Vicodin – Should it Be Banned?

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A 30-year-old Michigan man was recently arrested for possession of prescription pills not in a prescription bottle. The pills he was carrying were Vicodin.

New York recently conducted a drug amnesty program in a bid to curb teen drug abuse. One of the drugs included in the program was Vicodin.

A 44-year-old doctor, Constance Sweet, was arrested in Bradford County for prescribing Vicodin to patients for treating drug addictions.

So what is it that makes Vicodin desirable as well as a restricted substance at the same time?

Vicodine is an analgesic given orally in a tablet form. It contains hydrocodone and paracetamol (acetaminophen) and is generally the drug of choice for pain relief, because it provides better pain relief than either of the two constituents taken separately; however, inappropriate and uncontrolled use of the drug can be dangerous, and the potential for addiction and abuse is well known.

The human body develops tolerance to the drug, meaning that increasingly larger doses are required to produce the same degree of analgesic effect. For this reason, patients might start increasing the dosage or the frequency without being actually addicted to it. However, over a period of time, patients develop an addiction, physical or psychosocial, to the drug.

Prolonged usage of Vicodin results in physical and emotional dependence. Initially, patients tend to convince themselves that nothing is wrong and that a slight increase in dosage or frequency is not going to harm them. They couldn’t be further from the truth. Therefore, it is important to recognize the symptoms of addiction to Vicodin.

Symptoms of Addiction:

• Using the drug even after the pain for which it was used is no longer there
• Inability to cope with routine things       
• Feeling physically ill
• Trying to buy Vicodin without prescription or looking for doctors who will prescribe Vicodin
• Your family or friends indicate that your behaviour has changed after starting the medication

Please remember that addiction is treatable, and, if one feels that he/she is showing signs of addiction, a doctor should be immediately consulted, since it is much easier to control at the initial stages. The withdrawal symptoms on stopping the medication include insomnia, tremors and agitation.

It is estimated that the drug, along with its other generic equivalents is prescribed more than a 100 million times a year in the US alone. The hydrocodone/paracetamol is also available under other brand names like Anexsia, Dolorex Forte, Hycet, Liquicet, Lorcet, Lortab, Maxidone, Norco, Polygesic, Stagesic, Vicodin, Xodol, Zamicet, and Zydone.

In the US hydrocodone is a schedule II drug, but when combined with paracetamol it becomes a schedule III drug, essentially meaning that it can cause low or moderate physical dependence and high psychological dependence if abused. A federal advisory panel has voted to ban sale of Vicodin because of its harmful effects on the liver.

By itself, hydrocodone has the same structure as morphine, even though it is not as potent as morphine and is metabolized by different enzymes. Paracetamol (Acetaminophen) overdose, on the other hand, causes close to 400 deaths and about 40,000 hospitalizations.

Side Effects:

A visual representation of the side effects of Vicodin can be appreciated in the interactive diagram presented at the following link:

http://upload.wikimedia.org/wikipedia/commons/b/b7/Side_effects_of_Vicodin.svg

The side effects of Vicodin are upset stomach, dizziness, and lightheadedness, and can occasionally cause seizures, allergic reactions, fatigue, bleeding, sweating, hot flashes, nausea, vomiting, itching, constipation, etc., and may also have a depressant effect on the nervous system.

An overdose of Paracetamol (Acetaminophen) is known to cause harmful effects to the liver. The maximum amount of Acetaminophen recommended by specialists is 4 grams per day. As Vicodin contains up to 750 mg of Acetaminophen, one needs to be very careful with the intake.

Contraindications and Drug Interactions:

A doctor’s prescription and advice should be taken when taking Vicodin as a medication for pain relief or any other condition. When consulting a doctor who is contemplating prescribing the drug, you must inform him if you have any of the following conditions:

• History of head injury or tumor,
• Low blood pressure
• Liver or kidney disease
• Stomach or intestinal disorder
• Mental illness
• Spinal disorders
• A history of alcohol abuse
• Hypothyroidism
• Adrenal gland disorders
• Asthma, other breathing disorders like COPD or sleep apnoea

Vicodin interacts with more than 500 drugs. That should be reason enough for anyone to shy away from self-medication with Vicodin. Vicodin is also contraindicated during pregnancy. It is not known for sure whether it hurts an unborn baby, but it could cause breathing problems or withdrawal symptoms on birth. Acetaminophen and hydrocodone can pass into breast milk and may harm a nursing baby.

To conclude all the side effects, contraindications and the addictive properties make Vicodin a dangerous drug to use, and perhaps that is why there is a debate about banning the drug.