Are Changes to Powerful Painkiller Zohydro Enough to Alleviate Concerns?

photo of prescription painkiller drug Zohydro on top of a doctors prescription pad

Worries of mass overdoses, backdoor conspiracies and blatant indifference for public safety surrounded the 2013 release of Zohydro, an extended-release, hydrocodone super painkiller. The new drug is said to have five to 10 times the power of Vicodin. [1] A coalition of health care, consumer advocacy, and addiction treatment groups even banded together under the name FED UP! to protest the release. [2] A recent makeover was done to make it more abuse-resistant, but is it enough?

The concern about Zohydro stems from its strength; Zohydro will be the strongest single dose of hydrocodone available on any market. Considering the massive number of hydrocodone-based and other opiate-type painkillers available, and that the number of Americans addicted to prescription medication is at an all-time high, most groups with a vested interest in public health and addiction medicine are understandably concerned.

A Shaky Start

Zohydro was approved by the FDA in October 2013, directly against the advice of the FDA’s own advisory panel, which voted 11-to-2 to not approve the drug for public use. [3] It was the first hydrocodone formulation that did not contain acetaminophen, thus reducing the potential for liver damage. Due to the leak of several emails about meetings between FDA officials and representatives from Elan Corporation, the original manufacturer of Zohydro, concerns about some backroom dealing for the drug’s approval surrounded the release.

Zohydro ER, which was first made available for prescription in March 2012, initially did not have any of the new and popular tamper-resistant technologies, such as a hard-to-dissolve matrix or a difficult-to-crush coating. In September 2014, the FED UP! group held a protest rally in Washington to try and draw more attention to the FDA and its supposed collusion with pharmaceutical companies.

In January 2015, the U. S. Food and Drug Administration (FDA) approved an updated formulation that combines Zohydro ER with BeadTek™, which is an inactive ingredient that immediately forms a viscous gel when crushed and dissolved in liquids or solvents.

Addictive Appeal

Opioids work with the receptors in the brain to reduce discomfort. Not only do they help to dismiss pain, they also stimulate a shortcut to the brain’s reward pathways – causing a sense of euphoria. Once experienced, this feeling of elation is often desired again and again. With repeated use, tolerance quickly builds up. Users then need higher and higher doses to achieve the desired effects.

In its initial release, Zohydro could be crumbled and easily snorted. So while the new formulation does prevent inhaling, the addictive properties are still as prevalent.

Is There a Doctor in the House?

According to a recent article, 91 percent of those who overdose on prescription painkillers are able to get another prescription – most from the same doctors that they were going to before the overdose. [4] Doctors serve as a line of defense against addiction. As with any opioid-based drug, the physician prescribing Zohydro ER should:

  1. Prescribe it in the lowest dose possible and for the shortest duration of time
  2. Monitor regularly for effectiveness, side effects and patient compliance
  3. Educate your patient about the risk of addiction
  4. Strictly follow guidelines and regulations

The ultimate responsibility stills lies with the patient, but an effective health professional would serve as a guide to help steer a path clear of addiction.

Contact the National Alcoholism and Substance Abuse Information Center (NASAIC) anytime toll-free at (800) 784-6776 or through our online form, and we will recommend the leading drug and alcohol rehab centers for you or your loved one. 

[1] http://www.forbes.com/sites/melaniehaiken/2014/02/28/is-zohydro-the-super-potent-new-opiate-painkiller-just-too-dangerous/#2715e4857a0b5ac50f071f68

[2] http://feduprally.org/

[3] http://www.drugfree.org/join-together/fda-panel-votes-against-recommending-zohydro-for-approval/

[4] http://hereandnow.wbur.org/2016/01/13/opioid-prescriptions-after-overdosing

Contact the National Alcoholism and Substance Abuse Information Center (NASAIC) anytime toll-free at (800) 784-6776 or through our online form, and we will recommend the leading drug and alcohol rehab centers for you or your loved one.

-->