Hydrocodone belongs to family of drugs known as opiates because they are similar to opium. They block pain but also unleash feelings of euphoria and can create physical dependence.
Drug companies are developing a newer, more potent version of the nation’s second most-abused medication. The new pills contain pure hydrocodone – a highly addictive painkiller – in, by some counts, a dose10 times stronger than that in existing drugs such as Vicodin.
If the drug is approved by the Food and Drug Administration, patients could, for the first time, legally purchase pure hydrocodone, and addiction experts worry it could incite a new wave of prescription drug abuse. Current pain medications combine hydrocodone with nonaddictive painkillers like acetaminophen.
While these drugs are time-released and meant for managing moderate to severe pain, abusers learned that they can gain an intense and immediate high from the drug by simply crushing it. Oxycontin, which contains the nation’s most-abused medication, oxycodone, has since been reformulated in an abuse-deterrent form.
Four drug companies have begun testing the new hydrocodone product on patients. Zogenix in San Diego plans to apply to the FDA early next year to begin marketing its version, called Zohydro -- which is not being made in an abuse-deterrent formula.
Opioids are in important component in managing chronic pain, which affects at least 116 million Americans, according a study released this year by the Institute of Medicine. But does America need another, stronger pain medicine? The Centers for Disease Control and Prevention says that prescription painkiller overdose is the cause of around 15,000 deaths per year – more than heroin and cocaine combined.
Could stronger pain meds lead to greater addiction problems? Are doctors sufficiently educated in how to manage pain while monitoring for potential abuse? What about patients who need prescription opioids to manage chronic pain -- should they have the option of taking Zohydro? Who is really to blame for the “overdose epidemic”?
Paul Christo, MD, MBA, Associate Professor and Director of the Multidisciplinary Pain Fellowship, The Johns Hopkins University School of Medicine
Rick Chavez, M.D., Medical Director of the Pain Institute, Assistant Clinical Professor of Family Medicine at the UCLA David Geffen School of Medicine