The Zohydro hysteria !

First.. lets get’s straight… opiates THEMSELVES are not addictive.. they are POTENTIALLY addicting. When people with addictive personalities and/or mental health issues.. take opiates.. they become addicted to the side effects of the drug(s). Just like some of the same people when they drink alcohol and have no will power to know when to stop.

There are a lot on things in our lives that are capable of being potentially harmful. Driving your car too fast and/or poorly maintained,  letting a a pot boil over on the stove. Gasoline has some serious harmful potential when it interacts with a heat source.

People who abuse substance(s) will find something to abuse..what is in vogue, the most available or the most affordable.. Over the last couple of years…Ohio has been playing “hard ball” with legal drugs being diverted to the street .. and I have read statements from the bureaucrats in Ohio that they are puzzled as to why the use/abuse/deaths from Heroin use is on a dramatic upswing.

Everyone is focusing on Zohydro ER 50.. as this “mean new drug”.. Let’s put things into perspective Zohydro ER 50 is therapeutically between Oxycontin 30 and Morphine SR 60 and one can presume that the “high” that a person will get out of this drug.. would be similar… on a mg per mg basis

One more comparison.. Zohydro ER 50 is therapeutically comparable to fentanyl 25 mcg patch.  BUT.. The Fentanyl patch will release 25 mcg/hr X72.. you would think that this  means that there is 1800 mcg of Fentanyl in the patch.. But patch technology contains up to 100 % more than it is designed to release over 72 hrs.

Meaning that a “spent” patch could have as much opiate as 6 Zohydro ER 50 caps. Make that a new 100 mcg fentanyl patch and that number could be equal up to 48 caps of Zohydro ER 50.

I can’t find anything that suggests that HCD has any bio-availability via IV route and the volume of the contents of the caps may be large enough that makes it hard to snort.

Sure there are going to be some people that want to “try” this “new drug”… we saw the  same thing with Opana.. and the demand to abuse that drug eventually waned ..

And this too shall pass.. but.. in the mean while.. do we have the right to  deny those chronic pain pts access to  a  drug that may help them to improve their quality of life ?

26 Responses

  1. The disgusting thing about Zohydro, to me at least, isn’t the fact that it’s extended release hydrocodone. I fill oxycontin without blinking an eye. But I watched Purdue manipulate their way into getting extra years on their patent, allowing them to charge 1200 dollars for their product longer than they thought they’d be able to, because they reformulated to make it “tamper resistant.” Do we really think that Zogenix doesn’t know how to do the same thing? Reports are that “they are researching ways to find a way to make it tamper resistant” and I can promise you that it will come at approximately one week before their patent runs out. In the meantime, they don’t want it to be tamper resistant, because they want to appeal to whatever junkies they can find.

    That is not me saying that all chronic pain patients are junkies. But that is me saying that there are junkies out there, who are going to be curious and want to try this new mega-dose hydrocodone they can get high off of.

    I’m honestly not concerned about the drugs abuse – since oxycodone is so cheap for patients to get, there’s really no reason for them to spend the much higher price point on a less narcotic medicine. The street value for oxy30 is about 20 dollars a pill and costs a pharmacy about 60 cents. Zohydro 50 costs a pharmacy about 7 dollars a pill, so we can try to extrapolate out a street value from there – but if they’re going to abuse something expensive, I don’t see anyone wasting their time with Zohydro when they can get Oxycontin for a similar price. Yes, Oxycontin is now “tamper resistant,” which is good at diverting the “I want to see what it’s like” perps, but the true problems, like our friends over at opiophile, cracked how to break down the new oxycontin so it was still injectible in about 48 hours.

    I lost track of where I was going with this. I think the main point is “big pharma is a bigger problem than anything else”

  2. Hi Steve,

    I agree. Few reporters and “experts” will mention that literally millions of tablets of hydrocodone (Vicodin, Norco varieties) get dispensed to patients who never get addicted. Nor do they mention that the majority of those addicted to prescription medications began their addiction elsewhere (pot, heroin, alcohol). It is a RARE RARE story when an previously non-addicted person gets “hooked” and in trouble while using a narcotic SOLELY for medical (pain) purposes.

