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Hydrocodone Vs. Oxycodone: What’s The Difference?

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Medically Reviewed By: Diana Vo, LMFT

October 11, 2023

Table of Contents

Hydrocodone and oxycodone, both Schedule II semi-synthetic opioids, are prescribed for moderate to severe pain relief. They share chemical similarities and both bind to mu-opioid receptors in the brain to disrupt pain signals. These medications can slow down breathing and digestion. Due to their high addiction potential, it is vital to follow prescription instructions.

In this guide, you will learn:

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  • Is hydrocodone same as oxycodone?
  • Hydrocodone vs. oxycodone: what’s the difference?
  • How can you connect with opioid addiction treatment in Southern California?

Difference Between Oxycodone and Hydrocodone

When it comes to opioid pain medications, two commonly prescribed drugs are hydrocodone and oxycodone. While they belong to the same class of drugs and share similarities, there are also some important differences to be aware of. Read on to discover the similarities and differences of hydrocodone compared to oxycodone.


  • Origin: Hydrocodone and oxycodone are synthetic opioids produced in laboratories. However, while oxycodone is synthesized from thebaine, hydrocodone is synthesized from codeine.
  • Medical uses: Both oxycodone and hydrocodone are indicated for the treatment of severe pain. Additionally, hydrocodone may be prescribed as a cough suppressant since it is derived from codeine.
  • Chemical structure: The chemical structures of oxycodone and hydrocodone are almost identical, with the only difference being that oxycodone has an additional oxygen atom. Although a small distinction, it is still significant.
  • Side effects: There is considerable overlap in the side effects of hydrocodone and oxycodone. Hydrocodone may trigger more severe stomach pain and GI issues like constipation. Common oxycodone side effects that are less prominent with hydrocodone use include headaches, drowsiness, and dizziness.
  • Formulations: Oxycodone is available in extended-release forms of 10mg, 20mg, 40mg, and 80mg, as well as immediate-release capsules of 5mg. It is shaped like an oval and comes in various colors. Oxycodone can also be administered as an injectable. Hydrocodone is typically prescribed as tablets of 2.5mg, 5mg, 7.5mg, and 10mg, which are commonly white, yellow, or orange. It is also available in liquid form and as transdermal patches.
  • Intoxication: Those who misuse opioids have reported experiencing different types of highs with oxycodone and hydrocodone. In a study of 3,000 people with opioid addictions, 75% used either oxycodone or hydrocodone. Among them, 54% expressed a preference for oxycodone over hydrocodone due to the perceived stronger high associated with oxycodone. These individuals believed that the acetaminophen content in hydrocodone acted as a deterrent to consuming more of the drug to intensify the euphoric effects.


  • Mechanism of action: Both hydrocodone and oxycodone share a common mechanism of action. They exert their effects by binding to MOR (mu-opioid receptors) in the brain, spinal cord, and other parts of the body. By binding to these receptors, hydrocodone and oxycodone alter the perception of pain and produce analgesic effects. This interaction with opioid receptors helps to reduce pain sensations and provides relief for individuals experiencing moderate to severe pain.
  • Medical uses: Hydrocodone and oxycodone are prescribed for similar medical indications. Both medications are commonly utilized in the management of moderate to severe pain resulting from various conditions, including post-surgical pain, injuries, and chronic pain conditions like arthritis or back pain. Their potency and effectiveness make them valuable options for pain relief when other non-opioid treatments have proven ineffective.
  • Addictive potential: Both hydrocodone and oxycodone possess an addictive potential. Due to their opioid properties, prolonged use or misuse of these medications can lead to physical dependence and addiction. They should be taken strictly as prescribed by healthcare professionals, and patients should be closely monitored to minimize the risk of addiction. Both substances are Schedule II controlled narcotics.
  • Similar pain-relieving properties: Hydrocodone and oxycodone exhibit comparable pain-relieving properties. They are effective in managing moderate to severe pain by suppressing the transmission of pain signals in the central nervous system. These medications provide relief and improve the quality of life for individuals suffering from acute or chronic pain conditions.
  • Side effects: Hydrocodone and oxycodone share some common side effects. In addition to the desired effects of pain relief and a sense of euphoria, there are potential negative side effects associated with their use. These can include irregularities in heartbeat, hives, dry mouth, nausea, vomiting, swelling of the face (including lips and tongue), and difficulty breathing. It is important to be aware of these possible adverse effects and report them to a healthcare professional if they occur.

