More Powerful Painkiller Has Experts Worried

[NashVegas]

Drug companies are working to develop a pure, more powerful version of the nation’s second-most-abused medicine, which has addiction experts worried that it could unleash a new wave of abuse.

The new pills contain the highly addictive painkiller hydrocodone, packing up to 10 times the amount of the drug as existing medications such as Vicodin. Four companies have begun patient testing, and one of them — Zogenix of San Diego — plans to apply early next year to begin marketing its product, Zohydro.

If approved, it would mark the first time patients could legally buy pure hydrocodone. Existing products combine the drug with nonaddictive painkillers such as acetaminophen.
...
The companies say a pure hydrocodone pill would avoid liver problems linked to high doses of acetaminophen, an ingredient in products like Vicodin. They also say patients will be more closely supervised because, by law, they will have to return to their doctors each time they need more pills.

http://www.tennessean.com/article/20111227/NEWS07/312270018/More-powerful-painkiller-has-experts-worried

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Why should anyone delude themselves this is not being created specifically for the prescription-pill abuse market? How much Tylenol is a non-addict getting in the regular drug?

[Uben]

1. Some liver ailments do not tolerate acetaminphen or asprin products.....

....so I can see the necessity of such a product. But, does the addiction factor outweigh the benefits received?

[NashVegas]

10. If That Be the Case

Why not just offer a standard dose without the filler?

[TheWraith]

25. Because the "filler" as you put it is also a painkiller.

Without it, the pills aren't nearly as effective as usual.

[eShirl]

2. It is being created specifically for the people whose pain is that severe.

Their pain is that severe and they didn't do anything wrong; why should they have to suffer in agony because of what someone else is doing?

[treestar]

3. That struck me too

Why are they more worried about potential abusers than about the people who would benefit from it?

[cyberpj]

9. Because of the huge number of "pill mills" out there and the problems they create.

If you've ever seen the Vanguard program on Current -- or even one of the 60 minute specials on this you'd understand the caution.

[cthulu2016]

11. That is a reason to address pill-mills, not to ban effective medicines

[closeupready]

33. Forget it. People today don't use their brains, they are force-fed nonsense

and swallow it like kool-aid. Not directing that at anyone specific, but I've tried to have this discussion with real people, and they just give me this dumb, deer-in-the-headlights look, as if to say, "But wait - that's not in the script - what's my line???"

[Ichingcarpenter]

12. My mother was given morphine at the end

of her fight with cancer... its not handed out except in extreme cases.

I think the fear here is that this new med will be handed out like Oxycodone and Hydrocodone are these days for anything minor.

[cthulu2016]

19. But it IS hydrocodone

That's the point... it is the same old hydrocodone without an NSAID added to it.

The fact that a pill contains ten times the amount is an absurd concern... that means it is the same as taking ten smaller pills, or one half of a pill twice the size.

But pills, even at pill-mills, are not dispensed by the pill. They are dispensed by the milligram of the agent involved.

The concern here is bizarre... it assumes that abusers will get ten times more of the drug.

Why?

[cyberpj]

4. ..."up to 10 times" the 'now' amount?!

snip-
The new pills contain the highly addictive painkiller hydrocodone, packing up to 10 times the amount of the drug as existing medications...

Seems a bit much, doesn't it?

Aren't there enough pill mills around creating enough addicts?

What will 10x amts do to that problem and the addicts it creates?

[tridim]

8. It'll make the drug dealers (at all levels) 10 times richer.

[cthulu2016]

5. Have you ever had a bleeding ulcer?

NSAIDs, like ipuprofen and acetaminophen, inhibit the body's normal process of rebuilding the stomach wall, which would otherwise be burned through.

I had an ulcer once so when I was given a strong pain perscription for an unrelated neck problem and I asked whether there was a form of it that did not contain an NSAID. Answer: no.

Funny thing... back when I had the ulcer I was given oxycodone for the pain, which included an NSAID that would inhibit my body's healing of the very thing I was taking the pain reliever for! At that time I didn't realize that all these things have NSAIDS in them.

