Amid the clamor of criticism calling for the reversal the of the Food and Drug Administration’s approval for Zohydro, the alternative, if not lesser evil for the U.S. just might be heroin. Meanwhile, the system lets pain patients suffer without medication. Becoming more easily available at Walmart prices, heroin offers a desirable option among IV drug users who routinely inject prescription pain medications in crushed form. In the meantime, while the media attention rallies around drug abuse issues, people with chronic pain are finding it more difficult to get the attention they need.
Zohydro, manufactured by Zogenix, sets precedence as the first prescription narcotic that contains an extended release form of Hydrocodone in its pure state, without the addition of acetaminophen. Hydrocodone with acetaminophen (the active ingredient in Tylenol,) also known by the trade names Vicodin and Lortab, comes in five mg, 7.5 mg, and 10 mg tablets. Their potency lasts from four to six hours. The extended release form contains unit doses from 10 mg to 50 mg per capsule and works over a period of 12 hours.
In October, 2013, the FDA went ahead and approved Zohydro for release, despite an 11 to two vote by a panel of paid consulting experts advising against it. The decision provoked outcries from those who consider the new medication unacceptably dangerous. The main objection to the new medication is that it contains no abuse deterrents that prevent it from being crushed, making its full potency available for immediate release. But a repeal of Zohydro may turn out to be a legislative act that further opens the gateway to heroin and leaves pain patients suffer.
In fact, Hydrocodone takes last place for potency in a list that includes Morphine, Oxycodone, and Hydromorphone (Dilaudid.) And all of these medications come in the extended release form. Hydrocodone has a potency of little more than half that of Morphine. The potencies of Oxycodone and Hydromorphine both exceed that of Morphine, Oxycodone by up to two times, and Dilaudid by five times. While Purdue Pharma, LP reformulated Oxycontin, making it difficult to crush, the highest available dose of the narcotic is an outstanding 160 mg. This trumps the highest dose of Zohydro by three to four times.
Like all prescription narcotics, Zohydro was formulated for patients that require strong pain medication. In the case of this new drug, Zogenix directed the manufacture for people intolerant to other types of narcotics such as Morphine and Oxycodone, both of which have side effects, such as severe itching, that Hydrocodone does not.
Meanwhile, a parallel black market for heroin has infiltrated America’s suburbs. In in nation where narcotic addiction runs rampant and doctors become more cautious about prescribing painkillers, cheap heroin readily steps in to fill the void. After all, heroin, Hydrocodone, Morphine, and Oxcodone are all narcotics. But heroin, the illegal one, poses perhaps a greater threat as it potency is often unpredictable. Experienced users have died when they receive a bag of heroin that turns out to have a much greater potency than expected.
It is not difficult to empathize with those concerned about the release of yet a new prescription narcotic when abuse already runs high. Indeed, the problem of addiction and abuse need to be competently addressed. But even if there is a choice between Zohydro or heroin, there should be none that let pain patients suffer.
By Robert Wisnewski
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18 Responses
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Man oh man, some of the replys are my life to a tee. I live in absolute chronic major pain, and have most of my life. I was diagnosed with R\A when I was seventeen buy that time I already had major messed up disk in my neck and my back. I am 51 years old, I have had five shoulder surgeries none have fixed the problem in fact the last two made it wors. I need both shoulders and both knees and both hips replaced and like I said major neck and back disk damage. My neck is so bad that the surgeon that looked at my MRI, would not even do the operation saying that the damage is so bad he would not take the liability for any problems. So yeah guys and gals I get it. I live on 80 mg oxycontin and 30 mg roixy for break through pain.I cant even remember a freeking daynot one not even one day without major chronic pain. No one day!!!!!!. And try sleeping when your shoulders pop out of there sockets each time you roll over. I can remember as far back to when I was a little dude and would hurt so bad that my mom would stay up half the night rubbing me until I could fall a sleep. So man it really makes me mad when I can tell when a person is trying to get pain meds just to party, and in the meantime I have a pharmacist looking at me like I am a junkie man that really sucks to go through that. Oh well to all who really need it good luck and try to carry on I have all of yall in my prayers.
