March 24, 2023

Hydrocodone and its relative oxycodone result in more than 2 deaths every hour throughout the year. Sadly more than 85% of the world’s hydrocodone is consumed in the United States, yet it regularly fails to perform up to expectations. Governmental authorities who once championed prescriptions for chronic back pain, arthritis and fibromyalgia now realize the monster they created. Current recommendations suggest severe restrictions on this compound.

You you hello i’m dr. ken lined out thanks for watching let’s talk about hydrocodone hydrocodone is a semi-synthetic derivative of a material an alkaloid that’s found in the opium poppy seed it’s used for moderate to severe pain and sometimes used as a cough suppressant the overwhelming majority of hydrocodone produced in the world is consumed here in the united

States to such an extent that if we look at the number of prescriptions written with refills that would be enough to provide two prescriptions to every man woman and child living here in the united states and that far surpasses the number two drug thyroid drug the history well it was first synthesized in germany in 1920 was approved for use in the united states

In 1943 it was manufactured in germany by no pharmaceuticals that came out as a product known as dye quoted by closes fortunately for them didn’t really catch on and as a matter of fact they don’t even use the hydrocodone in germany anymore or frankly all that much in europe first cases of habituation and euphoria with the drug they were reported as early as 1923

The dependence and addiction that was reported as long ago as 1961 now there are hundreds of brand name and generic forms of hydrocodone typically mixed with acetaminophen that’s the product in tylenol and the most commonly used drugs or commonly known drugs are vicodin and lortab they’re basically the same thing well how do you rate the strengths of the drug

Most people do it on the ability of the hydrocodone to constrict the pupil that’s a false measure we know that it would take you about 50% more hydrocodone compared to oxycodone to get the same amount of people larry constriction on the other hand if you happen to break your leg and you go to the emergency room the drugs appear to be equivalent if you compare

It to an injection of morphine for everyone milligrams of injected morphine you would need about two and a half milligrams of oral hydrocodone but if you look at oral morphine versus oral hydrocodone they seem to be equivalent and if you compare it to codeine you need about thirty milligrams of coding to give you the same amount of pain relief that you would

Get with five milligrams of hydrocodone now most of the drug is used as an immediate release you take the drug and it dissolves and gets into your system right away it’s not an extended-release product that you can take once or twice a day most of the hydrocodone is either combined with that then sometime with ibuprofen but almost always with acetaminophen it’s

Combined with anywhere between 325 milligrams and a thousand milligrams of acetaminophen but the acetaminophen isn’t really there to provide extra pain relief it’s so that you don’t break the pill down and inject it now the old idea was that if you didn’t have pain you couldn’t become addicted to the products but that is absolutely false as a matter of fact if

You combine the hydrocodone acetaminophen with a depressant of the central nervous system you’re much more likely to have a side effect an overdose or die yet in spite of this it appears that one person in three taking the drug also takes a sedative that one person in eight consumes at least two drinks of alcohol within two hours of the pill one in 32 votes most

Of the deaths come from combination of the hydrocodone added to a muscle relaxant or alcohol or a benzodiazepine benzodiazepine the drug that would be like xanax it’s habit-forming can lead to physical psychological dependence so the food and drug administration in 2014 said we’re not classifying this like we have for the longest period of time is class three

Drug we’re going to consider the class two drugs and a class two drug you have to a doctor write a prescription you can’t call it in to the pharmacy and you can only get a 90-day supply one month supply times two refills you cannot get a five month refill that’s major difference far as how often you have to go see the doctor what costs are but it’s worth it

Because unfortunately people were abusing this drug in fact the overwhelming majority of people who take the drug abuse the drug they don’t take it for legitimate medical reasons now everybody has the potential to become addicted to this drug once they start to take it but there are special risk factors so for instance if you have a psychological or psychiatric

Disease if you’re suffering from anxiety or depression you’re more likely to become addicted to this drug if you start taking it if you have a history of substance abuse you smoke cigarettes you consume alcohol you’re more likely to be at risk and the longer you take the drug the more tolerance you get the more tolerance you get the more quantity you need either

A higher dose of the pill or you need to take the bill more frequently when we’re talking about the immediate release form once you take it it starts to dissolve and get into the system within 20 to 30 minutes of peaks at about 30 to 60 minutes and lasts for about four to eight hours and then you have to take another dose now it’s the most potentially deadly of

