Vicodin: Help or Hurt

Dear Sirs,

I felt compelled to write a brief response to the article that appeared on Sunday's front page, regarding the medication Vicodin. The generic name for Vicodin is Hydrocodone, and it usually is combined with Acetaminophen or Ibuprofen and it is an excellent medication when prescribed and used properly. The human brain, like many other animals that are studied by researchers, has a phenomenon called tolerance. Many of the readers of this essay might be familiar how tolerance develops with most medications or substances. For example, if you used to drink two beers and get intoxicated, after a brief period of time, you will develop tolerance to alcohol, and you might have to drink three or four beers to get the same kind of feeling. Hydrocodone is no different. If you hurt yourself or incur an injury, you may be prescribed Hydrocodone as an analgesic to relieve the pain. It usually works well.

Here is where problems begin. After taking 1 pill every four hours for five days, it might not have as good of analgesic effect as you needed. So, maybe you try two, and all of sudden, it works. You feel better, so now you take 2 pills four times a day, and the problems begin. You will run out of your prescription early and ask for a refill or another prescription. Since your physician is trying to help you, they might comment or ask why you need more so soon? A logical question. You are honest and nave at this point and you tell the truth, 1 pill just didn't seem to be enough in the morning when I woke up. The physician chides you for changing your dosage without consulting him or her, but gives you a new prescription because of the legitimate pain problem that you are experiencing.
(2 of 3)

I would like to touch on a more familiar substance for a moment, Alcohol. Yesterday was the Superbowl, and it was a great game, and many people watched it in about 140 countries. The sponsor of the NFL is Coor's. Their main product is beer, which is a vehicle to deliver alcohol to your brain. An interesting statistic is that approximately 6% of the people that try alcohol, become addicted to alcohol or alcoholic as we commonly refer to it. So this presents a problem for me. If 100 million people try Coor's Light, 6% of them will become addicted. That is 6,000,000. That's a lot of twelve packs! In the United States, 100,000 people die annually due to alcohol and alcohol related problems. Our laws need to be looked at, for example: a colleague of mine Larry Gentilillo MD is has been studying alcohol and drug related accidents which cause people to come or be brought to Hospital Emergency Rooms for treatment. The ER's don't check for intoxicants, because if the person driving the vehicle is found to be under the influence, their insurance company can refuse to pay the bill. Therefore, the hospitals don't tell this side of the story. Dr. Gentililo has proven statistically that would be the best time for an intervention by the attending physician.
Advertisement

Which brings me to my next point. Most physicians are not well trained in the treatment of pain, especially when it turns into addiction. The percentage that I quoted above for alcohol works for most drugs as well. Therefore, when many physicians see a patient exhibit the basic symptoms of dependence, as described in the Diagnostic and Statistical Manual of Mental Disorders IV TR, they assume, illogically that the patient is in addiction. Why? Because they are demonstrating tolerance and withdrawal, those are not the qualifiers of the disease of addiction. Moreover, they represent what is called “pseudo-addiction.” A medication such as Hydrocodone should never be prescribed as the main medication in a chronic pain situation, because pseudo-addiction will always appear; at that point the thought that this person needs addiction treatment is not based in sound medical training. An addiction medicine physician would be able to treat that person with the proper, long acting medications necessary to treat chronic pain.
(3 of 3)

To sum up what I am saying, is alcohol bad or good? It is neither. If you were stuck on a desert island and you accidentally cut your leg, pouring alcohol over it, may act as a disinfectant. In that case the alcohol is good. However, if a person with the disease of addiction to the drug alcohol (fondly known as alcoholism) it would then be a bad thing. So, one can see, it is not the substance that is bad or good; it is a very complicated understanding of brain chemistry to know whether that Hydrocodone or Vicodin is either bad or good. Actually, it is neither, once again, it is just a tablet. Helpful if you have acute pain, dangerous if you have developed the co-morbid diseases of pain and addiction.
Advertisement

The new medicines and psycho-social counseling that are offered by the office that I work at, have about a 90% success rate of being able to manage the disease of addiction and treat pain, if necessary. Please do not throw the baby out with the bath water as your article implied.

Sincerely,

Barry Schecter, LCSW-R, CASAC, MAC, SAP

Call us today to discuss how the V.I.P. Way can free you from your opiate dependency and get your life back. Call today: (800)276-7021 or (702)308-6353 Email: info@rapiddetoxlasvegas.com Medical Director: Board-Certified by American Board of Anesthesiology 1994, former chief of cardiac anesthesia, University of Nevada School of Medicine. Board-Certified by American Board of Pain Medicine 1997, Clinical Assistant Professor University Nevada School of Medicine.