I’d been on methadone for pain for over 12 years. My EKG showed heart irregularities that can develop due to long term methadone use. They took me slowly off methadone, and my pain rocketed, not to mention, the horrible withdrawal symptoms, even with “replacement” meds. We tried morphine…didn’t work. Tried Fentanyl patch…didn’t work. More pain and more withdrawal symptoms. I was a wreck. Couldn’t sleep at all. Finally, I mentioned ZoHydro to my pain specialist. I transitioned, finally, completely off the methadone and onto 2 40 mg ZoHydro’s a day (every 12 hours). It worked! No more methadone withdrawal, better pain relief, no cloudy thinking or falling asleep/nodding at inappropriate times, like at work! It was difficult to find a pharmacy that carried it, but now my Safeway will keep it in stock for me. People are having very good results. I have had no desire or need to open my pill and take it all at once like everyone seems to think all pain patients do. I’ve always taken my medication as prescribed. I’m so grateful for this medication. I was starting to fear that despite the risks to my heart, I was stuck on Methadone. I’m not!
I live in chronic pain in palm beach Florida. The oxycontin express is what is was called. Now 4 years later heroin flood the streets and is much more accessible. Reading the comments here it seems I am not the only one having a problem getting treated. I have been dealing with chronic pain for many years but upon moving to Florida I was inyroduced to diluadid and contracted hepatitis c. I have legitimate prescriptions for oxycodone I can’t fill because the one pharmacy I was able to find it in wanted 400$. While the national chains don’t seem to have a supply, where it would only cost 80$ per month. Something needs to be done about the monopoly the dea its causing here. Petitions to sign? I will sign them. Advice on who to vote for to make any changes, I will listen. I do not function like a normal person unmedicated cause of the pain and my doctor refuses to prescribe anything with tylenol to avoid any further damage to my liver. Zohydro should be available, and unless you suffer with severe chronic pain you will never understand. They have over regulated prescription medication here and created the perfect environment for black market and street drugs. The war on drugs will never be won so stop making people who would rather not use iv drugs suffer. Something has to give cause what is going on here is not funny and should be against the law!
I agree 100% those that do not have back issues cannot possibly fathom what those that do live with
I just want to say one important fact anyone that suffers severe chronic pain should have there choice if they want to suffer or if they want too have some kind of relieve my pain is so intense 24/7 i cry im 58 played college football and was a scuba diver for the miltary for 15 years any person that makes a decsion about pain medication no matter what type kind strenth and does not or have never had severe pain should do what they should say is nothing or imply they have any idea what its like to truly suffer to even begin too make any comment or make judgement sould do one thing close your mouths about something you know nothing about just pray you dont ever have to suffer thank you very much
I think it’s very obvious the reasons lawmakers, aka our elected people that are there to look at things with out their own opinion, and do whatever is best for the people of our country, Quite a few Americans are in pain , many in chronic pain. These people do what they do for their own reasons .They don’t take into account many suffer daily for no reason, There is a ton of new laws, bans,monitoring systems that cost tax payers ,also raises insurance rates. I have been on pain management since 2005.I don’t call it pain management anymore, it’s a hell ,also have been on oxycodone for years, state law in Florida says you only get 4 , 30mg. Oxycodone per day so the pain I had before has no choice deal with it, also had to switch to methadone for long action pain 6 , 10 mg. Methadone.The government has screwed pain patients. And that is the beginning, after getting your pain meds.Look all over Tampa trying to find them. They have made pharmacists very scared to even give the meds to legal people that have never done anything to deserve getting lied to. Or told we don’t feel comfortable filling your prescription.Drug Tests, pill counts,and good doctors just giving up and switching professions. Leaving the patient with a suboxone pushing, nerve block, steroid shots all which have never proven to last or help.It’s been bad in FL.Now it is actually to the point, I think they will not stop till the herion dealers are the only pain management left. Don’t move to Florida it is the most corrupt, non caring government, They let it run rampant, not doing things to stop it.They now strong arm every one , Dr.,pharmacy, patients,they implemented a communist type system that makes it virtually impossible to live.You really never know what is next and nothing surprises people because every day they add to the hoops you have to jump through, and take away more of our hippa rights ,treat every person on pain meds like garbage. I was born in FL. 40 yrs. Ago I thought I’d live here forever, but now I know like many others it’s just not going to let up,every year I thought it will settle down and be normal.Now I know it won’t, I’m moving,tired of the constant state of being afraid of how far these corrupted bastards will go to get their face on the news saying that they have numbers that show less addiction.See the addicts are not suffering, they are dying in our streets from very cheap, very pure herion that was not hard for them to switch to after, the oxycodone shortages pushed people to dilaudid, the only substitution drs. Could give for no oxycodone ,whether you lied to them or you cut the supply, The Point Is If There would have been something like this ZOHYDRO IN A 20,30,MG
INSTANT RELEASE WITHOUT LIVER FAILURE DO TO ACETAMINOPHEN I PERSONALLY KNOW PEOPLE THAT WOULD HAVE NEVER USED A NEEDLE BE CAUSE DILAUDID DOES NOT WORK IF YOU EAT it and you’re used to oxycodone , it is a very bad substitution, everyone knows that. So plenty of pain patients got addicted to that crap,next in line was heroin.but keep screwing up people and then ask why all the addicts. I remember having to eat those dilaudid, and I never thought I’d think of using a needle, I didn’t but the pain made me think about it, if you ignorant people would just stay out of legal peoples or people for that matter we might be alright,I do hope you have to deal with real pain and then have someone telling you how your not in pain deal with it. You people don’t care if it were you.I’d bet you would stay the hell out of good people’s lives.
