Vicodin 101: Pros and Cons of Vicodin

America has fallen hard for Vicodin. It was love at first sight when Uncle Sam first laid eyes on Vicodin in 1978. Thirty-four years later, the infatuation still holds strong: With over 131 million prescriptions filled in 2011, Vicodin is the most popular drug in the nation.

The United States makes up only 4.6 percent of the world’s population, but we consume 99% of the world’s hydrocodone, the active ingredient of Vicodin.

Why is Vicodin so Popular?

Two reasons: It works, and we can get it.

It works.

Vicodin is a very effective painkiller. As a combination of acetaminophen and hydrocodone, Vicodin targets two pain mechanisms simultaneously.

Acetaminophen and hydrocodone also have a synergistic effect, which means the combined effects of these drugs are greater than the sum of their individual effects. If the effect of acetaminophen was rated 2 and hydrocodone was rated 3, their combined effect should equal 5. But since they have a synergistic effect, their combined effect actually is greater than 5.  (It is only here that you can you say that 2 + 3 = 6. Cool, huh?)

It is easily available.

Unlike OxyContin or morphine, Vicodin is a Schedule II opioid. This means it can be called in to the pharmacy and refilled.

Although the advantages are significant, Vicodin is not without its flaws–and dangers.

Why is Vicodin dangerous?

Vicodin is dangerous because it contains a lot of acetaminophen (which is bad for your liver) and because it carries a strong potential for abuse. The good news is that both of these can be avoided if an individual adheres to prescription instructions.


Acetaminophen is toxic for your liver, and acetaminophen-induced liver injury is potentially life threatening. A typical Vicodin pill contains 5 mg hydrocodone and 500 mg of acetaminophen. That’s a lot of acetaminophen. The daily dosage of acetaminophen should not exceed 4,000 mg.  Taking 1,000 mg (1 gram) of acetaminophen at one time could cause permanent liver damage if done regularly.

A person who drinks more than two alcoholic beverages should not take more than 2,000 mg, and a person taking any other medication with acetaminophen (Percocet, Tylenol), should take care that their daily dosage does not pass 4,000 mg.


Hydrocodone is a powerful opioid that binds to opioid receptors in the brain. This produces pain relief and euphoria. Hydrocodone also affects the brain’s reward pathway, the pathway responsible for feelings of pleasure and well-being. However, long term use of hydrocodone alters the function of the reward pathway, until the brain completely relies on the opioid to produce even normal feelings of well-being. Though the euphoric effects are long gone, an addicted individual needs the drug simply to feel normal. Stopping results in extreme emotional lows as well as painful physical withdrawal effects.


In summary, Vicodin is extremely beneficial when used correctly. When taken as prescribed, Vicodin can effectively treat your pain and carry a low risk of addiction.