Thursday, July 2, 2009

Mixing Drugs

I've got a bit of a personal interest in the FDA's move to ban Percocet and Vicodin because of the liver toxicity problems associated with Acetaminophen.

ADELPHI, Md. — A federal advisory panel voted narrowly on Tuesday to recommend a ban on Percocet and Vicodin, two of the most popular prescription painkillers in the world, because of their effects on the liver.

The two drugs combine a narcotic with acetaminophen, the ingredient found in popular over-the-counter products like Tylenol and Excedrin. High doses of acetaminophen are a leading cause of liver damage, and the panel noted that patients who take Percocet and Vicodin for long periods often need higher and higher doses to achieve the same effect.

Acetaminophen is combined with different narcotics in at least seven other prescription drugs, and all of these combination pills will be banned if the Food and Drug Administration heeds the advice of its experts. Vicodin and its generic equivalents alone are prescribed more than 100 million times a year in the United States.

During my recovery from my broken humerus, I went through some serious pain that is treated with Hydrocodone (Vicodin). The main problem for me was the limit I could safely take (I have a tolerance level for opiates that rivals that of an elephant) because of the Acetaminophen content, and it's potential for liver damage. In the hospital, they could give me morphine, which is much safer, but once out of the hospital, that wasn't an option. (aside: Oxycodone (Percocet) does almost nothing for me when it comes to pain. All it does is make my brain as mushy as Lush Rimbaugh's. Stupid and still in pain is not a desirable situation.) I repeatedly wished that I could get Hydrocodone (which I needed) without Acetaminophen (which I didn't need), but thanks to the pharmaceutical lobby that wasn't an available opton.
I'm way better now, and rarely need to take a pain pill. But for millions of people with chronic pain, this could be really major. Getting rid of the Acetaminophen is a good idea, but Hydrocodone and Oxycodone need to still be available for those who need them. That's an issue that is still unresolved, what alternatives will be offered.
How typical of health care in America. The pharmaceutical companies can push Acetaminophen (which can kill you) into a wide variety of medications. But most of us can't get Medical Marijuana, which is safe AND effective.


Mike Goldman said...

They deliberately put the acetominophen in in order to make the opiate medications more toxic, so they will be less likely to be abused.


I also have been reliant upon Oxycodone (since Hydrocodone made me sick for some reason) after a near fatal car accident; a serious back, head, and neck injury as well as leg injury.

My doctors had me on 360 pills/month; it took me 4 years to wind it down to 10 pills/month because I wanted to get off the pain killers, and have to deal with it by alternating taking OTC pain relievers 2 days; then I get to treat myself to REAL pain relief on the 3rd day = 10 Oxycodone/month.

My pain management doctor was the one who had me on 360 - my general practioner helped me get off the pills; down to 10/month.

I read the article that you posted; it strikes me as ridiculous to lower the number of pills in a bottle to solve this problem (or reduce the dosage). People will buy what they need; all this will do is allow them to charge much more money 'per bottle' (no discounts for buying in bulk), and people in pain will still opt for getting that immediate relief, and take their chances with liver damage.

This is merely a profit venture; in many ways - 'divide and conquer'. Confuse and conquer. My doctor requires a monthly visit (makes money) because he can't write a prescription for more than one month at a time for any narcotic.

What's strange is my doctor claims he has to see me every month for those 10 pills. When I had my teeth extracted, my dentist was able to CALL IN A PRESCRIPTION for Oxycodone for my pain; no visit required.

The doctor says one thing; the dentist says another. Crazy - truly crazy.....

My dad suffered from pain; he just drank enough Jack Daniels to kill it and pass out. Talk about liver damage!!

So, for some people it will mean turning to booze which will drive up the profits for that industry.

It's nothing but a squeeze play on the people who suffer from arthritic pain; chronic pain, pain from injuries that continue beyond the hospital care, and in all of this the pharmaceutical industry wins; the doctors win - but costs for medical care goes up, and that drives up the insurance premium costs, etc. etc.

What a pile of horse shit!!!

pygalgia said...

H in NV, your case is exactly why we need to change health care. My complaint was that the pharmaceutical lobby has pushed the combination medication into being the standard treatment, rather than having the best for the individual patient. But each different patient has different needs. In my case, I'm a former heroin addict, so while I needed a very high dose in the short term, I don't need pain meds in the long term. The problem was that I couldn't take enough hydrocodone to effectively relieve the pain without nearing a toxic dose of acetaminephon. And alcohol (as much as I love beer) really isn't a very good pain med.
It's somewhat funny that the opiates, even with their problems, are actually safer than the drug you can buy OTC.

pygalgia said...

Added: The Oxycodone vs. Hydrocodone issue seems to be very individual in effecacy. The two chemicals are almost identical, but individual responses aren't. I have a friend who would be demographically and physically almost identical to me, but he reacts badly to hydrocodone, and finds oxycodone to be quite effective.