    Thanks for the great post.

    Jason

    • Addicted to pot, Not possible. Please get your facts straight. All patients will become addicted if they take them for more than 30 days. You are so miss informed. Many surgeries produce opiate addiction.
      Are you ignoarnt or playing stupid?

      • Addiction is a mental health issues – addictive personality disorder… people can abuse or be addicted to many things… from food, shopping, gambling, alcohol, nicotine, sex, porn… Not possible/never is an absolute.. and there are no absolutes when humans are involved. I left your comment posted.. because I want others to see how UNINFORMED some people are… and how those same people can be VERY RUDE and OBNOXIOUS … everyone is entitled to their own opinions.. NO ONE is entitled to their OWN FACTS. Unfortunately some people get those two things confused 🙁

  3. This demonization of Zohydro all started when a reporter opened his big ununiformed mouth saying Zohydro will be ten times stronger than Vicoden or 10 times more potent than hydrocodone .Things is you cant make hydrocodone any stronger than it already is because hydrocodone is hydrocodone is hydrocodone .
    Potency of hydrocodone is what it is and you cant make hydrocodone any more potent than it already is, why because hydrocodone is hydrocodone is hydrocodone. You can take more but you cant make hydrocodone anymore potent than it already is. So all this hype was so unnecessary scaring people in to a frenzy. Zohydro 50 mgs is equal to 5 Norco without the acetaminophen. Think about it this way and its not that strong after all. Zohydro will be a excellent pain medication for people who are allergic to other pain meds and finally don’t have to worry about the acetaminophen affecting your liver.
    Bottom line is this was nothing more than a reporter trying to better himself, herself and has no idea what their talking about.

  4. WIth the 1 yr anniversary of the Boston Marathon bombings, I wonder if Gov Patrick even THOUGHT about how many of those survivors may still need chronic pain medication assistance as some of them continue to undergo surgeries to correct some of the damage they suffered. I’m sure some of those people to this day aren’t down to just taking Tylenol or Ibuprofen for their pain.If I were one of those family members I’d be insulted that he even considered them an addict. This new APAP free med may be a better option for them. How many of our service men and women could benefit from this new medication. I would bet a good number are chronic pain patients due to certain war wounds. We should not forget about them. I also noted one commentator in Queen of Hearts article has already picked up on the misinformation on it being 10x more potent then Vicodin.

  5. I read somewhere that if a Child swallows a 50 mg pill it will kill them now what about the adults that has an addiction and chooses to swallow two pills with actual kill them and I know you have to keep your medicine away from kids

    • I read where ANY MEDICATION taken by someone that doesn’t have a medical necessity for it and/or takes much more than the recommended amount.. could be harmed… even DIE !

  6. So I have a question. I hace severe degenerative bone and joint disease. 4 hurniated disk spinal stenosis and an ankle surgery gone bad where I am about to have a fusion on the ankle. Onntop of all of this I also have been diagnosed with fibromyalgia. I once thought this was just another reason for painnmeds but truley believe in this case I may very well have it. I started on tramidol 50mg 2 tabs 4 X a day, then we changed to mutiple different doses of hydrocodone, eventually after surgery I was taking oxycodone 80mg 4 times a day and oxycontin 30 twice a day. I was changed to a “better drug” to be less drowsy. This was my request. I was placed on exalgo 12mg once a day and norco 10 twice a day. I went thru pure hell for 2 weeks!!! I was told this was an even switch…….my body did not agree. Now I still hurt and after 6 months on exalgo my dr is offering zohydro 10 twice a day with no breakthru medication. Does anyone feel this would be a smart switch? Thanks for the insight!
    Cathy

    • Everything now is based on what is labeled as “Morphine equivalents” and the conversion is a rough estimate and not exactly black/white
      The first dose of Oxycodone you were taking was MS equiv of 550
      Your second therapy was MS Equiv of 68
      The proposed change of therapy is MS Equiv 20
      As you can see.. the first reduction was quite severe and the proposed therapy is going to be another significant step down.