While hydrocodone and oxycodone have similarities in their mechanism of action, medical uses, and side effects, it is essential to approach their use with caution, under the guidance of healthcare professionals. Careful monitoring, adherence to prescribed dosages, and open communication with healthcare providers can help maximize their benefits while minimizing the risks associated with their use.

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Addiction to Hydrocodone Vs. Oxycodone

Hydrocodone and oxycodone share a high potential for addiction and abuse due to their opioid properties. Misuse or prolonged use of these medications can lead to physical and psychological dependence. The risk of addiction is influenced by various factors, including personal susceptibility, dosage, duration of use, and individual medical history.

Addiction Similarities & Differences

Like all opioids, hydrocodone and oxycodone have a strong potential for addiction. Sustained use or misuse of these medications can trigger the development of physiological dependence and psychological addiction. The brain’s reward system can be affected, leading to cravings and compulsive drug-seeking behavior.

Oxycodone may have a higher abuse potential compared to hydrocodone. This is believed to be partly due to the differences in their formulations. Hydrocodone is often combined with non-opioid pain relievers like acetaminophen or ibuprofen, which can act as a deterrent to misuse. Oxycodone, by contrast, is a single-ingredient opioid medication, making it more prone to misuse or diversion.

Individual responses to these medications may vary, and susceptibility to addiction may differ among individuals. Factors such as personal history of substance abuse, genetics, and mental health conditions can also contribute to the risk of addiction. 

Treatment Similarities & Differences

When it comes to treating opioid use disorder, both hydrocodone and oxycodone require similar approaches to promote recovery and reduce the harm caused by addiction. That said, there are some notable differences in the specific treatment options available.

Similarities in Treatment

Both hydrocodone and oxycodone addiction can be effectively addressed through MAT (medication-assisted treatment). MAT combines the use of FDA-approved medications with behavioral interventions to support individuals in their recovery journey. The primary medications used in MAT for opioid use disorder are opioid agonists like methadone or buprenorphine, which help manage cravings and withdrawal symptoms. These medications work by targeting the same opioid receptors in the brain that hydrocodone and oxycodone affect.

CBT (cognitive behavioral therapy) is a widely utilized therapeutic approach in the treatment of opioid addiction, regardless of the specific opioid involved. CBT helps individuals identify and modify negative thoughts, emotions, and behaviors associated with substance use. It focuses on developing healthier coping strategies, building resilience, and promoting long-term recovery.

Differences in Treatment

Treatment plans for hydrocodone and oxycodone addiction will vary based on individual needs and circumstances. Factors such as the severity of addiction, medical history, and personal preferences are taken into account to tailor the treatment approach accordingly.

While both hydrocodone and oxycodone addiction can be addressed using MAT, the choice of medication may differ. Buprenorphine, for example, is commonly used in the treatment of opioid use disorder involving oxycodone, while methadone may be preferred for cases related to hydrocodone. The specific medication prescribed will depend on factors such as the individual’s response to different medications and their treatment goals.

The duration and intensity of treatment can also vary based on individual needs. Some individuals may require more intensive treatment, such as residential rehabilitation programs or partial hospitalization, while others may benefit from outpatient programs or intensive outpatient treatment. The treatment duration will depend on factors such as the progress made, level of support needed, and individual goals.

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Get Treatment for Hydrocodone and Oxycodone Addiction at Renaissance Recovery

Engage with effective hydrocodone addiction treatment at Renaissance Recovery near Laguna Beach. Begin your recovery with our supervised medical detox, featuring medication-assisted treatment to ease withdrawal symptoms and cravings. Transition seamlessly into our inpatient program, PHP, IOP, or dual diagnosis program for comprehensive care. 
Our evidence-based interventions and holistic therapies include group and individual counseling, psychotherapy (CBT and DBT), family therapy, holistic treatments, and aftercare. Immediate assistance is available at 866.330.9449.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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