In New Hampshire, more people die of prescription drug overdoses than car accidents. CDC statistics report that prescription drugs are involved in 75% of all drug-related deaths in the United States. In 2011, the Centers for Disease Control estimated 14,800 deaths related to opioids (opioids or opiates defined as morphine, heroin, oxycodone, codeine, methadone, hydrocodone and hydromorphone.) Note that with the exception of heroin, all drugs of abuse are available from your friendly healthcare provider.
Whether drug sales are illegal enterprises selling vials on the corner or a transaction that takes place in an exam room, it’s all about numbers and turf. Getting people hooked and keeping them coming back are the keys to a thriving business. For people with insurance, getting narcotics (opiates) from their local doctor or Emergency Room is easier and less expensive than going to the corner drug dealer, particularly since drug dealers don’t settle for a co-pay. Just as dealers rename their products to generate interest, Big Pharma continues to feed the appetite of addicts with new medications and new formulations of old medications.
Narcotic painkillers have been combined with over the counter meds because of the belief that the two medications together provide better pain relief than either of the medications taken alone. Unfortunately when people take two Vicodin (hydrocodone and acetaminophen) every 4 hours for pain round the clock (12 pills daily), they run the risk of liver damage because of the amount of acetaminophen bundled in the pill. The makers of Tylenol (brand name acetaminophen) are so concerned about acetaminophen overdoses that they have decreased the recommended maximum daily dose from 8 pills daily (4000 mg) to 6 pills daily (3000 mg). This change forces the makers of Vicodin to lower their recommended maximum dose to stay within the new guidelines and will result in Vicodin users having their daily dose decreased. Sad that in the face of increasing numbers of overdose deaths due to prescription narcotics and the increasing number of prescription drug addicts, the push to change labeling is due to the potential for a Tylenol overdose resulting in liver damage, rather than concern about overdose or addiction.
Of course the makers of Vicodin don’t want to see their business cut in half. They want to keep on selling the same number or more pills every year. Faced with the very real possibility that providers will decide to switch patients on Vicodin to a drug without any pesky daily maximums, the makers attempted the business affirming move of trying to get approval for a pure hydrocodone pill. Luckily the FDA panel on pain relief voted against it.
The panelists agreed the higher dose of hydrocodone would be an effective pain reliever, but they felt uneasy providing another formulation of a drug in a class that is already widely abused. According to the Drug Enforcement Agency (DEA), hydrocodone is on the top of the list of most abused drugs in the United States. Sounds like a no-brainer.
Hopefully the FDA will agree with the panel and prevent a new dangerous drug from flooding America’s streets, school yards, and homes. In the war on drugs, our government has gone after the dealers of meth, pot, heroin, and crack. Somehow the legal dealers, Big Pharma, are allowed to thrive while they destroy lives.
Do some people need narcotic painkillers to control their pain? Of course. In the face of increasing narcotic use, do we need to add more potential drugs of abuse to the marketplace? I think not. Big Pharma seems to be doing pretty well with what they have.
chart courtesy of the National Institute on Drug Abuse.
- FDA panel opposes pure hydrocodone painkiller (miamiherald.com)
- FDA panel opposes pure hydrocodone painkiller (usatoday.com)
- Zogenix Drug May Be Abused at Higher Rate, FDA Staff Says – Bloomberg (bloomberg.com)
- Viewpoint: Are Doctors to Blame for Prescription-Drug Abuse? (ideas.time.com)