Zohydro: The FDA-Approved Prescription for Addiction

[Purveyor]

In a few weeks, a powerful new opioid painkiller called Zohydro is expected to hit the market. Zohydro's easily crushed capsules will contain up to 50 milligrams of pure hydrocodone; that's 10 times more hydrocodone than a regular Vicodin. One capsule will pack enough hydrocodone to kill a child. An adult lacking a tolerance to opioids could overdose from taking just two capsules.

Many folks on the front line of our nation's opioid-addiction epidemic were shocked that the FDA approved Zohydro despite the strong objection of an FDA advisory committee, which voted 11-to-2 against it. This may be the first time in history that the FDA will allow a drug to be released despite a landslide vote to keep it off the market.

Concerned about FDA approval of Zohydro? You are in good company. This morning a letter signed by more than 40 organizations was sent to FDA Commissioner Hamburg, urging her to keep Zohydro off the market. The organizations include some of the most prominent addiction-treatment agencies in the country, including Hazelden, Caron, and Phoenix House. Other co-signers include CASAColumbia, the American Society of Addiction Medicine, Blue Cross Blue Shield, the consumer advocacy group Public Citizen, and dozens of community-based addiction-prevention organizations.

Understandably, concerns about Zohydro have focused on the fact that, like the original version of OxyContin, it can be easily crushed -- a feature that makes it especially lethal. But there are other good reasons to be concerned about Zohydro. It isn't just bad for so-called "abusers" who crush the capsules; Zohydro's risks will also outweigh benefits when swallowed whole by the chronic-pain patients Zohydro's maker is targeting.

Opioids are excellent medications for easing suffering at the end of life. They are also effective when prescribed short-term to treat severe acute pain. But they don't work well when taken on a daily basis for months and years. Over time, many people develop tolerance to the analgesic effects, leading them to require higher and higher doses. As the doses go up, quality of life and ability to function often declines. They can even make pain worse, as seen in a phenomenon called hyperalgesia.

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http://www.huffingtonpost.com/andrew-kolodny-md/zohydro-the-fdaapproved-p_b_4855964.html

[Warpy]

1. This article is drug warrior bullshit

Pain patients do take a set dosage for many years without constantly upping the number of pills or doctor shopping. I know because I'm one of them, on opiods for 23 years now. I don't get high and in fact I don't want to get high. What they do for me is allow me to function for several hours, something I can't normally do all that well.

This new formula is a godsend for people who don't quite need the much more powerful oxycodone but who might be showing kidney damage from the preparations that contain Tylenol.

I find this hysteria cruel and unfounded.

[Liberal Veteran]

2. I don't have any current need for these drugs, but I agree with you.

There is a potential for abuse with prescription painkillers, but I firmly believe that the fears of misuse/abuse causes a lot of unnecessary suffering.

There are people who really need strong painkillers and honestly, I can't abide people living in pain when we have the means to prevent it.

[kcr]

3. Agree

The fear mongering articles about Zohydroooo! Oooga booga! have been awful.

[5X]

5. Totally agree. Been on strong pain killers for about ten years.

Having other choices so long term users can switch meds when you do become tolerant
is a big help. The strongest zohydro is only going to be 50mgs. That is like 5 lortabs,
not all that much to someone that is opioid experienced.

[Seeking Serenity]

7. I agree as well. n/t

[REP]

10. Or for kidney patients who should be avoiding acetaminophen and can't take NSAIDs

The fun thing about kidney disease is that it really fucks up your bones, joints and tendons in truly painful ways.

[irisblue]

4. I gotta ask

Last edited Thu Feb 27, 2014, 09:31 PM - Edit history (1)

I have 2 knees that are bone on bone, L3, 4,5 have disc protrusions to the left pressing on left I have great difficulty carrying a 22# container of kitty litter into the basement, carrying up 28# of used damp, particulate matter, divvied into 4 bags, meaning 2 trips up and down, one bag to each hand w/o being in so ***much pain that I need to sit for a half hour. Yes, some day I will have a one floor living space, no cats, no dogs in a nursing home. I MIGHT have had surgical correction by then, depending on income and insurance and health. Yes I realize some may abuse the non acetaminophen ophoid....what will be available to me to control my daily pain so I will be able to be a participating full member of society? Now, any one looking for pain control is assumed to be a junkie looking for meds because the FDA has leaned so hard on doctors that they are afraid to prescribe w/o the doctors into trouble with the FDA and their state. Why do I have to continue being in pain that has made me cry in public?

