bhamdave
Threadhead
Reged: 01/11/02
Posts: 949
Loc: U.S.A.
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Here is the article:
http://www.msnbc.msn.com/id/4031091/
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AIDS
It's not YOUR problem (I hope that)
It's not MY problem (I know that)
But it is still OUR problem and WE know that!
Edited by bhamdave (01/23/04 07:15 AM)
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plotinus
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Reged: 09/16/03
Posts: 273
Loc: California
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Quote:
Here is the article:
http://www.msnbc.msn.com/id/4031091/
It would be helpful to point out that the article is entirely about APAP/Tylenol OD's. It has been well understood by many of us on DB that combo codones with APAP are designed by FDA/DEA to "kill you before you get addicted." This seems like a very peculiar mentality for a compassionate Christian country??
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"War on ...." is the wrong metaphor!
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2muchpain
Enthusiast
Reged: 10/07/03
Posts: 274
Loc: USA
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Maybe the Powers That Be think it's better to be dead than addicted.
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zeuzjuz
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Reged: 12/16/01
Posts: 1155
Loc: the milky way
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BhamDave -
I know you have been around, and I have always respected your opinions - so please don't take this the wrong way, but thread titles such as the subject title of this one, don't help the cause here too much.... Especially, as someone mentioned, when the article is mainly referring to overdose by Tylenol (not opioids)-
As most people here know (I don't know if I agree that the APAP is compounded with the opioid to *purposely* harm someone that is taking too much - APAP does potentiate the pain relief of an opioid) BUT I will agree, that in an average Hydro/APAP combination - like say 7.5/500 - Even in an opioid naive inidividual - the APAP would very likely overdose/kill the individual before the hydrocodone would. (In someone trying to take a huge dose) - I mean say they took 10 of these pills (Lortab's) - That's 75mg's Hydrocodone and 5grams (!!) of APAP.....
The APAP would certainly be MUCH more toxic to the body, although the high amount of hydrocodone COULD cause someone to pass-out/suffocate/forget to breathe - especially if they already had respiratory issues like asthma, heavy smoking, they had been drinking or taking other sedatives, etc..... But, if the Hydro/APAP was the ONLY medication taken, and the indiviudal was for the most part healthy - the 5gram APAP doseage would do MUCH more bodily harm than the 75mg's Hydrocodone.... Now, I am not saying it is safe for anyone to take 75mg's Hydrocodone.... I am sure someone with a big tolerance could do that with no problems. But like I said - the manner in which the two drugs would harm you would be totally different.
The huge dose of APAP would poison your liver, it is very toxic. Opioids are relatively non-toxic. If the high dose of opioid harmed the individual AT ALL, it would be due to over-sedation/too much respiratory depression, it would not poison or otherwise be toxic to the individual..... To summarize? APAP is much more poisonous than ANY opioid.
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//zeuzjuz
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lemongrass
Board Addict
Reged: 09/23/03
Posts: 361
Loc: IL
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You know, there's always some sort of conspiracy in our government.
It was to my understanding that they once didn't give a hoot about putting addicts on SSI because when they received the lump sum cash settlement after winning their case, then they would go out and get loaded, hopefully succeeding in overdose...that being the mentality of our lovely government, at any rate. So, the mentality being that they lost out on a small amount of money as opposed to having to shell out a monthly check to these so-called undesirables. Pity, but I tend to think this to be true.
lemongrass
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lemongrass
Board Addict
Reged: 09/23/03
Posts: 361
Loc: IL
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Also, I know this topic wasn't about opiates, but it was informative just the same.
Another thing I just thought of is this; If we are receiving opiate painkillers, what exactly is the need/reason to have APAP included in it's compound? I find this extremely baffling, especially since all of the awareness about APAP and liver/kidney diseases and failures.
And lastly, what sort of painkiller would be optimal and not contain any APAP whatsoever? Am I correct in thinking Percodan or Darvon?
Thanks for the help, folks!
lemongrass
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CeeBee
Member
Reged: 08/09/03
Posts: 183
Loc: garden state
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Lemongrass, I have wondered the same thing, due to it's toxicty at high doses why is APAP included in Hydro/Vicodin etc. To enhance the pain reliever properties? well why then can't we just be told to take Tylenol, Advil or whatever if we feel the need to enhance?
