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Loritab Addiction Drug Rehab
Loritab abuse has been escalating over the last decade. There has been
large scale diversion of loritab. For example, an estimated 7 million dosage
units were diverted in 1994 and over 11 million in 1997. In 1998 there were
over 56 million new prescriptions written for hydrocodone products and by 2000
there were over 89 million. From 1990 the average consumption nationwide has
increased by 300%. In the same period there has been a 500% increase in the
number of Emergency Department visits attributed to hydrocodone abuse with
19,221 visits estimated in 2000. In 1997, there were over 1.3 million
hydrocodone tablets seized and analyzed by the DEA laboratory system. A recent
petition submitted to the DEA has requested a review of the control status of
all hydrocodone-containing products.
Licit Uses of
Loritab
Hydrocodone is an effective antitussive (anti-cough)
agent, and as an opiate it is also an effective analgesic for mild to moderate
pain control. Five mg of hydrocodone is equivalent to 30 mg of codeine when
administered orally. Early comparisons concluded that hydrocodone and morphine
were equipotent for pain control in humans. However, it is now considered that
a dose of 15 mg (1/4 gr) of hydrocodone is equivalent to 10 mg (1/6 gr) of
morphine. Hydrocodone is considered to be morphine-like in all respects.
Chemistry/Pharmacology
Hydrocodone
[4,5a-epoxy-3-methoxy-17-methylmorphinan-6-one tartrate (1:1) hydrate (2:5),
dihydrocodeinone] is a semisynthetic opioid structurally related to codeine and
is approximately equipotent to morphine in producing opiate-like effects. The
first report that hydrocodone produced a "striking euphoria" and habituation
symptoms was published in 1923; the first report of hydrocodone dependency in
the U.S. was published in 1961. It was removed from exempt status in the U.S.
by the Narcotics Manufacturing Act of 1960. There are over 200 products
containing hydrocodone in the U.S. In its most usual product forms hydrocodone
is combined with acetaminophen (Vicodin, Lortab), but it is also combined with
aspirin (Lortab ASA), ibuprofen (Vicoprofen), and antihistamines (Hycomine).
Both tablet and liquid forms of hydrocodone are available (e.g., Tussionex)
Hydrocodone will react as a normal opiate in the available field test kits.
Illicit Uses
Hydrocodone is abused
for its opiate-like effects. It is equipotent to morphine in relieving
abstinence symptoms from chronic morphine administration. The Schedule III
status of hydrocodone-containing products has made them available to widespread
diversion by "bogus call-in prescriptions" and thefts. Three dosage forms are
typically found (5, 7.5, and 10 mg) and their behavioral effects can last up to
5 hours. The drug is most often administered orally. The growing awareness and
concern about AIDS and blood-borne pathogens easily transmitted by syringe
needle use, has made the oral bioavailability of hydrocodone attractive to the
typical opiate abuser.
As with most opiates, the adverse effects of
hydrocodone abuse are dependence and tolerance development. Its co-formulation
with acetaminophen has also increased the likelihood of acetaminophen-induced
hepatic necrosis with high dose acute dosing, but slow escalation of dose over
time seems to protect the liver during high dose chronic exposures seen with
this drug.
User Population
Every age
group has been affected by the relative ease of hydrocodone availability and
the perceived safety of these products by professionals. Sometimes seen as a
"white-collar" addiction, hydrocodone abuse has increased among all ethnic and
economic groups. DAWN data demographics suggest that the most likely
hydrocodone abuser is a 20-40 yr old, white, female, who uses the drug because
she is dependent or trying to commit suicide. However, hydrocodone-related
deaths have been reported from every age grouping. |
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