It will be a very sad day in America for chronic pain suffers if these idiot lawmakers get their way and has Zohydro taken off the market because of their ignorance and god like attitudes. READ THIS
Now, the issue at hand is that Congress wants to ban a slow release formulation of hydrocodone because 1) Joe Manchin’s daughter is CEO of a company that sells oxycodone and 2) because they would rather see patients suffer.
As someone that is taking Zohydro I can say it works much better and makes my intestines feel much better.
The real war should be to force all the drug companies making all this other hydrocodone pain relievers take the acetamenophine out of all the pain meds. Instead they are trying to take a medicine that does not cause liver damage off the market because of there ignorance about how it works.
I cannot begin to say how happy I am with the performance of this Zohydro As a long time spinal cord disease sufferer that has been on Norco to control my unrelenting pain for 8 years.
This Zohydro has made my pain levels go from a 7-9 to a 3-5 in 1 week!!! Plus it has made my intestines feel so much better since I started taking Zohydro and lowered my Norco intake by 70%
It’s truly amazing the difference between 2 40mg Zohydro a day + 1 Norco every 4 hrs vrs 9-12 norcos a day plus 2 15mg morphines a day
I think the Norco companies are shorting the hydrocodone in their pills because there is a major difference between taking 4 10mg norcos and 1 40mg Zohydro I MEAN MAJOR DIFFERENCE.
GO ZOHYDRO
Hello
So I am on 15 mg oxycodone 5 times a day and that is barely gets me threw specially
When I work and I am seeking a new pain Dr cause mine dropped me cause I did not get a
Job I told her I was on disability but she is a bit slow I guess not really I know why she dropped me it’d because she tried to have me do a pain pump trail and it failed bad she messed my back up even more and 2 days after the trial I couldn’t get up I had a lumbar leakage and spinal fluids was giving me headaches and I was supposed to have a blood patch but the anthologist said I should try and stick with the pain and stick it out because
Of my spine and having DDD so bad so I never had the blood patch but I have headaches almost on a daily basis and it sucks I was wondering how much different is this than oxycodone I’m gonna asks my Dr tommrow about this Zorhydro but what I want to know will the strength wish diff from oxycodone 15 to the 15 mg of zorhydro ? And I only have one kidney and liver ain’t so good ain’t bad but ain’t good and also its a 12 hr time release how will this affect me cause I had weight loss surgery and thing don’t absorb right that is why I am on the fast acting oxycodone so it will work somewhat but I been on 15s for ever now and they ain’t working like they used to how dose these new meds work I mean I don’t want to be all loopy doopy at work but I need to be able to focus while at work so could you please let me know what the different is in strength if you can please anyone thanks
Clayton
I take to 80 milligram oxy contin every 8 hours and I take 1 15 milligram I are in between for breakthrough pain my doctor at the VA has no problem giving me that medicine everyone else I talked to treat me like I’m a drug addict I have MS and I have severe pain as long as I have that medicine in my body I am at ease if I don’t have that opiates in me I can’t live I don’t know what the doctors problem is but the medicine is good for some people thank you disgusted person treat it as a drug abuser
Zohyrdo is the best new painkiller on the market in years just the fact it has no acetaminophen is very big a lot of people die every year on pain meds no because they overdosed but because they killed their liver with toxic acetaminophen if anything should be banned it should be the painkillers with the acetaminophen that Zohyrdo can replace.
