Hydrocodone’s Evolution: From Helpful to Harmful
Many different substances have proven to be quite problematic on a cultural and societal level. Of course, the first substances that we often think about might include alcohol, marijuana, and cocaine. But these are just a few of the substances that have affected the lives of millions and millions of people.
Some of the substances to which many people have become addicted were actually created to help people rather than harm them, which is the case with pharmaceutical drug hydrocodone. But what is hydrocodone, exactly? Where does it come from and what are its effects? And how does someone overcome hydrocodone addiction?
Where Did it All Start?
Before diving into hydrocodone specifically, it’s important to go over the background of opiates in general, which begin with a substance called opium. As you may already be aware, opium is an extremely potent narcotic that comes from the seeds of the opium poppy.
According to historical records, our history with opium extends back thousands of years. The plant itself originates from the Mediterranean region, but it didn’t take long for opium use to spread to such places as Egypt, Syria, Greece, and numerous other nations in Eastern Europe, Northern Africa, and Western Asia areas.
From Surgery to Recreation
Initially, opium was mainly used during surgical procedures as well as for religious practices. However, it would eventually be used for recreational purposes, too. In fact, as opium became a more recreational substance, the drug was making its way into China, which is one of the places that has a very strong historical association with opium.
Upon making its way into China, opium quickly spawned an addiction problem among the Chinese, resulting in the many so-called opium dens that emerged throughout the country. As Chinese immigrants moved westward, opium was finally introduced to the Americas. On the cusp of the American Civil War, we had learned just how powerful and addictive this substance is, leading a number of researchers to search for safer or less addictive alternatives. This led to the discovery that opium’s effects are the work of two important alkaloids: codeine and morphine.
Thereafter, morphine usurped opium’s place as the primary opiate for use in surgical procedures. Soldiers who were wounded in battle were usually treated with morphine during the Civil War. However, experiments with these substances were ongoing and would soon lead to the development of heroin. Although they had been hoping to develop something similar to morphine with fewer risks, heroin proved to be even more powerful and addictive than morphine. As a result, chemical development continued, leading to the synthesis of such pharmaceuticals as oxycodone and hydrocodone.
The Birth of Hydrocodone
Hydrocodone was first synthesized in Germany in 1920, but it wasn’t until more than twenty years later — 1943 — when it was officially approved in the United States by the Food and Drug Administration. While oxycodone was created from thebaine — one of the less-used derivatives of opium — hydrocodone was created by adding hydrogen to codeine; however, hydrocodone appeared to lack the stomach discomfort and high risk of toxicity that characterized codeine. Through testing, it was found that hydrocodone was effective at three things: (1) alleviating pain, (2) alleviating a cough, and (3) producing feelings of euphoria.
Reduction Through Regulation
It was hoped that strong regulations surrounding the substance would mitigate its abuse, but it has, at times, been the most-prescribed painkiller as well as the most widely abused. Today, the trade name Vicodin is most closely associated with hydrocodone, but there have been several other brands to release versions of the drug.
In the past few years, there has been a purer form of hydrocodone called Zohydro to receive F.D.A. approval although surveys show that it’s not being prescribed very often. However, hydrocodone remains one of the most frequently prescribed painkillers with estimates from 2013 indicating at least 136 million annual prescriptions for the drug.
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What Exactly is Hydrocodone?
Hydrocodone is part of a class of medications that are called opiate (narcotic) analgesics. It relieves pain by changing the way the brain and nervous system respond to pain. It is used to treat severe pain in people who can’t be treated with other medications. Hydrocodone is a derivative of codeine which comes from poppy seeds.
When a person takes hydrocodone, the brain experiences a surge of neurotransmitters, including dopamine, serotonin, and norepinephrine. The cumulative effect is to essentially dampen a person’s ability to feel pain. However, the drug has been found to induce euphoria, which is why it’s often abused.
As is the case with other opiates, abusing hydrocodone causes feelings of warmth and a tingling sensation throughout the body. The limbs often feel heavy and an individual often becomes quite drowsy and has difficulty staying awake. The drug can also cause things like respiratory depression when taken at high doses, which is a major contributor to overdoses.
