Hydrocodone:
Vicodin ®
When we speak of people being addicted to prescription drugs, we often mean they are addicted to Vicodin ® or other combinations of the opioid hydrocodone. Vicodin ® addiction is the most common reason given for admittance to drug rehabilitation centers.1 In one study, it accounted for 53 percent of admittances.2
Ten years ago, a typical abuser was a white-collar worker or homemaker who began using the drug through a doctor's prescription for pain relief.3 However, today that is changing.
What now concerns drug enforcement officers and others who work in the field of substance abuse is that Vicodin ® is increasingly becoming a drug of choice among young people. According to one 2006 survey of American high school students, almost 10 percent of high school seniors and three percent of eighth graders had tried it at least once during that year.4
The U.S. Drug Enforcement Agency is now trying to change how hydrocodone is regulated, because it is too easily available on the Internet, from unethical physicians, or through "doctor shopping." 5
Forms and Brands
Hydrocodone is nearly always mixed with other drugs, usually acetaminophen (Tylenol ® ), ibuprofen (Advil ® ), or antihistamines. It is sometimes sold as a pill to relieve coughs.
Vicodin ®, a combination of hydrocodone and acetaminophen, is one of the most commonly prescribed medications in the U.S. The pill is white and oval, and says "Vicodin" on one side. The other side is bisected. Other versions have "Vicodin ES" or "Vicodin HP" printed on them and have flatted ends.
Other trademarked names for the same combination that is found in Vicodin are Anexsia, Dolorex Forte, Hycet, Liquicet, Lorcet, Lorcet Plus, Lortab, Maxidone, Norco, Stagesic, Xodol and Zydone.
- Hydrocan ® is a white pill for coughs. It says "hycocan" on one side and is about the size of a baby aspirin.6
- Lorcet ® is very common and can be either a white or a blue pill. The 10 mg (an oval light blue pill) version has "UAD" in a circle on one side and "6350" on the other.
- Lorcet ® Plus is 7.5 mg, and it is a white oval pill with "UU" on one side and "201" on the other.
- Lortab ®, with 7.5 mg of hydrocodone is a white oval with speckles, and has "AWhitby" on one side and "903" on the other. The lower dose Lortab (2.5 mg) is also a white oval with "AWhitby" on one side, but it has "106" on the other.
- Tussionex ® is a common white pill for coughs. It says "18-894" on one side and has a stylized "Y" on the other.
- Vicoprofen ® combines hydrocodone with ibuprofen. It is a small white pill about the size of an adult aspirin with "VP" on one side and a stylized "A" on the other.
Hydrocone and ibuprofen made by Teva also looks like a white adult aspirin that says 5151 on one side.
Effects and Use
Hydrocodone is a Schedule II narcotic used for pain relief and cough suppression. As it blocks pain messages to the brain, it can cause an intense feeling of pleasure and euphoria. Side effects can include liver and kidney damage, chest pain, skin rashes, nausea, confusion, wheezing, difficulty in breathing, and flu-like symptoms.7
Doctors prescribe hydrocodone for severe to moderate pain - for example, for broken bones or slipped discs.8
Dangers and Risks
Hydrocodone is highly addictive. When teens first try this drug, they often feel a sense of euphoria and joy. If they keep using it, they quickly develop a tolerance for the drug and have to increase the amounts they take even to achieve the effect of relaxation. They usually cannot stop using hydrocodone on their own, because withdrawal will make them sick or give them severe headaches.
One danger of hydrocodone abuse is that it is usually comes in combination with acetaminophen, which damages the liver and kidneys in any amount over medically recommended levels. The recommended level of acetaminophen is 1000 mg at any given time and no more than 4000 mg in one day. It should never be mixed with alcohol. Teens will often pop three or four Vicodins ® (750 mg of acetaminophen in each pill) along with alcohol. Even one time like that can cause severe liver damage.9
If your teen has asthma or allergies, hydrocodone can slow his breathing, and cause wheezing and chest pain. It interacts not only in a dangerous way with alcohol, but also antihistamines, barbiturates and muscle relaxants.10
Addiction to any drug puts a teen in contact with drug dealers. Possession of hydrocodone is a felony in most states that can lead to a prison term of five to ten years or more.
Signs of Use
Teens take hydrocodone in order to relax, so you may notice that your child is sleeping more and acting as if she is in a "stupor." She may have pinpoint pupils and seem confused and "dopey." She may be unable to keep up her grades or schoolwork. She may quit sports and other activities because she has no energy for them.
Without her drug, she may be extremely irritable and suffer from sleeplessness. She will not want to travel with the family or leave her drug supply for any long period. She will appear secretive.
Many parents find out about their child's drug problem when she begins to steal money from them or run up their credit cards. She may sell her own clothing and other possessions or even household items like cameras and video game sets.
Others find out when the teen is arrested for drug possession or dealing, or becomes involved in a car accident when the police declare her to be under the influence of a drug.
Overdose
A teen overdosing on hydrocodone will probably have flu-like symptoms such as fever, chills, sweats, headache, and vomiting. A severe overdose will include chest pain, cold clammy skin, difficulty breathing, pinpoint pupils, nausea, confusion, and sometimes a skin rash. This person needs to go to an emergency room for immediate treatment.11
Some teens will react violently to the ibuprofen component and have black tarry stools or vomit what looks like coffee grounds. This too requires immediate medical treatment. Teens who take too much ibuprofen should not have dental work or surgery without telling their dentists or doctors because they may bleed too much during such procedures.12
Withdrawal and Treatment
Teens who are addicted to hydrocodone have to go through a physical withdrawal period that is not pleasant. Often they get sick, vomit and experience severe headaches. Other withdrawal symptoms can be intense cravings for hydrocodone, sweats, abdominal pain, and seizures. They need medical intervention to help them through this period or they will return to hydrocodone to relieve their symptoms. Because withdrawal can in rare cases cause sudden death or coma, they will need professional help.13
One addict described the first seven days of withdrawal as a time "when I couldn't function. I couldn't sleep. I had memory problems. I felt exhausted and had to stay in bed."14
Hydrocodone often becomes a crutch for its abusers. As one teen put it, "I wasn't living life on life's terms. Anytime something upset me, it would become an excuse to take more Vicodin." 15 Your teen may need help breaking his psychological dependence on this drug. He has to learn new methods of coping with everyday problems and upsets. It might take a long time to completely stop using this drug permanently. Since hydrocodone is a drug that enables a user to "tune out the world," the teen often needs help to renew interest in school, hobbies and career goals.
Many teens benefit from enrolling in a residential boarding school or wilderness program where they can get away from their old friends and drug lifestyle and start over in a new environment. These programs are intense and provide twenty-four hour supervision, daily counseling and education in how to live drug-free. Once the teen returns home, he will need to undergo aftercare in the form of attending support meetings and continued psychological counseling to help him through relapses and cravings.