This insane preoccupation with the use of pain medications. Have had chronic pain as a result of sever destruction of joints from the top of spine to hips and knees and ankles! Have felt like a criminal just filling modest levels as 20mg daily of oxycodone. I’ve read that that is a low dosage for the most part but live with unnecessary pain because i’m afraid to ask for more. The harm so many other drugs do and anything that is illegally abused has such restrictions. I have to get a new prescription picked up at the doctors office monthly because they can not allow refills — just crazy. It shouldn’t be hard to isolate abusers or underhanded doctors rather than making the administration of this these drugs so difficult and stigmatized!
I am among the 100 million chronic pain patients that suffers every day of my life. I was injured at 23 years old and after 8 failed spinal surgeries have had to take pain medication daily for 17 years. The first doctor I had for 12 years prescribed me 160 mgs. Oxycontin 3 X day for 4 months and 30mgs. IR Oxy 4 X day for breakthrough pain. For 4 months he’d have me on 200 mgs. Morphine Sulfate and 60mgs IR Morphine for b/t pain. And then for 4 months he had me on 125mcg. Duragesic patch every 3 days in a 100 and a 25mcg. Patch and 1600mcg. Actiq fentanyl suckers 4 X day for b/t pain. The fda’s guidelines are there are no limits to the dose required for pain sufferers. That it’s based on their tolerance and you titrated upwards until pain is managed. My Dr moved to a different state and I saw 3 new doctors who all told me that 80 milligrams of Oxycontin 3 X daily is the “limit” they’d prescribe. For 5 and a half years I have suffered more and more as my tolerance only went up but my dosage did not. To the point that I only sleep 60-90 minutes per day and most days all my energy, focus, and will is spent just convincing myself to get through the next minute or two. I use ice, heat, meditation, and have done and tried every single thing my current Dr has asked including installing a pain pump which didn’t work because his “limit” for that was 10mgs. Dilaudid per day. I will be picking up Zohydro tomorrow and am praying it gives me more relief even though my scripts only for 2 50mg. Tablets twice a day. No one can explain to me where these “limits” come from. My guess is they are either from malpractice attorneys or more likely just the Dr’s fear of the good old Nazi’s at the DEA. I am so sick and tired of listening to nonsense. If zohydro helps 1% of chronic pain sufferers, that is 100 times more people than could ever overdose on it.
160mg Oxycontin is not available in the US, not to mention that It’s difficult enough for legit patients to obtain an Rx of 80mg Oxycontin if they can/do, they are prescribed the Patient will only receive an Rx for a 28 Day supply with a max dosage of BID. TID is rare although the new formulation really had a negative impact on the drugs efficacy most patients were screaming for QID or to switch over to OPANA because Purdue really screwed the pooch on the “abuse proof Oxy formulation”. That’s why you see an increase in demand for 30mg IR’s (e.g. Roxi’s), besides they are less expensive and have a higher efficacy.
Not to mention the side effects of most opiates are mostly the same: constipation, feeling flushed, euphoria, changes in time perception. The list goes on. All I see here is another reason for heroin use to skyrocket like it has in the last year or so after the “non-abusable” OxyContin started hitting prescription pads. All while the DEA has a budget the size of Liberia’s deficit. More money to institutions that cause the problem they are trying to fix.
Hydrocodone doesn’t make you itch? Yeah. Sure. I itch like crazy on Vicodin
Hands off how we take care of our selves. This drug will cost a lot less then Vicodin so we will be able to prescribe more for less and instead of methadone which kills more then this drug ever will. a safer cheaper alternative will help people that can’t AFFORD it. People trying to block this love in a bubble that have no idea what is happening outside there town. It’s usually these more affiliate kids in these drug. Just because your kids have problems doesn’t mean it should effect us all.There will be abuse but welcome to America, not your choice to say what I can do. I have no addiction or want to do this drug but I hope it’s there when I need it.