Hydrocodone’s Half-life
If you have been prescribed hydrocodone, you might wonder how long the drug lasts in your body and how long it might show up on a drug screening. Measuring the half-life of a drug is one way to find out how long a drug lasts in your body. The half-life is the amount of time it takes to eliminate half the drug from your body.
Hydrocodone has an average half-life of 3.8 hours in an average healthy adult male. However, everyone metabolizes drugs differently, so the half-life will vary somewhat from person to person.
It takes several half-lives to completely eliminate a drug. Generally speaking, hydrocodone will clear the blood within one day. According to the American Addiction Center, it can still be discovered in the saliva, urine, or hair for much longer.
How long?
- Saliva: 12 to 36 hours after the last dose
- Urine: up to 4 days after the last dose
- Hair: up to 90 days after the last dose
Possible Side Effects of Hydrocodone
You should stop using hydrocodone and call your doctor immediately if you have these serious side effects:
- A weak pulse or slow heart rate
- Pain or burning during urination
- Confusion, tremors, or severe drowsiness
- Feeling light-headed, like you might pass out
- Noisy or shallow breathing, sighing, breathing that stops while you sleep
- Nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness
Serious side effects appear to be more likely in older adults and people who are malnourished or in a weakened condition. Long-term use of opioid medications may have an effect on fertility in men or women. Whether the effect is permanent is not yet known.
Common side effects:
- Headache
- Constipation, nausea, vomiting
- Dizziness, drowsiness, feeling tired
- Cold symptoms such as a stuffy nose, sneezing, sore throat.
Hydrocodone Withdrawal Symptoms
When a person takes hydrocodone frequently, he or she becomes quite likely to experience withdrawal symptoms during times when he or she is not using hydrocodone. Many of the withdrawal symptoms associated with hydrocodone apply to most other opiates, too. For instance, individuals experiencing hydrocodone withdrawals often experience:
- Anxiety
- Insomnia
- Sweating
- Depression
- Loss of appetite
- Excessive yawning
- Nausea, diarrhea and/or vomiting
- Intermittent hot flashes and cold chills
- Physical discomfort in the joints and muscles
- Runny nose, watery eyes, and other symptoms that are comparable to the flu
Overcoming Hydrocodone Addiction
It can be quite disconcerting to suffer from an addiction to hydrocodone. But there are plenty of resources available to help. In most cases, recovery from hydrocodone addiction begins with:
Detoxification
This is an initial period to address the physical aspects of addiction so that the individual in question isn’t experiencing withdrawal symptoms when he or she begins actual treatment.
Symptoms of withdrawal can be classified and mild, moderate, moderately severe, and severe. Mild symptoms can be treated with Tylenol, aspirin, and anti-inflammatory drugs. Over the counter medications can help with diarrhea and nausea. Intense withdrawal symptoms may need hospitalization and other medications. Clonidine is a prescription medication that can reduce the intensity of symptoms by 50-75%. It is used mainly in an inpatient setting.
Treatment Phase
This phase consists of individual psychotherapy, group therapy, relapse prevention education, and other important components. The goal is to help the individual achieve lasting sobriety by meeting his or her unique recovery needs. Depending on the severity of the addiction and how long the patient has been dependent, there are options for a treatment program such as these:
Residential: During residential treatment, you will live at the treatment facility. This is a safe, secure environment that ensures that you won’t be exposed to the situations, environments, and people that used to trigger your need to use the drug. You will spend your days in therapy sessions with your therapist or in group sessions with other patients.
Outpatient and Intensive outpatient treatment: If you are in outpatient treatment, you will still live at home but you’ll still be spending a considerable amount of time at the treatment facility, where you will attend your group and individual therapy sessions. The difference between Intensive outpatient treatment and outpatient treatment is the length of time spent in treatment each week. Outpatient treatment is sometimes used as a step-down from a residential program or for people who have completed a program and subsequently relapsed.
Continuing care: Also called aftercare, this is an immensely important part of continuing your abstinence after treatment. This might consist of a sober living residence or continuing therapy, or a peer support group. Or all of them. This is one of the best things you can do to prevent relapse.
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