Understanding Drug Dependence
Vicodin, The Other Killer Narcotic
There is a joke being told by a number of comics: “I am on Vicodin that I got when my wisdom teeth were pulled--eight months ago.” They think it’s funny. However, to many people it is not funny. To some, Vicodin is the drug that started their son, daughter, father mother, brother, sister or friend on the path that led to a drug overdose and death.
THE ROLE OF PAIN
People have always experienced pain. Pain is an annoying and sometimes unbearable result of having a body that can be damaged.
Pain is the body's signal that there is trouble. If you didn't feel pain, then you could place your hand on a hot stove and only realize there was a problem when you smelled the burning flesh. You would continue lifting an object that was too heavy until you seriously damaged your back.
You would not feel the decay in the tooth until the only solution was to have the diseased tooth removed. We could go on and on with examples, but pain is actually a signal that warns us that something is wrong with the body. It is no more and no less than this.
WHY THE INCREASE IN NARCOTIC USE?
No one likes to be in pain. No one likes to see someone in pain. However, this society has increasingly become a society that looks not to a solution but to something that hides the real problem.
If our children are telling us that they are bored or we want them to be occupied so we can do something else, we often put them in front of the television. We do this in spite of the fact that study after study has shown a direct correlation between the amount of time watching television and a decrease in IQ.
We do this instead of working with the children to find the real source of their “boredom” and find productive ways to let them handle the boredom without making them television zombies.
A dentist extracts a wisdom tooth and prescribes not aspirin but a dangerous narcotic like Vicodin, not to help the gum heal, but simply to block the feeling of pain.
Why? One reason is that no doctor likes to get calls from people who say that they are hurting. They know that the narcotic may be more than is really needed, but they believe that giving this narcotic will make it less likely that the patient will call and complain. Another reason may be related to marketing -- a patient who doesn't complain about the pain will likely be a patient who will return and send others.
Vicodin is a combination of two drugs—hydrocodone and acetaminophen.
Hydrocodone has been available in the United States since 1943. Hydrocodone provides more pain relief (analgesia) than codeine, but it is less effective than morphine. It is considered to be about 66% as effective oxycodone, the active ingredient in OxyContin.
Hydrocodone is highly addictive—as tens of thousands can attest. It is a Schedule II drug—just like oxycodone. Presently, when less than 15 milligrams of hydrocodone is combined with another drug such as acetaminophen, then the combined drug becomes a Schedule III drug. However, the Drug Enforcement Agency is considering making these combined drugs Schedule II as well because they recognize that they are becoming more and more abused and creating more and more harm.
In 2006, there were 131 million prescriptions written for products containing hydrocodone. This makes it the most frequently prescribed opioid in the United States. The hydrocodone and acetaminophen combination is prescribed the most of any of the other hydrocodone combinations. Besides Vicodin, other common hydrocodone/acetaminophen drugs are:
The second ingredient in Vicodin is acetaminophen. Available in the United States since 1955 when it was introduced as Tylenol, acetaminophen has become a favorite drug for controlling pain (analgesia) or fever (anti-pyretic). On prescription medicine containers, the label will say “acetaminophen” or “APAP.” As drops, syrups and capsules, it is also combined with other active ingredients and used to treat:
• symptoms of colds and flu
DANGERS OF ACETAMINOPHEN
One of the primary tasks of the liver is to metabolize foods and drugs and cause any unused parts to be removed from the body. When acetaminophen is metabolized, there is a metabolite (a product of the metabolism) that is very toxic to the liver. Ideally, the liver will process the toxic metabolite and eliminate it from the body. However, the liver can be damaged because:
• Genetic problems interfere with eliminating the toxic metabolite from the body;
• Too much acetaminophen has been ingested, leading to more of the toxic metabolite than the liver can handle.
Obviously, taking a drug containing acetaminophen is even more of a risk if you are drinking alcohol, more than three to four drinks a day, or if you already have liver problems. Your weakened liver will likely have less ability to eliminate the toxic acetaminophen metabolite and this will damage the liver even more.
