Hydrocodone: The Potential Benefits, Downsides, and Risks
In 2013, nearly 40 tons of hydrocodone was consumed worldwide. According to the National Institute of Drug Abuse (NIDA), the United States accounts for nearly 100% of world total prescriptions for hydrocodone. Where are all those pills going? Chances are you or someone you know has a bottle of hydrocodone lying around somewhere. My bottle of hydrocodone expired years ago but I still cling to it “just in case”, which is generally not a good idea. But now is a time for real honesty; to discuss the potential risks and benefits of using this prescription drug.
Honestly, I have not used a hydrocodone pill in years. But 10 years ago, I sure did need it in order to be able to sleep through the pain of two lumbar disc herniations. And that is the good thing about this semi-synthetic opioid; it works when you need it to work for acute pain. From broken bones to post-surgical pain, hydrocodone is a great hammer for knocking down sudden pains. The onset of analgesia is fast and it last about four to six hours. This short-acting opioid can be a real life saver because it allows people experiencing pain to sleep and to do activities of daily living.
But to be honest, using hydrocodone can have some downsides too. The side effects that can be experienced when taking hydrocodone are common with most all the opioids. These effects include opioid-induced constipation, nausea, itchiness, drowsiness, dizziness, and headache. Most of these common side effects are easy to manage. Additionally, because hydrocodone wears off fairly quickly, a person with 24/7 pain has to take it around the clock to stay ahead of the pain. This type of frequent user is then at risk for other adverse effects too. Once dependent to it and taking it around-the-clock, one can then experience anxiety, restlessness, insomnia, more nausea, and more pain. These side effects are caused by the chemical dependency that drives a cycle of frequent withdrawal symptoms. This vicious cycle can really disrupt a person’s life to the point of causing more harm than good.
The ugly truth about hydrocodone is that it has ruined many lives too. Because hydrocodone is so easily obtained in medicine cabinets, from friends, and from unsuspecting doctors, this drug is a frequent gateway drug for addiction. Prescription drug abuse is a major risk for using opioid medications like hydrocodone. One use can lead to another, and another, and eventually lead to the beginning of downward spiral to the point that the prescribed drug is being used for other symptoms besides pain. Sometimes the spiral of prescription drug abuse leads straight to heroin use. This scenario happens to people from all walks of life. The epidemic of prescription drug abuse is very ugly and has blanketed this world in a shroud of darkness.
The government has tried to stop the spread of hydrocodone abuse by recently rescheduling from schedule III to schedule II, thereby making it harder to obtain. New opioid prescribing guidelines have also been issued to help curtail the amount of prescriptions. Unfortunately, these limits have the potential of hurting some that can really benefit from the pain control offered by appropriately using hydrocodone. On the other hand, limits can also help to save lives too because limited access helps to reduce abuse potential. With a drug that has both the potential to save lives and ruin lives, a delicate balance of political sense and clinical judgment must be sought. Honestly, it is up to us who have the bottles of opioid medications like hydrocodone in the medicine cabinets, in the purse or in the gym locker to stop sharing our pills with others, keep our medications locked up and dispose of our medications properly when the need for use is gone. I think it is time for me to dispose of my bottle of hydrocodone too. And it is time for all of us to weigh the potential benefits versus risks carefully and honestly.
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.