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vicodin
vicodine
Hydrocodone
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Hydrocodone
relieves pain. Acetaminophen is a less potent
pain reliever that increases the effects of hydrocodone.
Together, acetaminophen and hydrocodone are most
commonly used to relieve moderate-to-severe pain.
Acetaminophen and hydrocodone may also be used
for purposes other than those listed here. For
more information about hydrocodone ( side effects
, warnings , dosage and more ) click
here.
Vicodin
: Pronounced: VY-koe-din Generic ingredients:
Hydrocodone bitartrate, Acetaminophen .Other brand
names: Anexsia, Co-Gesic, Hydrocet, Lorcet, Lortab,
Maxidone, Norco, Zydone. Vicodin combines a narcotic
analgesic (painkiller) and cough reliever with
a non-narcotic analgesic for the relief of moderate
to moderately severe pain. You can find information
including side effects , dosage , special warnings
and other special information by clicking
here.
Vicodin® is the brand name for the combination
of acetaminophen (Tylenol) and hydrocodone. Vicodin®
is prescribed for moderate to moderately severe
pain. Hydrocodone binds to the pain receptors
in the brain so that the sensation of pain is
reduced. Acetaminophen halts the production of
prostaglandins which otherwise cause pain. Vicodin®
is available in tablet, capsule, and liquid form
and is taken every 4-6 hours by mouth. Since hydrocodone
can be habit forming, care must be taken to follow
the doctor's instructions when taking Vicodin®.
Do not take a larger dose, or take it more frequently,
or take it for longer than the doctor has prescribed.
Just when really serious things like war, disease
and a bummer economy threaten to make the media
business a rather dreary realm, enter the downfall
by drugs of Rush Limbaugh. The drama has spawned
comparisons (he's the "new Elmer Gantry"),
compassion (he's an addict and we should show
mercy even if he didn't show it to others) and
vengeful rebuke (talk about hypocrisy!). Yet the
truth about Limbaugh's fall may be more mundane
than anyone wants to admit, Limbaugh included.
Beyond the cultural politics swirling outside
his detox room door, one truth is clear: What
you don't know can hurt you, especially when it
comes to a little pill called Vicodin, one of
the painkillers Limbaugh is said to have used.
Anyone who's had a tennis injury, root canal
or — at least on the Westside — a
bad hangnail knows Vicodin is good stuff. Not
only does it kill pain but it also, as "Permanent
Midnight" author Jerry Stahl said about heroin,
"makes you feel so good, you feel like calling
the phone company and telling them what a good
job they're doing." Between 1988 and 1998,
the number of prescriptions written per year for
first-time users — most of them middle-
and upper-middle-class — of Vicodin and
similar powerful painkillers grew from 500,000
to 1.6 million. Some of the people who got those
prescriptions have undoubtedly become addicted
to the euphoria they produce.
And yet this aspect of Vicodin is little appreciated
by the prescription-writing medical community.
That is because critical, objective information
about the drug — the kind we are accustomed
to in these days of long FDA reviews and dramatic
advisory committee meetings — is thin at
best.
Hydrocodone (the chemical name of Vicodin's primary
ingredient along with acetaminophen) is one of
hundreds of older drugs that were introduced before
1962, when Congress passed a landmark amendment
to the Food and Drug Act that gave the FDA much
more power to oversee safety and efficacy testing.
But buried in a series of tests done in the 1930s
are a number of troubling facts.
First, a primer: Hydrocodone was first manufactured
in the early 1920s by the German pharmaceutical
company Knoll. As its name denotes, hydrocodone
is the codeine molecule with a hydrogen atom attached.
At the time, Knoll believed hydrogenizing codeine
might make it less toxic and easier on the stomach.
At about the same time, the U.S. government was
searching for an answer to the growing "opium
problem," the thousands of middle-class Americans
who became hooked on opium derivatives then used
as cough suppressants. In 1929, the U.S. Bureau
of Social Hygiene gave the National Research Council
several million dollars to study various new compounds
like hydrocodone, seeking to find a less addictive
painkiller.