All prescription medicines it and oxycodone as a matter of fact by 2011 there were more people who died of overdoses of either oxycodone or hydrocodone than there were who died in automobile accidents each year in the united states somewhere between 50,000 and 55,000 people died of drug overdoses some of those are legal drugs some of those are illegal drugs it

Seems that about 25,000 to 30,000 people are going to die of a narcotics significant number about 500,000 people going to go to the emergency room every year because of toxic reactions to these kind of drugs people who take them get a feeling of euphoria they feel better so they start off at one or two pills and then pretty soon they’re on ten or 20 bills or even

More the pills can have some side effects associated with them we all know that they can cause you to have nausea or vomiting a colossal case of constipation so you go to the bathroom only once or twice a week they can cause dizziness and drowsiness lightheadedness and anxiety they can lead to either an elevated mood or a depressed mood that can cause rashes

Itches they can narrow your pupils they can lead to irregular breathing and sometimes chest tightness shortness of breath and for men especially men to take the prolonged release or the extended-release form it can interfere with production of testosterone you know what that means infrequently it can cause progressive hearing loss and there’s a special problem

For women who were pregnant to take the pill we know that the unborn child may become addicted and then cause problems after delivery with a neonatal withdrawal syndrome we also know that it can lead to respiratory depression in the fetus and it can also lead to an increased incidence of birth defects the pill is especially problematic for people who have sleep

Apnea or as more bad bronchitis now the hydrocodone by itself isn’t really toxic to the liver small benefit doesn’t increase your liver blood test but when you combine it with acetaminophen then you open the door for significant problem there’s no evidence that taking more than 325 milligrams of acetaminophen combined with hydrocodone provides any extra relief but

It does lead to an increased incidence of liver failure need for liver transplant and death from liver toxicity there’s specialy problem with your liver if you drink alcohol or maybe have muscle ache or pain or maybe you have a coffee and you go over to the drugstore and you get one of the commonly used over-the-counter drugs they frequently contain additional

Acetaminophen there’s a limit to about 4,000 milligrams of acetaminophen that you can take per day without increasing your risk of liver toxicity or cirrhosis or some other kind of severe problem the acetaminophen with added to hydrocodone in 1998 in order to prevent people from crushing the pills snorting it or injecting the pill well interestingly the food and

Drug administration in 2011 said to the drug companies that manufactured hydrocodone they said you’re putting too much succeeding in offense in the pill let’s limit it to no more than 325 milligrams and do that by 2014 it’s voluntary but if you don’t do it we’re going to make a rule that says all drugs that have more than 300 milligrams or 325 milligrams have to

Come off the market there’s a problem with hydrocodone if you combine it with other drugs that are going to affect the central nervous system so if you combine it with alcohol you’re at higher risk of respiratory failure and death or if you take it with another opioid or you take it with an antihistamine or an anti-psychotic anti-anxiety drug like xanax or maybe

Even if you take prozac or zoloft any of the central nervous system depressant can increase the likelihood of tech talks isset e withdrawal reactions can occur as early as 6 to 12 hours after your last dose that means if you take a pill before you go to bed or by the time you wake up you can start to have withdrawal reactions withdrawal reactions peak about

72 hours after you stop taking the pill they last for about 5 to 7 days but can last for weeks or even months and the cravings and the emotional changes they can last for years the symptoms of withdrawal they include restlessness sweating chills they include muscle and bone aches and pains you can have some insomnia diarrhea you can have vomiting mood swings

Headaches some people have depression or fatigue some people even consider suicide but you also can take too much of the drug and if you take too much of the drugs if you overdose on the drugs then we have other kinds of problems the pupils become narrow but as there’s less oxygen going to your brain they become widened you respirations can become shallow and

Short or ultimately stop your heart rate goes down your skin gets to be cold and clammy sometimes turns blue excessively sleepy you can lose consciousness you can have seizures you can even die the maximum you should take at 60 milligrams of hydrocodone per day and four thousand milligrams of acetaminophen per day so that means you should take no more than 12

