Among the myriad of drugs being abused today, prescription painkillers are still growing in popularity. Around 12 million Americans abuse prescription pain medications every year, according to Oxy Watchdog. Vicodin entered the drug market in 1984 as a prescription analgesic. Hydrocodone, the key ingredient that is combined with acetaminophen to make Vicodin, is diverted and abused more than any other controlled pharmaceutical drug in America, according to the Foundation for a Drug-Free World. The hydrocodone/acetaminophen prescription was the most commonly prescribed variation of hydrocodone products, per the Drug Enforcement Administration.
The Skinny on Vicodin
While there are certainly plenty of Vicodin addicts who picked up the habit merely from hanging out with the wrong crowd or seguing from another drug, many become addicted after using the drug as prescribed for an injury. Business Week reported that generic forms of the drug were dispensed 128 million times in the United States just in 2009.
Hydrocodone, coupled with oxycodone, accounted for 75 percent of addictions to opiates in a study by the American Academy of Pain Medicine, relayed by Everyday Health. A total of 3,520 opioid abusers were polled and an astounding 90 percent claimed to use either oxycodone or hydrocodone to alter their mood, while 60 percent attested to using the latter for pain as well, according to the National Council on Alcoholism and Drug Dependence.
A study of nationwide drug abuse churned out alarming results for some cities in particular. In Atlanta, hydrocodone was determined to be the most widely abused narcotic painkiller, a class of drugs responsible for almost 50 percent of drug-related deaths in 2005, according to a combined study published by the University of Texas at Austin. Hydrocodone is one of the top three opiates being abused in many cities across the nation, such as Chicago and Los Angeles. Deaths and treatment admissions for the drug in Hawaii are consistently on the rise while the painkiller has surpassed even the appearance of oxycodone in emergency room and toxicology lab reports in San Diego.
From 2007 to 2013, more deaths occurred due to prescription painkiller overdoses than car crashes, according to NewsOK. In addition, the Centers for Disease Control and Prevention accounted for almost 500,000 trips to the emergency room in 2009 being due to misuse or abuse of prescription pain pills. In 2008, opioid pain relievers, inclusive of Vicodin, were responsible for 14,800 overdose-related fatalities in America, according to the CDC and relayed by the New York Daily News. As of 2012, that number was closer to 17,000, per the Substance Abuse and Mental Health Services Administration’s Opioid Overdose Toolkit.Vicodin belongs to a class of drugs known as opioid analgesics, which are highly addictive and dangerous when abused. Nearly three in every four pharmaceutical overdose fatalities are attributed to this class of drugs, per the Prescription Drug Monitoring Program Center of Excellence at Brandeis University. The same study accounted for 74.3 percent of 22,134 pharmaceutical-related overdose deaths being unintentional, as published in the Journal of the American Medical Association.
As with any group of drugs, there are certain groups and types of people who are more likely to abuse or overdose on prescription painkillers. The Centers for Disease Control and Prevention identifies said groups with the following parameters:
- Males are more likely to die of a prescription painkiller overdose than females, based on historical data.
- The majority of people who have died from a prescription painkiller overdose are middle-aged.
- Those living in rural counties have a nearly doubled risk of overdose on prescription painkillers than people living in big cities.
- Of all ethnic groups, Caucasians, Alaska Natives, and American Indians are most likely to overdose on prescription pain pills.
Elaborating on that theory, the CDC also notes that around one in every 10 American Indians or Alaska Natives over the age of 11 used prescription pain medication non-medically within the year prior to the survey, compared with one in 20 Caucasians and one in 30 African-Americans. Many of the individuals who become dependent on prescription painkillers started out taking them with a legitimate physician-prescribed pain remedy in mind. Thus, those with chronic pain who may be exposed to the drug for extended periods of time are at an increased risk of tolerance and dependency on the drug.
Once the body develops a tolerance for the drug, more of it is required to thwart withdrawal symptoms like depression, muscle pain, perspiration, fever, and insomnia. In a study published in the Journal of Addiction Medicine, 74 percent of the participants — all of whom were being hospitalized for medicated withdrawal from opioid drugs — possessed a high school diploma or the equivalent of such. Furthermore, just over half (52 percent) were unemployed. Harvard Health Publications reports that teens and young adults are more likely to abuse opioid painkillers or become dependent on them.
Symptoms of Vicodin Abuse
Most long-term abusers of Vicodin will experience serious changes in their behavior, mood and health. Initially, the misuse of the drug may present with symptoms similar to the side effects a prescribed user would experience, such as feeling lightheaded, nauseated, dizzy, and sedated, as well as possibly experiencing episodes of vomiting, per RxList.
According to the same source, abusers of Vicodin, much like other prescription drug addicts, will often request refills or an increased supply of the drug from their physician or dealer. Many will engage in “doctor shopping,” frequenting more than one doctor at a time in attempts to get multiple separate prescriptions for Vicodin. Mood lability, anxiousness, and agitation are also all common symptoms of Vicodin addiction.
If you find yourself unable to quit or reduce your use of Vicodin or developing an increased tolerance to the drug, spending large amounts of time and money on your habit, losing or gaining a lot of weight, sleeping more than usual, stealing or engaging in other criminal behaviors to pay for your drug use, or continuing to use even when you’ve faced health troubles or problems with work or family due to your drug use, you might be addicted, per Healthline.
Cause and Effect
As with any addiction, the detrimental effects imposed on the addict tend to have a ripple effect that reaches out across friends, family, coworkers and the like. Recurrent absences from work or poor productivity often leads to the loss of employment for drug abusers.
