How to help a friend with possible Vicodin Addiction?

You are right in believing that she is becoming dependent on the Vicodin. These type of drugs are for the management of short term pain, not chronic long term pain. Three years is a ridiculously long time to be taking them and 6 a day is definitely excessive. You are a good friend to be concerned for her and would not be overstepping any boundaries by going to the Doctor with her. I am not sure that telling the family is necessary at this stage since she will probably consider that a betrayal. Let the Dr. know she is taking 6 a day, he is probably prescribing three or four a day. 800 mg. of ibuprofen may help her pain while she slowly reduces her Vicodin dosage. Tell the Doctor that you will help her wean off the medication and offer to help with her husband so she can have the surgery. Be compassionate and empathetic but stay strong. She really needs you right now and the Doctor will probably be thankful for your help.