Hydrocodone is a semi-synthetic opioid derived from either of two naturally occurring opiates: codeine and thebaine. It is an orally active narcotic analgesic and antitussive. It is available in tablet, capsule, and syrup form.
It is often compounded with other generally less effective non-opioid compounds such as paracetamol or ibuprofen, both often added to discourage recreational use, and to provide a possible synergy of analgesic effects between hydrocodone and the non-opioid compounds present. It is used to treat moderate to moderately severe pain. It is also used for the symptomatic relief of nonproductive cough, alone or in combination with other antitussives or expectorants.
Abstract
Hydrocodone is a semi-synthetic opioid derived from either of two naturally occurring opiates: codeine and thebaine. It is an orally active narcotic analgesic and antitussive. It is available in tablet, capsule, and syrup form.
It is often compounded with other generally less effective non-opioid compounds such as paracetamol or ibuprofen, both often added to discourage recreational use, and to provide a possible synergy of analgesic effects between hydrocodone and the non-opioid compounds present. The particular niche in which hydrocodone is most commonly used is as an intermediate centrally acting analgesic. Abrupt discontinuation of hydrocodone may result in withdrawal symptoms.
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Street Names
Vikes
Viko
Hydro
Norco
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Brand Names
Vicodin
Lortab
Lorcet
Vicoprofen
Norco
Xodol
Tussionex
History
Hydrocodone was first synthesized in Germany in 1920 by Carl Mannich and Helene Löwenheim.It was approved by the Food and Drug Administration on 23 March 1943 for sale in the United States and approved by Health Canada for sale in Canada under the brand name Hycodan.
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Pharmacology
The chemical formula for hydrocodone is: C18H21NO3.
Hydrocodone, a semisynthetic opiate agonist and hydrogenated ketone derivative, is similar to other phenanthrene derivatives, such as codeine. Used as an analgesic, hydrocodone is combined with acetaminophen, ibuprofen, or aspirin to treat pain.
Well absorbed from the gastrointestinal tract.
Symptoms of overdose include respiratory depression, extreme somnolence progressing to stupor or coma, skeletal muscle flaccidity, dizziness, ringing in the ears, confusion, blurred vision, eye problems, cold and clammy skin, and sometimes bradycardia and hypotension. In severe overdose, apnea, circulatory collapse, cardiac arrest and death may occur.
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Uses
It is used to treat moderate to moderately severe pain. It is also used for the symptomatic relief of nonproductive cough, alone or in combination with other antitussives or expectorants.
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Scheduling
In the US, it is Schedule II drug when sold in bulk quantities or as stand-alone product; but is Schedule III when in combination product.
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Psychological and physical addiction liability
The possible are the Psychological and physical addiction liabilites of hydrocodone:
Hives
Difficulty in breathing
Swelling of face, lips, tongue, or throat
Shallow breathing, slow heartbeat;
Feeling light-headed, fainting;
Confusion, fear, unusual thoughts or behavior;
Seizure (convulsions);
Problems with urination; or
Nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
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Long term effects
The major effect of taking hydrocodone long-term is the development of dependence on this drug. Stopping hydrocodone abruptly can cause severe withdrawal symptoms. Hydrocodone can also cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. The most common side effects of hydrocodone are blurred vision, constipation, difficulty breathing, dizziness, drowsiness, flushing, lightheadedness, mental or mood changes, nausea, and vomiting. Most hydrocodone products also contain acetaminophen. Excessive acetaminophen consumption can cause liver toxicity. The maximum daily dose of acetaminophen is 4000 mg per day. Do not take other products that contain acetaminophen without consulting with your physician. The risk of liver toxicity is increased in patients who already have a high risk for liver problems due to alcoholism, other medications, or liver disease.
As per some research, hydrocodone use in long term may also have liability to cause hearing loss over periods of use, though these actual findings are quite rare.
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Physical effects
Common physical effects could range from allergic reaction, blood disorders, to racing heartbeat, mental fogginess, anxiety, lethargy, difficulty urinating, spasm of the ureter, irregular, and rash.
Withdrawal Effects
Hydrocodone withdrawal symptoms can vary in intensity and may include:
Sweating
Insomnia
Shivering
Shakiness
Diarrhea
Goosebumps
Cravings for hydrocodone
Anxiety
Pain
Nausea
A runny nose.
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Medical Treatment options
The main aim in the treatment for hydrocodone addiction is get rid of the symptoms that cause both physical as well psychological effects. The medical options are limited in that case. At times, using drugs that mimic hydrocodone may do the trick. This helps in hydrocodone detox, which will mitigate the pain and discomfort of withdrawal significantly.
Psychological treatment options
The pyschological treatment option for hydrocodone addiction involve:
Detox at addiction treatment centers, followed by counselling. Rehab centers often help addicted patients to learn to overcome the emotional issues that led them to addiction. Rehab also offers important tips and strategies for achieving relapse prevention.
Psychological treatment
As medication is limited in combating hydrocodone addiction, psychological treatment options are often explored more.
The psychological treatment is generally carried out at rehab centers. About 10% of addicted patients have been successfully able to overcome this addiction without the rehab centers. The treatment involved detox followed by followed by counselling. Rehab centers provide guidelines, following which one may find it easy in preventing relapse.
Related drugs
The drugs that are related to hydrocodone are:
Opium
Codeine
Heroin
Methadone
Fentanyl
Oxycodone.
Related synthetics
The related synthetics to hydrocodone are:
Oxycodone
Fentanyl
Buprenorphine
Hydromorphone
Methadone
Naloxone
References
[1] http://www.drugbank.ca/drugs/DB00956
[2] http://www.justice.gov/dea/concern/hydrocodone.html
[3] http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.DrugDetails
[4] http://www.drugs.com/hydrocodone.html
[5] http://www.drugs.com/sfx/acetaminophen-hydrocodone-side-effects.html
[6] http://www.painphysicianjournal.com/2007/may/2007;10;467-472.pdf