[Warpy]

6. It's the DEA that leans on doctors

You know, the clowns who are supposed to be working on busting the biggest dealers, not doctors, not the poor bastards on he street looking for a fix, and certainly not those of us with medical conditions that leave us in pain.

The dumb fucks will just never admit that untreated pain is lethal. It causes people to isolate get severely depressed, and commit suicide as the only way to make it stop.

[Seeking Serenity]

8. And, at least here, the State Medical Board

Bastards will threaten an MDs license if they think the MD is prescribing "too much."

[REP]

9. What a load of complete drug hysteria bullshit

I almost wish the author of this ill-informed piece could experience severe, chronic pain for a few years. Almost, but I'm not as stupid and cruel as the writer, who did almost zero research.

[NaturalHigh]

11. Chronic pain patients will benefit from this.

I was just talking to my pain management doctor today. Yes, there are risks, but there are risks with current drugs on the market (both narcotic and non-narcotic) as well.

[W H]

12. This is all about money

My reaction based on 40+ years of practice in this dystopian prescribing world that the USA has become:

Just one more item in the perverted, hysteria-laden yammering about "epidemics" of drug abuse. You have chronic pain? Opiates, written by a well trained physician and managed carefully by you, give you relief and return to normal life style? The system could care less. Except to create these artificial issues in order to rip you off big time for inherently inexpensive meds.

1. There is always the kernel of truth inside the big lie. Addiction and inadvertent overdose has always been a problem, just not the Chicken Little crisis that is currently portrayed. That does not mean it is not still a big lie. And the"war on drugs" is truly one of the biggest lies Americans continue to endure. True, Zohydro is not very "abuse deterrent" and that never mattered anyway. It is just the latest catch phrase used to justify a patent on the pill formulation in order to jack the price and to force doctors to prescribe it while scaring the crap out of them about "abuse deterrence". The small, <1.5% of the populations that is die-hard shoot up addicts has not changed in the 60 or so years we have been monitoring this stuff. They already know whether it is usable to them or not and don't care (Recent headline - "Heroin is Cheaper Than Beer in Pennsylvania&quot .
Recreational drugs are so readily available that it is laughable. And only a tiny fraction come from deliberate prescription writing. Most come from stolen supplies, who knows where, in the supply chain. To say nothing of the array of manufactured "designer drugs" that would not exist except for the market created precisely by that same perverted "War on Drugs". The active ingredients are a tiny fraction of a penny a dose and things like Zohydro go for maybe $30 each. Maintain the hysteria and you maintain your market for a phonied up concoction with a contrived-only purpose, that is tens of thousands of percent marked up by restricting the market.

2. Addiction has been amply demonstrated, over and over, by prospective research and by empiric retrospective data, to be far more a psychosocial and environmental problem that a purely biochemical one. 80-90% of the heroin addicted US soldiers in Vietnam, simply stopped of their own accord, with no intervention whatsoever, when their environment changed. There are many other examples. 80-90% of people who would be classified as addicts are fully functioning in all social and personal aspects. The highest function in addict who meets all the criteria of addiction in the US is your president. He continues to need his Nicoret and to sneak a smoke now and then, as he simply cannot break his nicotine addiction. Yes, nicotine, not thc, IS the gateway drug. It is highly habituating.

3. Zohydro is maybe marginally useful for some. Probably unnecessary for most. The main point is it deserves virtually no mention. Just that doctors need to know what they are doing if they use it and patients need to be informed and to pay attention, just as with all drugs.

4. The War on Drugs can only be won one way. Decriminalize possession of ALL drugs, All of them. Period. End of story. All countries who decriminalize all drugs, see addiction and abuse go down, way down (and the concordant massive crime, imprisonment and personal cost, in the hundreds of billions, also disappear). Venues (USA) where the "War on Drugs" is fought most overtly, see the highest use of recreational drugs and associated crime and frightful cost of (totally failed) law enforcement.

So - stop fretting about Zohydro. It is just a gimmick for profit. It wont make a dime's worth of difference good or ill, in this idiotic, cruel and horrifically expensive war on drugs.

Tell you Congressman to decriminalize possession of ALL drugs. The use will down. Education, the only effective approach, can begin to work. Zohydro will have no street market and those chronic pain patients who can benefit from time release meds will be able to afford it.

Cheers