Vicodin ® Information
Vicodin ® is a trade name for hydrocodone,
which is an orally active analgesic and antitussive Schedule II
narcotic that is marketed in multi-ingredient Schedule III products.
Vicodin ® has an analgesic potency similar to or greater than
that of oral morphine. Sales and production of this drug have increased
significantly in recent years (a four-fold increase between 1990
and 2000), as have diversion and illicit use. Other trade names
for hydrocodone include Anexsia®, Hycodan®, Hycomine®,
Lorcet®, Lortab®, Tussionex®, Tylox®, and Vicoprofen®.
These are available as tablets, capsules, and/or syrups. Generally;
this drug is abused by oral rather than intravenous administration.
Currently, about 20 tons of hydrocodone products are used annually
in the United States.
Vicodin ® abuse has been escalating over the last decade. There
has been large scale diversion of Vicodin ® and other hydrocodone
drugs . For example, an estimated 7 million dosage units were diverted
in 1994 and over 11 million in 1997. In 1998 there were over 56
million new prescriptions written for hydrocodone products and by
2000 there were over 89 million. From 1990 the average consumption
nationwide has increased by 300%. In the same period there has been
a 500% increase in the number of Emergency Department visits attributed
to hydrocodone abuse with 19,221 visits estimated in 2000. In 1997,
there were over 1.3 million hydrocodone tablets seized and analyzed
by the DEA laboratory system. A recent petition submitted to the
DEA has requested a review of the control status of all hydrocodone-containing
products.
There are over 200 products containing hydrocodonein the U.S. In
its most usual product forms hydrocodone is combined with acetaminophen
(Vicodin, Lortab), but it is also combined with aspirin (Lortab
ASA), ibuprofen (Vicoprofen), and antihistamines (Hycomine). Both
tablet and liquid forms of hydrocodone are available (e.g., Tussionex)
Vicodin ® is abused for its opiate-like effects. It is similar
to morphine in relieving abstinence symptoms from chronic morphine
administration. The Schedule III status of hydrocodone-containing
products has made them available to widespread diversion by "bogus
call-in prescriptions" and thefts. Three dosage forms are typically
found (5, 7.5, and 10 mg) and their behavioral effects can last
up to 5 hours. The drug is most often administered orally. The growing
awareness and concern about AIDS and blood-borne pathogens easily
transmitted by syringe needle use, has made the oral bioavailability
of hydrocodone attractive to the typical opiate abuser.
As with most opiates, the adverse effects of Vicodin ® abuse are
dependence and tolerance development. Its co-formulation with acetaminophen
has also increased the likelihood of acetaminophen-induced hepatic necrosis
with high dose acute dosing, but slow escalation of dose over time seems
to protect the liver during high dose chronic exposures seen with this
drug.
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