Hydrocodone chemical structure
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Hydrocodone

Hydrocodone or dihydrocodeinone (marketed as Vicodin, Anexsia, Dicodid, Hycodan, Hycomine, Lorcet, Lortab, Norco, Tussionex, Vicoprofen) is an opioid derived from either of the naturally occurring opiates codeine or thebaine. Hydrocodone is an orally active narcotic analgesic and antitussive. The typical therapeutic dose of 5 to 10 mg is pharmacologically equivalent to 30 to 60 mg of oral codeine. Sales and production of this drug have increased significantly in recent years, as have diversion and illicit use. more...

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Hydrocodone
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Hydrocodone is commonly available in tablet, capsule and syrup form.

As a narcotic, hydrocodone relieves pain by binding to opioid receptors in the brain and spinal cord. It may be taken with or without food, but should never be combined with alcohol. It may interact with monoamine oxidase inhibitors, as well as other drugs that cause drowsiness. It is in FDA pregnancy category C: its effect on an unborn embryo or fetus is not clearly known and pregnant women should consult their physicians before taking it. Common side effects include dizziness, lightheadedness, nausea, drowsiness, euphoria, vomiting, and constipation. Some less common side effects are allergic reaction, blood disorders, changes in mood, mental fogginess, anxiety, lethargy, difficulty urinating, spasm of the ureter, irregular or depressed respiration and rash.

Hydrocodone can be habit-forming, and can lead to physical and psychological addiction. In the U.S., pure hydrocodone and forms containing more than 15 mg per dosage unit are considered Schedule II drugs. Those containing less than 15 mg per dosage unit are Schedule III drugs. Hydrocodone is typically found in combination with other drugs such as paracetamol (acetaminophen), aspirin and homatropine methylbromide. In the UK it is listed as a Class A drug under the Misuse of Drugs Act 1971.

The presence of acetaminophen in hydrocodone-containing products deters many drug users from taking excessive amounts. However, some users will get around this by extracting a portion of the acetaminophen using hot/cold water, taking advantage of the water-soluble element of the drug. It is not uncommon for addicts to have liver problems from taking excessive amounts of acetaminophen over a long period of time--taking 10–15 grams of acetaminophen in a period of 24 hours typically results in severe hepatotoxicity. It is this factor that leads many addicts to use only single entity opiates such as OxyContin.

Symptoms of hydrocodone overdosage include respiratory depression, extreme somnolence, coma, stupor, cold/clammy skin, sometimes bradycardia, and hypotension. A severe overdose may involve circulatory collapse, cardiac arrest and/or death.

Notes

  1. ^  Tarascon Pocket Pharmacopoeia.

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Drug rush: Limbaugh to listeners: I belong in jail! - Rant
From Reason, 12/1/03 by Jacob Sullum

RUSH LIMBAUGH MAY not be arrested, let alone spend time behind bars, for illegally buying narcotic painkillers. "We're not sure whether he will be charged, a law enforcement source told CNN in early October. "We're going after the big fish, both the suppliers and the sellers."

Following up on a story The National Enquirer broke on October 2, CNN reported that the conservative radio commentator's name had come up during "an investigation of a black market drug ring in South Florida," where Limbaugh has a home. A former housekeeper told the Enquirer she had sold him tens of thousands of hydrocodone and oxycodone pills during a four-year period.

If Limbaugh escapes serious legal consequences, there will be speculation about whether a pill popper who wasn't a wealthy celebrity would have received such lenient treatment. Still, the distinction between dealer and user drawn by CNN'S source is both widely accepted and deeply embedded in our drug laws.

That doesn't mean it makes sense. If drug use is the evil the government wants to prevent, why punish the people who engage in it less severely than the people who merely assist them? That's like giving a murderer a lighter sentence than his accomplice.

Another argument for sending Limbaugh to jail was suggested by the talk radio king himself. In an October 3 column, Newsday's Ellis Henican cited remarks Limbaugh made in 1995 concerning the drug war's disproportionate racial impact. "What this says to me," Limbaugh told his listeners, "is that too many whites are getting away with drug use.... The answer to this disparity is not to start letting people out of jail because we're not putting others in jail who are breaking the law. The answer is to go out and find the ones who are getting away with it, convict them, and send them up the river too."

Before we start building a boat for Limbaugh, perhaps we should consider the arguments for letting him keep his freedom. The strongest is that it's nobody's business but his if he chooses to pop Lorcet and OxyContin, as long as he's not hurting anyone else. When the painkiller story broke, the New York Daily News reported that Limbaugh's lawyers "refused to comment on the accusations and said any 'medical in formation' about him was private and not newsworthy."

On his show the next day, Limbaugh already was moving away from that position, promising to tell his listeners "everything there is." A week later; be announced he was entering treatment for addiction to painkillers he began taking after back surgery. "I take full responsibility for my problem," he declared, while blaming his situation on "highly addictive medication" (thereby reinforcing the opiophobia that has led to scandalous undertreatment of pain in this country).

The quick switch from privacy claim to public confession is reminiscent of Bill Bennett's humiliating retreat on the issue of his gambling. Before renouncing the habit, the former drug czar noted that losing large sums of money on slots and video poker hadn't "put my family at risk." Nor does it seem that the time Bennett spent in casinos interfered with his personal or professional life. It certainly did not keep him away from TV cameras mad op-ed pages.

Likewise, drug use did not stop Limbaugh from signing an eight-year contract reportedly worth $285 million in 2001, or from maintaining a demanding schedule that included three hours on the radio five days a week, or from retaining his status as the nation's leading talk radio host, reaching nearly 20 million listeners on about 600 stations. If Iris housekeeper hadn't ratted on him, we might never have known about all those pills.

I'd say that's how it should have been, except that Limbaugh seems to prefer a different approach. "If people are violating the law by doing drugs," he told his radio audience in 1995, "they ought to be accused and they ought to be convicted and they ought to be sent up." Maybe the government should respect his wishes.

Jacob Sullum (jsullum@reason.com), a reason Senior editor, is the author of Saying Yes: In Defense of Drug Use (Tarcher/Putnam).

COPYRIGHT 2003 Reason Foundation
COPYRIGHT 2004 Gale Group

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