Hydrocodone Abuse

Physiological aging leading to wear and tear changes in tissues, unwanted and unseen accidents, or injuries, life- saving surgeries, chronic health issues, inflammatory disorders and uncontrolled infections are some of the reasons why most of us consume pain killers. It is logical to say that in some cases, pain- killers are indeed helpful in improving the quality of life.

• Imagine how difficult it is to bear the pain of a fractured limb for a few weeks without any pain- killer support.
• Imagine how disabled and unproductive you can become without pain- killers if you wait for the fracture/ wounds to heal completely before resuming any activity.

In a practical world, we take analgesics to reduce pain and to maintain productivity (or compliance with primary treatment modalities that may also involve invasive procedures like surgery).

But what determines the choice of a pain- killer besides the potency and effectiveness?

According to a report published in the Journal of Pain and Symptom Management, if consumed for a period of 12 months, the risk of addiction of hydrocodone is almost twice as that of NSAIDs and 1.5 times higher than that of tramadol. In order to study the abuse liability and addiction potential, 11,352 individuals were enrolled in a study for 12 months and it was observed that even with physician control and trial enrolment, 4.9% hydrocodone users developed addiction whereas only 2.5%  of NSAID users and 2.7% of tramadol users developed some degree of dependence.

In the past few years, a rapid rise in the abuse of hydrocodone has been observed. Are you aware that non-therapeutic use of hydrocodone in high school seniors is 8 to 10% (3). Likewise, currently hydrocodone is the second most common abused drug (first being marijuana ).

What is hydrocodone abuse?

Pain killers are consumed only to alleviate the symptoms of pain and discomfort. When an individual consumes a pain- killer or drug for following reasons, he/ she qualifies the criteria for pain- killer abuse (or hydrocodone abuse as the case may be).

• Continuing hydrocodone use even when it is not needed (just to support the habit)
• Consume the drug without pain (or in between pain episodes)
• Increase the dose without prescription and thinking of ways to obtain more drug (even through unfair means)
• Using unhealthy means to enhance the duration of action and potency of hydrocodone (like using a combination of pain –killers or mixing the hydrocodone with alcohol).
• Using extra- therapeutic sources and formulations to get hydrocodone.

Factors influencing hydrocodone abuse:

Hydrocodone is a potent analgesic (a dose of 5 mg is as effective as 30 mg of codeine). It is available in different potencies (5 mg to 10 mg). Following factors increase the risk of complications and abuse liability of hydrocodone.

• Consuming hydrocodone with benzodiazepines and other CNS depressants (or even with alcohol). Such behavior increases the duration of action and increases the risk of early tolerance/ habituation and dependence.
• Consumption by intravenous route or inhalation/ snorting (instead of oral administration).
• Co- administration with acetaminophen increases the risk of hepatic necrosis 5 folds
• Dose plays a significant role in the development of addiction. Research data indicates that the therapeutic dose hydrocodone is similar to the dose consumed by drug addicts (4)
• Dosing frequency is equally important (regardless of total dose consumed)
• Most importantly, sometimes when people are consuming prescription analgesics like hydrocodone, they tend to miss out minor details and signs of tolerance/ addiction mainly because of false impression that a drug prescribed by a healthcare professional is always safe (4)

What happens when you over-dose on hydrocodone?

Hydrocodone overdose is a fairly common complication that is associated with a high mortality. Following sign and symptoms suggest hydrocodone overdose:

• Changes in the normal breathing rate/ heart rate
• Inability to stay awake/ altered level of consciousness
• Changes in the tone of muscles (flaccid)
• Upper gastrointestinal upset (like nausea, vomiting and diarrhea)
• Discoloration of skin (bluish tinge) that suggests respiratory depression
• Cold skin and moist/ clammy extremities suggesting an impending circulatory failure.

Hydrocodone versus other analgesics:

Sufferers of chronic pain are always looking for a drug with less addiction potential and better therapeutic efficacy. Research conducted by CA Marco (1) suggested that most therapeutic opiates like hydrocodone and Oxycodone are fairly similar in efficacy and benefits when used for pain relief.

If you or a loved one is struggling with hydrocodone abuse, know that there is hope. Waismann Method provides rapid detox for hydrocodone, we’ve been successful with thousands of patients and can help you too give us a call at 1-888-987-4673.

References:

1. Marco, C. A., Plewa, M. C., Buderer, N., Black, C., & Roberts, A. (2005). Comparison of Oxycodone and Hydrocodone for the Treatment of Acute Pain Associated with Fractures: A Double‐blind, Randomized, Controlled Trial. Academic emergency medicine, 12(4), 282-288.

2. Adams, E. H., Breiner, S., Cicero, T. J., Geller, A., Inciardi, J. A., Schnoll, S. H., … & Woody, G. E. (2006). A comparison of the abuse liability of tramadol, NSAIDs, and hydrocodone in patients with chronic pain. Journal of pain and symptom management, 31(5), 465-476.

3. Volkow, N. D., & McLellan, T. A. (2011). Curtailing diversion and abuse of opioid analgesics without jeopardizing pain treatment. JAMA: The Journal of the American Medical Association, 305(13), 1346-1347.

4. Fischman, M. W., & Foltin, R. W. (1991). Utility of subjective‐effects measurements in assessing abuse liability of drugs in humans. British journal of addiction, 86(12), 1563-1570.

5. Dayer, P., Collart, L., & Desmeules, J. (1994). The pharmacology of tramadol. Drugs, 47(1), 3-7.