Introduction
According to Herper, it is interesting to note that the most popular prescription drug in the USA was prescribed 128 million times in 2010 (Herper 2010). This point is especially surprising given that a number of experts and the Food and Drug Administration (FDA) called for its banning.
The drug popularly known as Vicodin is addictive and is likely to cause several potentially fatal side effects among users (Herper 2010). Due to this precarious position it appears wise to prepare a brief report on the drug to highlight the truth in relation to its position. It would also be useful to verify the truth behind claims made in reports such as Herper’s (2010). The remainder of this report will thus concern itself with providing insight into this drug.
The symptoms and cause of the medical condition(s) requiring treatment
Among the most common complaints among invalids is that of pain (Breguet & Brogan 2008). Pains can be described as the familiar sensations caused by varying factors that could be described as throbbing, burning, searing or stabbing. Although most individuals report pains from time to time it has been reported that of the US population aged 20 years and older, more than a quarter experience pain for more than 24 hours (Breguet & Brogan 2008).
These statistics suggest that this problem is currently experienced by more than 76 million Americans and may provide a clue as to why this drug is so popular.
Many of the individuals that rely on this drug are known to suffer chronic pain and are essentially in pain all the time. For these individuals pain is not only unpleasant but it also affects how they go about their day to day experiences. This degree of pain suggests without a suitable remedy their daily activity may be adversely affected (Breguet & Brogan 2008). Such pain comes about due to countless diseases and medical conditions.
The most commonly reported pain that falls in this category is back pain. Pains in the back are also among the leading causes of disability among Americans aged below 45 years old (Breguet & Brogan 2008). Back pains are caused by a variety of reasons such as genetics, poor posture among other factors.
Other types of pain that also may be classified as chronic include other types of muscle and bone pain. These include pains such as those sometimes experienced in the neck. These may be caused by working conditions and prolonged sitting. Other forms of acute pain reported include headaches such as migraines and jaw or facial pains (Breguet & Brogan 2008).
Chronic pain may also come about following an injury that did not heal properly thus inhibiting motion and muscular movement. Other common causes of pain include infectious disease such as ear infections (Breguet & Brogan 2008). In some cases individuals suffer chronic pain continuously owing to a persistent ailment such as arthritis.
Chronic pain is a major problem because of its potential to affect other areas of one’s daily life. For example, due to chronic pain it is common for sufferers to sleep poorly several nights each week. This prolonged loss of sleep is likely to result in exhaustion which in turn causes poor functioning during the day (Breguet & Brogan 2008).
Sufferers of such pain may be limited in terms of their leisure activities due to the effects of pain. This in turn suggests a reduced quality of life due to the pain. In light of such situations the sufferers are likely to also suffer additional complications such as anger, anxiety, emotional distress, depression and feelings of hopelessness (Breguet & Brogan 2008). This is observed based on evidence from a 2007 survey where chronic pain sufferers were reported to have indicated en masse that their greatest immediate concern was finding a lasting solution to their pain (Breguet & Brogan 2008).
In addition to serious effects on quality of life, it has been observed that chronic pain can lead to missed workdays, weeks and months. This loss of workdays means lost income for both the individual and the company (Breguet & Brogan 2008). These expenses when tallied with health care expenses that deal with pain amounted to a whopping $10 million for a single year (Breguet & Brogan 2008).
It has already been mentioned that there are many instances where the cause of pain cannot be immediately identified (Koestler & Myers 2002). This inability to clearly understand the root cause of chronic pain has played a role in preventing the identification of a solution to the problem. For this reason it has been suggested that instead of seeking quick solutions it may be wiser to use an integrated approach to dealing with chronic pain.
This suggests that where chronic pain is concerned regardless of the diagnosis, psychological, social or physical factors some action should be taken to resolve the issue (Koestler & Myers 2002). This multidisciplinary approach may require that for back pains health care providers should consider including family practitioners, surgeons, physiatrist, anesthesiologist, physical therapist, psychologist and chiropractor. It is believed that this collaborative evaluation of outcomes may be better suited to finding the solution to chronic pain.
Structure of the drug
This popular pain relieving drug is unlike many other pain relievers in that it is a combination of two substances (Breguet & Brogan 2008). The drug is part acetaminophen and part hydrocodone. Hydrocodone is the narcotic component that makes the drug fall under the opioid category of treatments. However, it is essential to point out that hydrocodone is also used in production of some cough medicine and is found in some prescription cough syrup (Breguet & Brogan 2008).
The drug is mainly advertised as a pain killer. In addition to cough remedies, hydrocodone is also available in combination with aspirin, ibuprofen and some allergy medications. Despite these various combinations and uses the most common combination is the one that includes acetaminophen (Breguet & Brogan 2008).
This drug and other hydrocodone based medications are the most popularly prescribed opioids in America. The drug Vicodin and its generic versions constitute as much as 80% of hydrocodone prescriptions (Breguet & Brogan 2008). Based on the chemical strength, hydrocodone is considered a weak opioid and is thus prescribed to deal with moderate to severe pain relief.
An example of its use is a prescription for a few days following a major dental procedure. In some cases for individuals with chronic pain due to injury or some disorder may receive a prescription of Vicodin after other remedies have proven inadequate (Breguet & Brogan 2008).
The drug is available for use in the form of tablets, capsules and liquid. However, the most recognizable form is that of a long oblong shaped tablet with a groove in the middle (Breguet & Brogan 2008). Each pill sometimes bears the stamp VICODIN or V or the word WATSON, a capital M, a capital A, followed by a three digit number (Breguet & Brogan 2008).