      • Wow! That is interesting! So pain management does not seem to be the route they are going. …… seems more like detox more than anything. I hurt terribly. I’m only 35 and suffer to the point of not enjoying life out my children. I don’t want to be doped up but I want to be out of pain. Maybe a new pain management dr is in the future?
        Thoughts. …. suggestions?
        Cathy

        • Cathy, I feel your pain. I have degenerative discs, on top of having had an L5-S1 discectomy with fusion. My pain management Dr wanted to switch me to the zohydro, but I told them no. Don’t be afraid to tell your Dr how you feel. After all you are the only one that truly knows what had worked for you. Everybody is different, what works for one patient doesn’t necessarily mean that will work for others. Don’t be afraid to vice your opinion to the Dr. If they won’t listen, then you should start looking for another doctor. Hope everything works out for you.

          • Ok correct me of I’m wrong, but isn’t this just basically hydrocodone without the filler? That’s all drugs come in Europe to my knowledge. Yes they can abuse it, but no more than a roxy 30. As was said above, a hydrocodone is a hydrocodone.

            Per Steve: Zohydro is hydrocodone without the Acetaminophen that is found in Vicodin/Norco which can harm the liver with high doses or long term use

    • That’s what I am prescribed as soon as my insurance decides to pay for it. They claim I need to fail morphine phentanol and ocycontin before they’ll cover it. But I am to receive breakthrough meds as well. It strikes me funny that 10 MG of zohydro requires me to fail or be allergic to the other meds. Seems as if it must be fairly potent stuff.

    • Hi, Ms. Cathy. I’ve got DDD, n my lower back constantly feels like its being crushed. I see a pm Dr, I’ve been on norcos, high doeses of morphine, n would barely have any relief. Then they started me on 30 mg zohydro, the difference it made was night n day. I’ve been on it for awhile, n just been upped to 50mg, 2x a day, plus 7.5 norco 2x a day for any break thru I may have. I was absolutely scared to try it, but glad I did, it helps the pain emensely, n I don’t feel all weird I feel the same it as I do off, only difference, my pain isn’t nearly as bad. Good luck, hope u can find wat works for u. Sorry u going thru so much. God bless

  7. What a Federal Case out of a modestly effective Rx. I am still baffled why HCP’s were put into schedule II. The APAP is more harmful than the hydrocodone . The plain fact is: fentanyl is better for the searing acute severe exacerbations of so called “breakthrough pain” It seens when you need it most is when you aren’t allowed to ammaliarate pain the likes of which are unrelenting.

  8. As a long-term chronic pain patient (rare disease, no cure), I have found that Morphine, (MS-Contin and other morphine based RX meds) do less for me than Oxycontin (old formulation, the new coating on the OPs has some filler that gives me a rash-hives) so, my PM dr. put me on 50mcg Fentanyl patch. So, far this has been the best to cover my pain (and some small Breakthrough oxycodone when I overdo it). I think that no one plans on becoming ‘addicted’ because of an illness, disorder, or disease they did not count on. However, it is when trying to either maintain the amount of pain relief or, they get better and then try to discontinue the pain med that they find an unbearable discomfort in trying to quit.

    This is when they realize – or wonder – “Am I addicted to this?” The comforting way to put it is “No, you are dependent on the meds.” It’s almost if (in a non-humorous way, but sort of true) that a disease remains so the new way of life with pain meds is not interrupted. I do believe that no one intends to become a junkie – when most junkies are people who just hit a huge bump in life or life goes upside down – life just throws them so much to handle, they choose the door out.