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Caveman6666
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Reged: 01/15/03
Posts: 218
Loc: Earth
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Quote:
Also, I know this topic wasn't about opiates, but it was informative just the same.
Another thing I just thought of is this; If we are receiving opiate painkillers, what exactly is the need/reason to have APAP included in it's compound? I find this extremely baffling, especially since all of the awareness about APAP and liver/kidney diseases and failures.
And lastly, what sort of painkiller would be optimal and not contain any APAP whatsoever? Am I correct in thinking Percodan or Darvon?
Thanks for the help, folks!
lemongrass
Hydromorphone, or similar schedule II medications.
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tray1
Enthusiast
Reged: 11/22/03
Posts: 241
Loc: US
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I concur with Zues, Is it possible to edit the thread title to read APAP overdose vs Painkiller? It is misleading.......just my .02
Tray 
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prettyday
Threadhead
Reged: 02/09/03
Posts: 901
Loc: Coastal Sage Scrub
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I will never forget one young lady who was so frantic to get out of pain and so worried about what her family would think that she did not go to the ER. She swallowed 30 Tylenol in a short time period.
She died.
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First they ignore you, then they laugh at you, then they fight you, then you win.
- Mahatma Gandhi
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Tiger47
Member
Reged: 08/23/03
Posts: 102
Loc: Georgia
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This just goes to show that if people that are in pain were treated with the right pain meds (like hydro) they wouldn't feel the need to take hands full of OTC and kill themselfs. If the DEA would not hound the docs so that they can do their jobs and script legit pain patients meds that will help them so many people would live better lives. And BTW why is the DEA not trying to arrest the store that sold the OTC painkillers like they are doing to the doctors that are brave enough to help legit pain patients.
Thanks for posting the news article. And also I really don't understand why all of you people are saying something about the post heading. The exact heading in the article was "Painkiller overdoses on the rise FDA says" At least bhamdave added to the heading with ""OTC"" I guess some didn't see that at the end which means Over the Counter which of course leaves out all scripted controlled meds.
Thanks again for keeping us up to date about what some of these reporters are putting in the papers or Tv that relates to any meds.
Tiger47
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gottadoit
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Reged: 10/21/03
Posts: 269
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The title of this thread does indicate that it is about over the counter pain medications (OTC).
"Painkiller Overdoses on the Rise (OTC)".
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NJ_Hoss
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Reged: 10/29/03
Posts: 263
Loc: USA
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Quote:
If we are receiving opiate painkillers, what exactly is the need/reason to have APAP included in it's compound?
And lastly, what sort of painkiller would be optimal and not contain any APAP whatsoever? Am I correct in thinking Percodan or Darvon?
Thanks for the help, folks!
lemongrass
Lemongrass,
There is a three-fold reason for the common combination of narcotic and non-narcotic analgesics in a single medication. The first is therapeutic. Many types of pain respond better to treatments of multiple mechanisms, for example, blocking the pain impulses at the brain, at the site they or occur, and/or systemically en-route, usually in the spinal area. It is an exponential increase in efficacy, not just cumulative. The second is that many conditions that result in pain also have accompanying symptoms that an NSAID or other analgesic treats better, including fever for infections (abscesses), anti-inflammitory properties for swelling, etc. The third is that it reduces the abuse potential for the medication by not only making it more effective and abating (at least theoretically) the need to further increase opiate/opiod use, but the side-effects, including potential toxicity of the the other additive is preceived to mitigate abuse. For example, Hydrocodone itself is a Schedule II Controlled Substance, but when delivered with a specific proportion of APAP, it becomes Schedule III.
There are many dosage forms of simply the opiate component of pain medications, including OxyIR (Immediate Release Oxycodone) and OxyContin (Sustained Release Oxycodone), Roxicodone (Roxane Labs' Brand Version of Oxycodone), as opposed to Percocet and Roxicet, which are both Oxycodone/APAP combinations. All of these are Schedule II. As C-II's are the most regulated of the legal controlled substances, almost all products can be or are available in their pure form as a C-II. Those that aren't typically aren't sufficiently strong enough to warrant their usage in the pursest form in lieu of a different or more potent product. