hydrocodone is somewhat more likely to result in addiction. It is the most abused opioid drug in the U.S.

How Addictive are Oxycodone and Hydrocodone?

Both drugs are highly addictive and users can become dependent when the drugs are taken over a long period of time, even if used exactly as a doctor prescribes. Both are dangerous when used with alcohol or benzodiazepines such as diazepam (Valium), alprazolam (Xanax), or clonazepam (Klonopin).

Researchers at Washington University School of Medicine and Nova Southeastern University found that oxycodone produces a high that makes it the most popular choice for opioid drug abusers who were surveyed in rehab, with hydrocodone coming in second.

This preference for oxycodone is likely because hydrocodone is usually combined with acetaminophen or other pain control medications, which makes it more difficult to inject or snort.

Both drugs are intended primarily for oral use, but researchers found that nearly 64 percent of oxycodone abusers crush and inhaled the pills, compared to slightly over 25 percent of hydrocodone abusers.

Approximately 20 percent of oxycodone abusers admitted that they dissolved the drug in water and injected it, compared to less than five percent of those who abuse hydrocodone. (OxyContin is now available in a form that is more difficult to inject or snort.)

Oxycodone, which is available in its pure form, tends to be the drug of choice for young, male drug abusers who are inclined to purchase the drug on the street or via doctor shopping. Hydrocodone is more popular among women and the elderly, who prefer to get drugs from a physician or friend.

It’s important to note that not all hydrocone and oxycodone abusers become addicted because they misused the drug to get high. Many people become addicted to the medications in an attempt to control severe pain. In time, tolerance develops; the drug becomes less effective and larger doses are needed to provide pain control.


If you suspect you have a problem with hydrocodone, oxycodone or other painkillers, seek treatment as soon as possible. Never stop the drug suddenly. Trained medical staff at a drug and alcohol treatment facility or detox clinic can help you stop the drug gradually, thus reducing many of the unpleasant (and sometimes dangerous) effects of withdrawal.

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