The Drug Class Blog

Aug 11

New Opiates

New things to pay attention to.  Here is some info that was sent to me from an associate at La Paloma Treatment Centre.


Zohydro: The Risks of Extended-Release Painkiller Abuse

HYDROCODONE ABUSE TREATMENTZOHYDRO: THE RISKS OF EXTENDED-RELEASE PAINKILLER ABUSE Controversy swirls around the approval of Zohydro, a new narcotic pain reliever manufactured by Zogenix, Inc. Zohydro ER is an opioid containing hydrocodone in capsule form that is intended as an extended-release formula. This means that one pill should last 12 hours, so those suffering from chronic pain don’t have to take as many pills throughout the day.

Zohydro is also one of the only opioid pain relievers to contain only hydrocodone and no acetaminophen, which can cause liver damage. Zohydro isn’t the first opioid created to treat chronic pain, so why all the fuss? Reasons for Concern For one thing, Zohydro packs a bigger punch than its counterparts, containing 50 milligrams of hydrocodone in one capsule as compared to 10 milligrams in one Vicodin pill.[1] This is in part due to the fact that Zohydro is meant to be an extended-release formula as opposed to Vicodin’s instant release.

Another element of this drug that has emergency rooms and physicians on standby is its lack of tamper-resistance. The fear is that people looking for a high will crush the pills and either snort or inject all 50 milligrams at once, sending the entire dose into the bloodstream simultaneously which can lead to overdose and death.

Other drugs with high doses of opioids meant for extended release like OxyContin have safeguards in place. These pills turn into a jelly-like substance when crushed, making them nearly impossible to use recreationally. It was years before the makers of OxyContin created this tamperproof pill however, and in that time, millions of addicts were created and overdose deaths skyrocketed. Many believe that creating a new hydrocodone medication without these safeguards is inviting another epidemic.

Zohydro’s Battle The FDA’s advisory committee voted 11-2 against approving Zohydro citing its high potential for abuse and asking for safeguards to be put in place before marketing. The drug was approved anyway in part due to its simplicity, lack of liver-damaging acetaminophen, and “on the grounds that it is safe and effective for pain when used as directed.”[2] This, of course, is the crux of the issue. Abusers and addicts are not likely to use the medication as directed.

 Dangers of Opioids

Opioid medications are derived from the opium poppy plant and meant to treat people with consistent and reoccurring pain. These narcotics are prescribed when the traditional and less potent forms of pain medication are no longer enough. Those suffering from back pain or cancer pain who need constant pain management typically present a case for this type of medication. Other known opioids include morphine, codeine, and even opium and heroin. Opioids work by attaching to opioid receptors in the brain, dulling pain, stimulating the reward system in the brain, and increasing the production of the neurotransmitter dopamine which gives the user a euphoric feeling.[8] These good feelings are usually what hook patients, as it is hard to resist the pleasant feelings. The problem with these medications is that if you take them constantly, they alter brain chemistry and you can build up a tolerance to the drug. Users need more and more of the drug for it to continue to be effective.

Opioids suppress the part of the brain responsible for respiration and breathing, so increasing dosage increases the chances a user will just stop breathing, creating a fatal overdose. Withdrawal symptoms are also harsh, making it harder for users to stop once they have started developing a dependency. Some of the other risk factors include: Dizziness Nausea Drowsiness Constipation Trouble sleeping Anxiety Trouble breathing Physical dependence Overdose Every day in the United States, 100 people die from a drug overdose, and a large percentage of deaths are due to prescription drug overdoses, particularly prescription painkillers.[9] Prescription painkiller abuse and overdose deaths continue to rise, with over 12 million people reporting using prescription painkillers for nonmedical purposes in 2010.[10] Getting Help Although Zohydro is a relatively new drug on the market, medical professionals are no stranger to the effects of hydrocodone and its addiction potential. Whether the dependence started out as an attempt to find relief from chronic pain or from abusing prescription medications for nonmedical purposes, we can help. Finding the right treatment center is important to recovery.

Citations [1] Hall, S. (June 2014). “How Much Does It Hurt?” New York Magazine. Accessed July 10, 2014. [2] Olsen, Y.; Sharfstein, J. (May 2014). “Chronic Pain, Addiction, and Zohydro.” New England Journal of Medicine. Accessed July 10, 2014. [3] Ibid. [4] Ibid. [5] Smith, S. (Feb. 2014). “New Pain Pill’s Approval; ‘Genuinely Frightening.’” CNN. Accessed July 10, 2014. [6] “How Drugs are Developed and Approved.” (Feb. 2014). FDA. Accessed July 10, 2014. [7] Ibid. [8] Grush, L. (April 2014). “Zohydro: Why This Painkiller Could Spark Another Addiction Epidemic.” Fox News. Accessed July 10, 2014. [9] “Policy Impact: Prescription Painkiller Overdoses.” (July 2013). Center for Disease Control and Prevention. Accessed July 10, 2014. [10] Ibid.

What do you think?

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