Even the closest of family members may eventually turn away from the addict after they can no longer withstand the pain that comes with loving someone with an addiction. Regular abuse of opioids is associated with a heightened risk for legal issues, incarceration, trouble in career or school settings, and the abuse of other drugs, according to the National Alliance on Mental Illness.
The impact that drug abuse can have on your health varies dependent upon what substances are being abused, how frequently they’re being abused, and also whether there are any underlying illnesses present. When Vicodin abuse is coupled with one or more mental health disorders, the symptoms of both can be significantly increased, consequently blurring the line between the two. The Fix reports that half of all general psychiatric patients have a substance use disorder too. Further, NAMI attests that 53 percent of drug addicts meet the criteria for a minimum of one mental health disorder.
One of the overlooked side effects of prolonged use of Vicodin actually has little to do with the key ingredient and more to do with the acetaminophen that accompanies it. Extended exposure to this drug can pose some risks, but most stem from excessive doses. Many people are unaware of the serious adverse health effects that acetaminophen — the primary drug in Tylenol — can impose.
Overdose is entirely possible and more likely because of the fever-reducing pain-reliever component. An analysis of data from 1990 to 1998 published in Pharmacoepidemiology and Drug Safety in 2006 reported an approximate 56,000 trips to the emergency room and 26,000 hospitalizations due to overdoses involving acetaminophen. The same analysis touted 458 deaths per year within the time range that data was collected, 100 of which were not intentional. The majority of all acetaminophen overdoses stem from users who mix different medications that contain that drug as an ingredient, pushing them over the 4000 mg daily recommended adult dose.A 2005 Hepatology publication touted injuries linked to acetaminophen as being the majority cause for acute liver failure from 1998 through 2003. In addition, everyone is not created equal, and what is a safe dose of acetaminophen for one person isn’t always safe for another. Likewise, the recommended maximum daily dose of acetaminophen is 4 grams, and the potential for harm looms only slightly above it. In some instances, acute liver failure has stemmed from less than 2.5 grams daily, per the Food and Drug Administration.The liver faces problems when toxic metabolites that formed from acetaminophen bind themselves to liver proteins. According to the FDA, this causes damage to healthy liver cells, the amount of which is dependent upon how efficiently the liver can remove said metabolites. Thus, in cases of overdose where excessive amounts of metabolites may be present, the liver struggles to survive.
MedlinePlus notes the following symptoms of Vicodin overdose:
- Blue-tinged lips and fingertips
- Cold and/or clammy skin
- Confused state
- Small pupils
- Liver failure as a consequence of acetaminophen overdose
- Loss of consciousness
- Decreased blood pressure
- Respiratory arrest
- Shallow breaths
- Slow and/or labored breaths
- Intestinal or stomach spasms
- Throwing up
Perhaps what is most important to keep in mind is that overdose doesn’t always occur with intent, and it doesn’t always take large amounts of a drug to do serious damage. Vicodin presents such a situation, because it has a high acetaminophen content, a drug that has been linked to acute liver failure, sometimes consequently accompanied by liver transplant or fatality. Consuming alcohol while taking Vicodin increases the chance of acute liver failure. Furthermore, acetaminophen can inflict users with severe skin problems, such as Stevens – Johnson syndrome, acute generalized exanthematous pustulosis, and the potentially fatal toxic epidermal necrolysis. Some users have also exhibited signs of anaphylaxis and hypersensitivity when using acetaminophen-containing products like Vicodin.
CNN News recently reported that while the FDA made a request in 2011 that drug manufacturers limit combination medications containing acetaminophen to no more than 325 mg, many remained on the market past the January 2014 deadline. The New York Times reported that acetaminophen overdose is generally asymptomatic until drug-induced hepatitis develops up to a week later, bringing with it symptoms of jaundice, abdominal pain, fever and more.
Prolonged use of hydrocodone and acetaminophen combination drugs can lead to depression for some users. Vicodin can also bring about unpleasant feelings of anxiety upon withdrawal that have been shown to persist in some patients beyond detox and treatment, becoming lasting conditions. Additionally, the drug is ototoxic, meaning it has the potential to cause up to 100 percent hearing loss that is completely permanent when abused, per ABC News, something only a cochlear implant can resolve.
Treatment for Vicodin Addiction
Medicated detox is generally the first step in treatment for an opioid painkiller addiction. Withdrawal is quite uncomfortable and often accompanied by intense cravings; in some cases, it can present life-threatening problems that make it advisable not to attempt to detox at home on your own. Following this period, patients enter a maintenance stage that has no set end point; some patients stay at this stage with no end in sight.
During treatment, the medication you will receive, such as methadone or buprenorphine, will decrease the effects of withdrawal and help to diminish drug cravings. Subutex and Suboxone are both buprenorphine-based drugs that contain naloxone, a drug that inhibits the high feeling some may get from methadone. Many physicians are weary of treatment with the drug though, because patients aren’t as supervised as those who take part in a regimented methadone program which makes the drugs more difficult to abuse.
In conjunction with drug treatment, individual and group therapy play a large role in the successful turnaround of an opioid painkiller addict. Outside of treatment, it is often advised that patients pursue other avenues of healthy support systems like their family or structured groups such as Narcotics Anonymous. Our skilled professionals here at Axis can render the appropriate diagnoses should mental illness be present in your case. From there, our professionals will treat both issues at the same time with effective medication and therapy, because we understand the importance of treating mental health and substance abuse issues together. We’re on your team; call us today for more details on how we can help.