But, unlike damage to the liver caused by alcohol or disease which normally develops over years, acetaminophen can cause acute liver failure quickly—sometimes in as little as 48 hours. Often a person who has suffered acetaminophen liver damage will not know that they have a problem until real damage has been done. The symptoms may not start for several days and even then the symptoms may seem to be just the flu. This creates a problem because liver damage is not easily treated unless diagnosed quickly.
Acute liver damage can result in needing a liver transplant or even death, but most people do not have this serious an outcome even though it can create problems requiring hospitalization and may damage the liver in ways that interfere with its vital functions. There are tens of thousands of emergency room visits linked to acetaminophen.
One of the largest problems is that people assume that they are taking Tylenol and there is no danger in taking a few extra if their headache doesn't ease or taking an additional drug containing acetaminophen for the beginning of a cold. If someone is taking a prescription drug like Vicodin which contains acetaminophen, and then takes over-the-counter cough syrup or Tylenol, this can cause them to ingest too much acetaminophen which can lead to acute liver damage.
So Vicodin is a combination of two dangerous drugs:
• The highly addictive narcotic hydrocodone
• The dangerous drug acetaminophen
Vicodin, or a product containing the same combination of hydrocodone and acetaminophen, is produced by a number of companies. Each pill will generally have between five and ten milligrams of hydrocodone and 500 to 750 milligrams of acetaminophen.
SIDE EFFECTS OF VICODIN
Vicodin and other combination hydrocodone acetaminophen drugs can have these side effects:
• Mental confusion
• Mood changes
• Slowed reaction times
• Respiratory depression
• Hearing impairment or permanent loss
• Liver damage
• Liver failure
WHY THE FDA ADVISORY PANEL VOTED TO RECALL VICODIN
The FDA routinely assembles a team of professionals who will examine various drugs and make recommendations. On June 29 and 30, 2009, an advisory committee meeting was convened about how to address the problem of liver injury related to the use of acetaminophen in both over-the-counter (OTC) and prescription products. More than 400 people per year die, and 42,000 are hospitalized, from overdoses due to drugs that use acetaminophen.
The advisory panel recommended:
• Reduce the maximum single dose from 1,000 milligrams to 625 milligrams;
• Reduce the maximum daily dose from 4 grams to 2.5 grams;
• Require liquid preparations containing acetaminophen to be easily understood;
• Remove from the market Vicodin, Percocet and five other prescription painkillers that combine acetaminophen and any narcotics;
• If the prescription drugs are kept on the market, the FDA should mandate that the drugs carry a “black box” warning, which is the strongest warning that can be placed on a prescription medication.
Vicodin dependence and addiction can be deadly, not only because of the dangerous narcotic hydrocodone, but because of the hidden killer—acetaminophen. A person who finds that they need to take more and more Vicodin to get high or stop the withdrawal symptoms is also taking more and more acetaminophen. If a person is taking ten Vicodin pills containing 7.5 milligrams of hydrocodone and 750 milligrams of acetaminophen, they are taking more than three times the maximum dose recommended by the advisory panel.
Frequently, these people are also taking Tylenol-type drugs for headaches, coughs or other ills and this just adds more acetaminophen.
We hope that the FDA listens to the recommendations of its own advisory panel and takes Vicodin off the market. Yes, the addicts will move to other narcotics, but at least we will eliminate many of the health problems that can come from a person who is not addicted and who takes Vicodin and then adds additional over-the-counter drugs with acetaminophen and has a serious liver problem or even dies.
Maybe, also, some people now prescribing Vicodin-type drugs will look to other non-narcotic drugs that studies have shown may provide a similar level of pain relief for most people.
At Novus Medical Detox Center, we specialize in helping people find a cure to the problems caused by drugs and alcohol. People come to us for a safe and more comfortable:
• OxyContin detox;
• Vicodin detox;
• Oxycodone detox;
• Methadone detox;
• Heroin detox;
• Hydrocodone detox;
• Alcohol detox;
• Paxil and Zoloft detox;
• Detox from other unwanted drugs.
Please contact us if we can help someone that you know.
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