Make drugs to best treat patients. Worrying more about how someone else might abuse the best-formulated drugs is perverse.

[NashVegas]

13. No

But I have had *minor* day surgery and was given a hydrocodone prescription. I took it for 24 hours and decided to accept whatever resulting pain in exchange for not feeling like a guest in my own body.

(Months later, I discovered the remaining 20 or so pills were stolen from my medicine cabinet, probably by one of the handymen at the apartment complex I lived in.)

I have had a clinic doctor go, "hey, didn't you say you get really bad headaches? ..? No? I could have sworn you said you get bad tension headaches. Why don't you try some of this?" and write a prescription, unasked, for barbituates.

Surely the manufacturer can come up with a normal dosage sans Tylenol.

[cthulu2016]

16. How about blood thinning?

Does everyone with severe pain need a blood-thinning agent in their pain reliever? (NSAIDS inhibit clotting)

Is there a persuasive reason why someone in a hospice with cancer must have a higher risk of cerebral hemeroge built into their pain med?

And does the fact that you, personally, prefer pain to the feeling caused by a pain-killer mean that everyone else should feel the same way?

[NashVegas]

22. My Tolerance of Pain Wasn't the Point

The point was, our medical professionals and bio-techs are over-prescribing ridicule-worthy amounts of medicine for profit.

Why hand over Hydrocodone when Tylenol 3 would have done fine? Why prescribe 20+, when two days worth would have been plenty.

[unblock]

30. acetaminophen is not really an nsaid.

at least, its anti-inflammatory effects are extremely weak, so as a practical matter it's not considered an nsaid.

personally, i can tolerate acetaminophen but asprin or ibuprophen make me bleed.

that said, i rarely take acetaminophen because it's virtually useless against my migraines, and i can't remember the last time i felt the need for a pain-killer otherwise.

i have a straight narcotic (stadol) as a back-up for migraines, but mostly rely on triptans (zomig lately, though i've used imitrex as well).

[backscatter712]

6. This may actually save the lives of addicts.

People addicted to Vicodin typically take far more than the doctor's prescribed dose, meaning they take far more acetaminophen than they're supposed to as well. As a result, a lot of Vicodin addicts pickle their livers.

Taking the acetaminophen out would help with this.

[NashVegas]

15. Yes, Well, It Does Help Repeat Business to Keep the Customers Alive, Doesn't It?

[tridim]

7. According to the glorious federal drug schedule it's still much less dangerous than Cannabis.

Which is obviously a bad joke on the entire human race. It's just insulting.

I'm so glad I have never been prescribed opioids, because the 4 or 5 random times I've taken one I enjoyed it enough to realize that having a prescription would be a very bad idea.

[hobbit709]

14. As we used to say back when I worked at a Drug Crisis center in the 70's.

"After all, heroin is the most effective pain reliever you can buy without a prescription"

[riverwalker]

17. already an epidemic

was a guy who kept bringing mom in for her pain, "tell them about your pain, Ma. Her pain is awful" of course the docs prescribed Vicodin, Oxycontin, etc. kept upping the dosage for her "terrible pain". Finally, they did a urine tox screen on her and lo and behold.....negative for any opiates..nada. Son had a nice side business, or addiction.

[HockeyMom]

18. Doctors push these on patients

They did to my husband, and didn't tell him the effects, after his surgeries. He ended up telling the doctor he didn't want to become a vegetable. They have with me also even for DENTAL surgery. I have had to argue with them saying I don't want, or need, anything. "But you will be in PAIN!" Besides knowing my own pain level best, it's my CHOICE, right? Two Tylenol works fine for ME.

Sometimes I think they get kickbacks from the drug companies.

[TheWraith]

26. Actually, most real doctors dramatically UNDER prescribe painkillers these days.

Primarily because too many prescriptions in a given doctor's name will trigger an investigation, and legitimate doctors don't want to run the risk of getting their ability to provide painkillers revoked.

[frazzled]

37. I agree

My husband had a bad accident a few years ago (bicycle) and broke his shoulder, 4 ribs, and punctured a lung. They gave him megadoses of hydrocodone for pain, but (under my orders) took only half the dose and within a few days took it only to sleep at night (sitting up!), then tapered off to Tylenol.