The fact that it is made up of an opioid and non opioid and its weakness when compared to other opioid medications, Vicodin is considered a Schedule III drug (Breguet & Brogan 2008). This essentially means the drug is less strictly controlled than morphine, OxyContin, codeine and many other narcotics. This position makes it possible for a doctor to prescribe six months use of Vicodin, allowing the patient to purchase a 30 day pack and five possible refills.
This is not the case with Schedule II narcotics that do not allow patients to obtain refills without a new prescription (Breguet & Brogan 2008). In addition to that patients are allowed to have Vicodin prescriptions from more than one doctor at once which is illegal under Schedule II narcotics. It has been suggested that this Schedule III status may be among the reasons behind the spiraling use of this drug.
Synthetic routes to the drug and the commercial manufacturing process
In beginning this section it is important to note that under the Drug Abuse Prevention and Control Act of 1970 all drugs with the potential for abuse are considered controlled substances. This means the government regulates their manufacture, possession, importation and distribution (Breguet & Brogan 2008).
This is achieved by categorizing such substances into five categories where Schedule I has the most control and Schedule V, has the least control. Most prescription opioids are Schedule II due to their potential for addiction, with the exception of Vicodin which is Schedule III (Breguet & Brogan 2008). Despite the strict regulation in manufacture the problem with this drug is due to the ease of access that has led to its widespread use for other purposes.
Among the illicit uses that have come about due to the improper scheduling associated with Vicodin include the use in production methamphetamines. This is supported by evidence that indicates increased production of methamphetamine in countries such as Mexico using imported substances (UNINCB 2008).
This issue has been further complicated due to availability of these and other drugs over the internet which is not as easily monitored when compared to traditional retail outlets. This position has seen effort increase in improving the monitoring of the sales of drugs such as Vicodin.
Among the most commonly used methamphetamines is MDMA although it has been indicated that a large degree of drugs such as Vicodin, oxycodone and morphine are also being diverted for recreational use (UNINCB 2008). According to statistics from 2006, more than half the teen respondents said that pain relievers were easily available and could be found anywhere (Breguet & Brogan 2008).
Over half of those using the pain relievers for ‘fun’ mentioned that they could find them free of charge from friends and relatives. In the same study it was reported that Vicodin was second to marijuana in its frequency of usage in the previous year (Breguet & Brogan 2008). This position highlights the degree to which this drug is finding its way into routes for which it was not intended.
How the drug acts
Like most prescription pain relievers Vicodin is a time release medication with the synthetic opiate known as Oxycodone (Alters & Schiff 2011). The drug is developed to be ingested and released slowly into the blood stream providing a calming or soothing effect that is effective in dulling pain (Alters & Schiff 2011).
However, it is a widely abused drug and the abusers often use mechanisms to speed the release of the active ingredients. Some of the popular means of abusing this medication involve chewing, crushing or dissolving the injecting the pills, inhaling which delivers the entire active ingredient all at once instead of over a period of time (Alters & Schiff 2011).
The result of these methods of intake is a rapid and intense euphoria which does not occur when the drugs are taken according to instructions (Alters & Schiff 2011). It should be noted that these techniques of consumption have potentially serious adverse outcomes including injury or death.
Side effects of the drug
The use of hydrocodone based drugs such as Vicodin may result in a number of side effects such as constipation. The main reason for this is the fact that hydrocodone slows down the intestines and thus constipation may arise as a side effect (Frances 2009). In addition to that it has also been reported that Vicodin may cause dizziness, drowsiness and stomach aches (Frances 2009). For this reason it is advised that after taking the drug one should not drive or operate heavy machinery.
However, the more serious side effect of this drug is that of addiction which may occur when the user does not adhere to prescription directions and either increases or prolongs the dose (Frances 2009). For this reason it is advised that users should use the drugs for a reasonable duration but avoid prolonged use of pain relievers.
How the drug was discovered
According to Fisher and Ganellin this drug can be traced to the efforts of Robiquet who first discovered Codeine which quickly became a new painkiller (2006). This natural occurring alkaloid from Papaver somniferum was first isolated in 1832 leading to a new analgesic substance in the market.
Following this discovery by the middle of the 19th century the use of pure alkaloids had become more popular than the use of crude opium preparations common in early medicine (Fisher and Ganellin 2006). The name codeine is derived from a Greek term that describes the head of the poppy plant. Through improved knowledge on synthesis the drug hydrocodone was eventually produced due to the increased potency when compared to codeine in relation to water solubility.
The commercial market for the drug
This drug as it has been mentioned earlier in the report is mainly produced to act as a pain reliever. Based on this therefore the drug is mainly used by medical practitioners for pain relief when other options have failed. It is common to use it in the treatment of cancer, arthritis, following surgery, following injury and in a variety of circumstances (Breguet & Brogan 2008).
References
Alters, S & Schiff, W 2011, Essential Concepts for Healthy Living, Jones and Bartlett Publishers, Sudbury, MA.
Breguet, AE & Brogan, RJ 2008, Junior Drug Awareness: Vicodin, OxyContin and other Pain Relievers, Infobase Publishing, New York.
Fisher, J & Ganellin, R 2006, Analogue Based Drug Discovery, WILEY-VCH Verlag, Weinheim.
Frances, C 2009, Relevant Interests, iUniverse Books, Bloomington, IN.
Herper, M 2010, America’s most popular drugs.
Koestler, AJ & Myers, A 2002, Understanding chronic pain, University press of Mississippi, Mississippi.
United National International Narcotics Control Board (UNINCB) 2008, Report of the International Narcotics Control Board for 2007, United Nations Publications, Printed in the USA.