| Ask The Pharmacist |
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| By Robert Anderson Phar. D |
The amount of prescription pills seized in the county increased more than 100 percent within the past year.
Oxycodone and hydrocodone are opiate narcotics or derivatives of morphine. They are often combined with acetaminophen and available as trade names such as Percocet, Vicodin, Lortab, Lorcet, Lorcet Plus, etc. These drugs are used for severe or moderate to severe pain respectively. The most frequently abused prescription medications for non-medical use in the U.S. are these pain medications.
These drugs are great for relief of short-term pain (broken bones, wisdom teeth, post-surgical pain, severe osteoporosis, etc) and long term round-the-clock relief of cancer pain. However their use in chronic back pain and headache has skyrocketed in recent years.
It pains me to report to you that the US uses 99 percent of all hydrocodone produced in the world!
Yikes!!
Nationally, the amount of hydrocodone seized has increased over 600 percent from the year 2000 to 2006. The amount of prescriptions prescribed for hydrocodone has increased 48 percent during this timeframe with 131 million prescriptions dispensed in 2006.
In 2005 there were 3,740 serious toxicities in the ER with this drug including 100 deaths. Not surprising this drug is the most frequent narcotic encountered in the forensic lab!
Where is Quincy when you need him? Oh, I date myself; how about CSI or NCIS?
Dr. Nora Volkow, director of the National Institute on Drug Abuse, states that the misuse and use of prescription medications is a growing public health concern with prevalence increasing in all age groups.
In a 2003 survey, almost 10 percent of high school seniors reported non-medical use of oxycodone. More recent survey results are not available, but the abuse of narcotics may be worse now.
Side effects and adverse reactions
Not surprisingly these drugs can cause tolerance and physical dependence if used in too large a dose for too long a time. Most of us remember the term "habit forming" and indeed they can be. Tolerance means that it will require a higher and higher dose (or more frequent administration) to exert the same desired pharmacological effect, be that pain relief or euphoria.
Some patients under very strict supervision may require one or even more than one narcotic for long term use. How long does it take to become physically dependent? It varies with the patient, drug, dose, frequency, etc., but generally after 30 days at the maximum dose some degree of tolerance withdrawal symptoms may be expected if the drug is stopped abruptly. Such symptoms may include restlessness, irritation, anxiety, insomnia, nausea, abdominal cramping and general muscle aches. These symptoms often can lead to dependence on other drugs such as nerve and sleeping pills.
The narcotics have other common adverse effects such as drowsiness, nausea, constipation and respiratory depression. Many are combined with a Tylenol-like drug, which can easily cause liver damage at higher than recommended doses especially if combined with alcohol. Be sure to not drink while on these drugs and do not use any OTC product that contains acetaminophen.
I daresay Pickens County is not alone in this drug problem, and narcotics are not the only prescription drug abused, but North Georgia appears to be above the norm.
This is one area where it would be better to be lower on the list. Remember it is OK to take these drugs short term (and for cancer long term or under close medical supervision), but as they used to say on Hill Street Blues, "be careful out there" with any long term use.
Dr. Anderson is Professor Emeritus from Mercer University, a sometime pharmacist at Walgreens Pharmacy in Jasper and a full-time resident of Big Canoe.