To do so, the National Research Council appointed
Dr. Nathan Eddy, a pharmacologist and professor
at the University of Michigan. Eddy's charge was
to assess the safety, efficacy and side effects
of 350 drugs, from morphine and codeine to Dilaudid
and hydrocodone. Efficacy testing was rigorously
carried out on hundreds of laboratory animals.
To find out how well a substance killed pain,
Eddy devised a test in which a cat would be immobilized
by a series of metal clamps; pressure would then
be applied to its tail. A researcher would record
how hard and long the pressure was applied before
the animal "displayed a response." The
animal would then be dosed with any one of a number
of compounds. The researcher would then apply
the same pressure, say, 25 minutes later. If the
animal did not yelp, more pressure would be applied
until the it finally "displayed a response."
The difference between the first number and the
last came to represent the compound's "analgesic
effect."
Fortunately for science, but unfortunately for
the animals, Eddy was a thorough and dogged researcher,
performing these experiments thousands of times.
The results showed, among other things, that hydrocodone
was an effective painkiller with predictable side
effects. But hydrocodone also stood out from the
pack in one remarkable way: It provoked such euphoria
in the animals that Eddy felt compelled to warn
of its abuse potential. Hydrocodone was a good
cough suppressant, he wrote in 1934, but it also
"induced euphoria, and therefore there was
danger of addiction." It produced "excitation
indistinguishable from that produced by morphine
in morphine- tolerant rats."
There was something else that made hydrocodone
different from the other addictive compounds.
As Eddy noted: "Its repeated administration
to dogs and monkeys leads to the development of
tolerance but more slowly than that of morphine
or Dilaudid and to the occurrence of abstinence
syndromes that are less severe than with the other
drugs." Translation: One can become dependent
on it without knowing one is dependent on it —
until one is really hooked.
Eddy never found a nonaddictive analgesic, but
hydrocodone and a number of other drugs he tested
did work their way into the U.S. drug system.
No one disputed that the drug was effective, and
when prescribed in the less-is-more fashion with
which painkillers used to be prescribed, it was
quite safe.
Approaches to pain medication changed dramatically
in the late 1980s, when advocates for pain patients
finally convinced medical authorities to loosen
their grip on the pills. Their contention —
a righteous one — was that bona fide pain
patients were routinely undermedicated despite
the existence of drugs that could alleviate their
suffering. The American Medical Assn. and other
medical groups issued guidelines to physicians
encouraging more aggressive prescribing. Pain
was dubbed the "fifth vital sign." Pharmaceutical
manufacturers seized the opportunity; samples
of hydrocodone, sold as Vicodin, were handed out
to pain specialists — and also to dentists,
family practitioners and any other physician who
might have patients with pain. Generic manufacturers
— five in the last eight years — jumped
on the bandwagon, making the drug affordable.
As prescribing culture changed, so did patient
culture. Increasingly, patients were encouraged
to "take a more proactive role" in their
care. That's not a bad attitude in general, but
misapplied to pain it can be disastrous, says
Dr. Clifford Bernstein, a pain and addiction specialist
at the Waismann Institute in Beverly Hills. "They
[patients] find out that Vicodin rounds out the
corners of life. Some of them actually think they
deserve it, and are ingenious at finding ways
to get it."
His colleague agrees. "All of the attributes
of the winner in today's economy — problem-solving,
learning a system and knowing how it works —
that's exactly what an addict needs to do,"
says Dr. David Crausman, a Beverly Hills psychologist
who treats many middle-class dopers. "They've
read the Physicians' Desk Reference. They read
the medical journals so they can tell you, for
example, that they are on certain other drugs
that preclude you from prescribing a non-opioid."
Yet these habits are now coming with bigger costs
— costs like broken careers, broken marriages
and broken bodies. Chronic abuse can cause liver
problems if the hydrocodone is mixed with acetaminophen,
as it is in Vicodin. Two studies of abusers strongly
implicate the drug in sudden and profound hearing
loss.
We may be finding out that a drug for a stoic
pharmaceutical culture may not be such a good
drug for a more permissive culture. As UCLA's
Dr. Robert Baloh, a co-author of a study published
in Neurology in 2000, puts it, "The question
for me is this: Who ever thought that plain old
Vicodin would ever become the recreational drug
of choice?"
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