Pills of the standard 5 milligram hydrocodone 325 milligrams acetaminophen per day additionally there are about 200 million prescriptions written for these drugs each year in the united states it’s estimated that there are 5 million addicts 5 million people taking the drug for inappropriate reasons here in the united states and unfortunately you take the pill

You feel well so the over uses and eventually that’s going to lead to addiction we have a lot of drug mills here in the united states some prescribe what’s known as the trinity that’s hydrocodone combined with a muscle relaxant and the benzodiazepine like xanax or the holy trinity that’s oxycodone instead again combined with a muscle relaxant and a benzodiazepine

Now every day in the united states somewhere between 45 and 50 people die of an overdose 45 to 50 people per day died of overdose of oxycodone or hydrocodone that’s a major number that adds up to more than 16,000 up to 20,000 people per year died of this medicine and for each person who dies 30 more are going to go to the emergency room the way the drug works will

It binds to some opioid receptors in the brain and in the gut you probably some other areas in the body that’s the way you get the benefits supposedly that’s the way you get the toxicity once you take the drug its metabolized by a liver enzyme to another product called hydromorphone in the hydromorphone is even more potent than the hydrocodone now interestingly

We have all this problem everyone knows you have a problem with hydrocodone when it’s combined with another pain medicine like either aspen or acetaminophen or ibuprofen but the food and drug administration in 2014 allowed marketing of a drug known as by hydro er the er stands for extended release this releases over a period of about 12 hours so you only have to

Take two a day supposedly it’s only for people who have severe pains who have prolonged pain round-the-clock necessity for taking some kind of a pain medication but there’s no evidence is less addictive no evidence it’s any better and unfortunately with these extended release pills we have a higher incidence of toxicity well it’s the schedule 2 drug just like the

Hydrocodone that the immediate release but interestingly the food and drug administration has an advisory panel in the advisory panel that they don’t market this drug don’t allow it to be marketed in 30 states protested to the fda that this drug should not be marketed so the fda said ok that’s marcus drug well unfortunately there was the tendency for the drug to

Be abused and potentially snorted or injected because it was a pure hydrocodone it didn’t have any of that acetaminophen in it so very quickly after it was approved in 2014 by 2015 it had to be reformulated we have a problem with diversion so people go to doctors offices and they alter prescriptions they steal the prescriptions has a doctor shop and gets lots of

Different prescriptions from lots of different doctors or they get an excessive number of prescriptions such as number of pills you go see the dentist he takes a two thousand see a month’s supply of the pill ridiculous you’re going to have pain for two or three or four days that’s all you need at most most of drug abuse in the united states is thought to be blue

Collar type sort of rural areas but hydrocodone is a white collar type pill now heroin cost about fifteen dollars a bag and when you compare that to a single black-market hydrocodone for about five to seven dollars a pill or oxycodone that can go for up to $80 ago you can see that now these drugs are fueling a heroin epidemic a horrible heroin epidemic that’s

Occurring in the united states and unfortunately heroin we’ll talk about the different segments is being added to fentanyl and now we have another major cause of death well hydrocodone is for short term pain relief it’s for the pain that you would have after an operation or a fracture or is for people who have terminal illness who are going to die in relatively

Short period of time on the other hand more than 90% 9 0 % of hydrocodone that’s used in the united states is used for chronic pain but guess what it doesn’t work the people who have chronic pain still have chronic pain when they’re taking the drug so that means the drug is ineffective for the purposes that it’s prescribed and the drug is often prescribed for

People who have arthritis or people who have low back pain people who have nerve pain it is not to be used for those particular kinds of problems and as a matter of fact it can cause a paradoxical problem so you take the pill and you actually have more pain now there’s another issue what about the cost well if we’re talking about going to a legitimate pharmacy

If you get a month’s worth of hydrocodone combined with acetaminophen the cost is usually somewhere around thirty five forty five dollars for the generic or maybe up to $500 for the name-brand product so what do we say about the overall cost cost is reasonable if you buy a generic product where we say about the effectiveness well it’s used mostly for chronic pain

And for chronic pain it doesn’t work it’s okay for acute pain after you have your operation after you have a two extracted if you break a leg yeah it’s okay on the other hand the way it’s used in the united states right now in appropriate anyway thanks for watching i’m dr. ken landau

Transcribed from video
Hydrocodone By wellnowdoctor