Tarun Gupta asked:


Hydrocodone or dihydrocodeinone is a semi-synthetic opioid derived from two of the naturally occurring opiates, codeine and thebaine.

Hydrocodone Prescription, Dosage & Administration:

Hydrocodone is an orally active, narcotic analgesic and antitussive. Being a narcotic analgesic, it is prescribed for the relief of moderate to severe pain & being a antitussive, it is prescribed as a medicine used to suppress or relieve coughing.

Hydrocodone comes both as a tablet and also in liquid form & thus can easily be taken orally. 5 mg of hydrocodone is equivalent to 30 mg of codeine when administered orally. Earlier hydrocodone and morphine were considered equipotent for pain control in humans. However, it is now considered that a dose of 15 mg of hydrocodone is equivalent to 10 mg of morphine. Hydrocodone is considered to be morphine-like in all respects and thus, final dosage is adjusted by physician according to the severity of the pain and the response of the patient.

Hydrocodone Abuse:

Vicodin i.e. hydrocodone in combination with acetaminophen, is a commonly abused version of hydrocodone in United States and Canada. Vicodin, as with all narcotic analgesics, can be habit forming—causing dependence, tolerance, and withdrawal symptoms if not used as it is prescribed. The presence of acetaminophen in hydrocodone-containing products deters many drug users from taking excessive amounts.

Effects of Hydrocodone Abuse:

Some of the common side effects of drug abuse include dizziness, lightheadedness, nausea, drowsiness, euphoria, vomiting, and constipation. Some of the lesser common side effects are various allergic reactions, blood disorders, mood swings, mental fogginess, anxiety, lethargy, difficulty in urinating, ureter spasms, rashes and irregular or depressed respiration etc.

Physical Dependence on Hydrocodone:

Opioid analgesics such as Hydrocodone may cause psychological and physical dependence. Physical dependence results in withdrawal symptoms in patients who abruptly discontinue the drug. Physical dependence usually does not occur to a clinically significant degree until after several weeks of continued opioid usage, but it may occur after as little as a week of opioid use.

Commercial Status in United States:

There are over 200 products containing hydrocodone in the U.S. When sold commercially in the US, hydrocodone is always combined with another medication due to a separate federal regulation. In its most usual forms, hydrocodone is combined with acetaminophen. Such commercial hydrocodone products which are combined with acetaminophen are known by various trademark names such as Vicodin & Lortab. Hydrocodone also can be combined with aspirin (Trade name: Lortab ASA), ibuprofen (Trade name: Vicoprofen), & certain antihistamines (Trade name: Hycomine).

Pure Hydrocodone tablets or capsules are not offered currently by any USA drug company. The cough preparation Codiclear DH is the purest available US hydrocodone item, containing guaifenesin and small amounts of ethanol as active ingredients.

With such a huge number of Hydrocodone containing products, the possibility of misuse and addiction remains substantial. As a result, Sales and production of this drug has increased significantly in recent years & so has its diversion and illicit use. To limit abuse of opioid drugs like Dilaudid it is necessary to properly assess the patient, employ proper prescription practices, periodically re-evaluate the opioid therapy, and properly dispense and store the drugs.

Hydrocodone Testing:

Hydrocodone may not cause a positive result in a standard opiate urine test. Many opiate tests test only for morphine (which both codeine and heroin break down into). This is true for both home/business kits and laboratory testing.

However, there are several specialized home and laboratory testing kits available that specifically detects hydrocodone (& hydromorphone, its metabolic product). So test results usually depend on the particular type of test that is used and whether or not laboratory verification is done. If a home drug test is given and the opiate test shows a positive result (due to hydromorphone use), laboratory verification might not result in a positive test because the lab may only test for morphine.



ROBERT

Jeffrey T. Junig asked:


Many people go to their doctors for treatment of an injury and are given a narcotic medication like vicodin or Percocet. These medications work initially, but over time two things happen; they tend to lose their effectiveness, and when a person stops taking them the person feels very sick. Both of these are signs of physical dependence, and are referred to as tolerance and withdrawal.

The medications that people take for pain relief have effects on how the person feels that go beyond their help with pain; people feel a sense of warmth and pleasure from the medication and often use the medication to temporarily relieve anxiety, tenseness, insomnia, or even fatigue. When the medications are stopped on the other hand the person has ‘rebound’ of these symptoms, and feels much worse than before starting the medication. Because of tolerance, patients often take more pills than prescribed, causing them to run out early; when they call the doctor they are suddenly treated as if they have done something wrong. Sometimes they are scolded; perhaps it is even worse when nobody says anything out loud, but instead the patients detects ‘little looks’ from the doctor’s staff or rude treatment that suggests that people in the office are thinking of them in a negative way. Patients wonder if they are imagining things, or if people are really talking about them.

Trouble at Home

At home the patient on pain pills becomes more and more irritable. He is worried about running out early and having the return of pain, or even withdrawal symptoms. He feels sick more often. He has become more depressed. He starts to feel as if nobody understands him, and he takes more and more of the pain pills to try to keep his mood and energy level up so that he can go to work. The fights at home become more and more frequent, and he feels more and more alone inside.

Recreational Use of Pain Pills

In other cases this same sequence will occur, but instead of starting win injury it starts with experimentation. A person is given the pills by a friend, or finds them in a parent’s medicine cabinet. Or maybe the person has been feeling down, and notices that the codeine that they took for their wisdom tooth surgery made them feel better, and so makes up an injury so that the doctor will prescribe more. In all of these cases the people involved become more and more depressed and more and more sick and tired, eventually reaching a level of desperation. This is the good outcome; other people find medications that are more and more potent, and accidentally take too much— causing a fatal respiratory arrest.

Treatment Options

Until recently there was one primary treatment for this type of addiction— residential treatment for one to three months in a treatment center. Yes, another option is to attend AA or NA (Narcotics Anonymous) meetings, but meetings alone rarely make headway against opiate dependence. Another option that has been available is ‘maintenance treatment’ in a methadone program. This type of treatment carries a number of inconveniences, including the need to report to the treatment center each morning to receive the medication.

We now have a third treatment option— buprenorphine or Suboxone— that has saved countless lives. This treatment option is almost universally effective given one requirement: the person must be truly sick and tired of taking the pills and must be motivated to get better.

If you or a loved one suffers from addiction to these medications I strongly encourage you to seek out more information and to learn about your options. Life is too short to remain miserable.



MARC