Hydrocodone as a Painkiller

Hydrocodone: An overview of a highly addictive drug

If you have ever had a cough and taken over-the-counter medications, you know sometimes Tylenol and gargling with salt water is not enough to alleviate the discomfort and the nagging unpleasantness of a lingering cough. Hydrocodone is often prescribed as a temporary pain remedy for relief in combination with other drugs to reduce pain and coughing. The drug is present in a number of medications, almost inevitably compounded with other drugs to relieve pain. Hydrocodone is classified as an opiate as well as an antitussive which inhibits cough. "Hydrocodone relieves pain by changing the way the brain and nervous system respond to pain. Hydrocodone relieves cough by decreasing activity in the part of the brain that causes coughing" ("Hydrocodone Combination Products," Medline Plus). However, despite its potential benefits the drug also has an addictive potential which cannot be disregarded. The potential palliative benefits of the drug must be weighed against the potential for abuse.

History

Hydrocodone products come in a number of different formulations including pills and syrups. These may include extended-release capsules or solutions. Standard dosages are every 4 to 6 hours while extended release formats are taken every 12 hours as needed. Hydrocodone has long been controversial because it derives from the opiate family and is similar in composition to oxycodone. Abusers often "crush, snort, or inject the drugs" to enhance the high caused by the drug ("Hydrocodone Combination Products," Medline Plus). Injecting pills to prevent crushing and snorting, however, has become an increasingly common deterrent by drug manufacturers.

The FDA recently approved a new form of hydrocodone. "Zohydro is made from high-dose hydrocodone undiluted with acetaminophen" (Liebelson 1). This move was highly criticized. "This drug will almost certainly cause dependence in the people that are intended to take it" noted one critic, much like hydrocodone in its current form (Liebelson 1). However, the FDA cited the drug's efficacy in its defense. "Researchers gave Zohydro to about 1,500 patients. One phase of the study, which weighed the drug against a sugar pill, showed that subjects taking Zohydro for chronic lower back pain reported less pain than those who received the placebo over a 12-week period" (Liebelson 1). However, the study was controversial because it did not compare the effects of non-pharmaceutical treatments, such as physical therapy, with the hydrocodone variant.

Effect

The primary effect of hydrocodone is pain relief and a relatively mild high. "When describing what the hydrocodone high is like, some users report feeling a sense of euphoria" ("The Effects of Hydrocodone Use," Coalition Against Drug Abuse). Hydrocodone increases the amount of dopamine circulating in the body, a 'feel good' neurotransmitter that is often at a deficit in persons with depression. But over time, the sense of euphoria becomes blunted, resulting in escalating drug tolerance and addiction. However, it should be noted that even non-addicted users experience negative side effects as a result of using the drug, including constipation, fatigue, and nausea ("The Effects of Hydrocodone Use," Coalition Against Drug Abuse). Because the drug causes physical symptoms in users (much like withdrawing from heroin), some kind of support is usually needed to facilitate recovery. Some people become addicted to the drug after being prescribed the medication for pain while others were never prescribed the drug at all and obtain it from a friend. Addiction is possible in both scenarios.

How hydrocodone has impacted the world

While in the short-term painkillers may make people more productive at work and more mobile in general, in the long-term addiction extracts a terrible cost from its victim and also ultimately decreases their subsequent productivity. According to recent estimates by the NIH (National Institute of Healthy), 52 Million people in the U.S. have abused prescription painkillers, most of which come from the opiate family like hydrocodone ("Popping pills," NIH). The problem is particularly pervasive in the U.S. While 5% of the United States is the world's population it consumes 75% of the world's prescription drugs ("Popping pills," NIH). Prescription drugs may be obtained on the Internet or the street, but the most common mechanism of abuse is taking them from a friend A survey of abusers found that "16.6% Bought/took from friend or relative and 54.2% obtained them free from friend or relative ("Popping pills," NIH). The reasons for using prescription drugs cited by abusers are their perceptions that these drugs are safer than illicit medications, despite being the same, chemically speaking, as opiate street drugs like heroin.