My dentist gave it to me after a root canal, and I refused to take it. I was also offered a strong painkiller (can't remember which one) recently after a Moh's surgery for a skin cancer. I told them I didn't want it and they said, well, take it and only get it filled if you need it, then. I didn't fill it and did fine on doses of Tylenol (not my favorite, but you're not supposed to take ibuprofen after surgery). Believe me, I'm no superperson when it comes to pain, but I'm more scared of the medications than I am of the pain.

There are times when you need this stuff, and different people have different tolerances to pain. But sometimes you need to get used to a bit of pain. (For the ladies out there who have gone through childbirth, you will know what I'm talking about!) But in most cases I think that doctors are too willing to overmedicate for pain right away. It's true you don't want to let a cycle of severe pain get started ... because it can be very difficult to break. But people should also be encouraged to take the least amount possible and to taper off as soon as possible. Life is not supposed to pain free.

[Marrah_G]

20. Or it could be being created for those in severe pain

[NashVegas]

23. I'm Sorry, I Don't Believe That

I believe Backscatter has the right of it. I believe this is for the Golden Goose.

[Marrah_G]

36. All any of us can really do is venture guesses.

You might be right, I might be right, we both might be wrong.

[hunter]

21. Adding acetaminophen to hydrocodone is fucked up, always has been.

Hey, let's poison the chronic pain patients and addicts, yeah, we're doing it for their own good, don't you know.

Puritanical America makes me vomit.

If you want to help the addicts, help the addicts. Drug addiction is a medical problem. Treat it as such.

Declaring a "war on drugs," banning inexpensive and effective drugs like marijuana, and adding toxins to pain killers is immoral.

[CTyankee]

24. This argument should not get in the way of people who are in real pain and need effective relief.

Even after extensive abdominal surgery, 6 weeks in the hospital and 2 weeks in rehab, all the while on painkillers, I ceased taking them after my pain went away. And I never felt a single withdrawal symptom. I simply wasn't addicted, despite all the handwringing of my surgeon. But a very wise family friend, an anaesthesiologist, told me that in his opinion, patients are more often under-medicated, rather than over-medicated. In fact, he has a pain specialist on his staff.

I had told my surgeon (in a flash of real anger) that I have never been addicted to ANYTHING. Even when I smoked, when I decided I didn't want to be a smoker, I stopped and never started again and had NO symptoms of withdrawal. After 20 years of having nicotine in my system every day...

[cthulu2016]

27. And that under-management slows post-operative recovery

Many studies demonstrating that the ingoing trauma of pain interferes with post-operative healing. The "over-medicated" heal faster and with fewwer complications.

Some dependency does often arise and that is part of the equation. It does not carry enough weight in real patient outcomes to warrant undermedication.

[CTyankee]

35. my surgeon was absolutely convinced I was "addicted." She truly couldn't get it.

Unless there is a different dependency withdrawal symptom that I didn't know I had, I was simply not addicted. And will power had nothing to do with it (I am self indulgent about lots of other things foodwise). I finally enlisted the help of my VNA nurse who advocated for me by calling the surgeon's office and doing battle with her staff. My "addiction" was only one of the lies that that office told me during my being her patient...

[closeupready]

34. Completely agree, but you and I know it WILL get in the way. Because after all,

if someone SOMEWHERE is having a good time, we need to put a stop to it immediately. Life in crazy, control-freak land.

[yellowcanine]

28. Limbaugh probably already has an order in at his local "pharmacy".

[ZombieHorde]

29. I would rather get medicine analysis from doctors and pharmacists. nt

[HopeHoops]

31. Hell, in PA you already have to do that.

They won't call it in as a prescription. You have to physically pick it up. Same's true for oxycodone, benzodiazapines and most other schedule IV, III, and II drugs, although they will allow refills on the bennies. You still have to pick up the new prescription at the doctor's office and it has to be approved by the doctor.

[Romulox]

32. The War on Drugs: Victory is *just* around the corner! nt