    And, even Grandpa could be a junkie if dependent on his Fentanyl patch for his bad *______ (pick something). It’s when the Dr. says “Well, it’s that time, you are much better physically” but doesn’t tell him (Man, you are gonna wish you were dead!) when titrated down to stop. Especially for someone over 60. Wouldn’t it be better to just keep them on the same regimen? Doesn’t hurt them near as much as having to stop. It’s a tricky situation – and to say no one is a junkie is just as true as saying everyone – eventually – is a junkie. And, I say “No one is an addict until they are made to stop – completely.” Then, the tune will change.

    • I once had a Dr. tell me there is a difference between Addiction and Habituation. Addiction means you will do almost anything, including breaking the law to obtain it, and Habituation simply means, you have pain, pill makes pain go away, body and mind want to have less pain…basically, an improved quality of life without breaking the law. Wiser words were never spoken…. Dano79

      • I love this post! It is so true!

      • Thank you Dano79 for those wise words. I’m 59 and have had 4 back surgeries. My latest was having my entire spine reconstructed as it had been crumbling. Pain, we’ll I’m sure you can imagine. I’ve been on zohydro for almost a year now and it’s almost controlling my pain. However, I’ve never gotten over the stigma of being on pain killers. None of my extended family members or friends have ever seen me in a state of what some people believe pain killers cause them to behave like. It’s because I take this medication for therapeutic reasons and not for recreational reasons. I wish whole heartedly that there was something other than opiates to take to make or at least help me feel some relief.
        Thank you for differentiating the difference between addiction and habituatuon. Many many people NEED to know the difference.
        Sincerely,
        Mslynniem

  9. Hi, I’m all beat up from back surgury etc. Morphine is like water to me, it don’t help at all. I started Zohydro 50 mg twice a day and Norco 10-325 three times per day. I’ve never felt better. I don’t feel high or good or stoned.. It takes the pain away and for that I’m thankful.. I get lower back injection 4 times per year and injections in my shoulder and elbow as needed.. I use to be healthy and in shape, 25 years in the Army Infantry and also working corrections… living the crazy life finally caught up to me. I don’t work anymore and that’s the worst feeling, I feel like it takes away my dignity..I would do anything to be pain free and not have to take drugs!!! To swing a golf club again or to play softball…O boy there are people in worse shape then me so let me stop complaining.. God bless those in pain and God bless their families!
    Jeff

  10. Hydro codone is a generic drug, crooked ,non caring greedy pharmaceutical comp with their greed have a med thst really helps with non stop pain and they make it unaffordable..even with coupons you can only get one month then it jumps back up..these people should be governed better..all they did was put an extended release in it…i have to take so morphime fir my pain plus tramadol and 10 mg 6x a day of hydro..when i could just take 2-3 zohydros a day..go ahead and enjoy your ill gotten funds there

  11. I have stenoseous of the spine and also a ruptured disc. I understand everyone on this thread complaining about these pain meds and the abuse associated with them, however for the people like me who have a very difficult time being able to work a full shift at work, these pain meds help me actually live a normal life. Nobody knows what it feels like to have a life where you cant do normal things like house work or simply just taking a walk with the family or throwing a football with the kids. I hope people also bring awareness to the need for more effective methods to combat pain and also other alternatives to fix disc problems and stenoseous for a long term without it costing a arm and a leg. I understand the abuse that takes place however now the entire world frowns upon anyone that needs pain meds and looks at them like addicts. My doctor said it today. most doctors are scared to even do anything anymore because of the view of the public, and the people suffering are the ones that have chronic severe pain and cant be treated properly because of the fear that comes with it.

  12. Hi, I take 50mg of zohydro twice a day and 2-3 Norco per day for break through pain… It’s the best I’ve felt in years!!! I’m so thankful.. Don’t get discouraged with zohydro my Dr. Started me at 20 mg and it did nothing!! Then 30, Then 40 and finally 50 did the trick!!! Almost zero pain!!!! My life is better!!! Thank you Lord!!! My pain doctor is an Angel from heaven!!

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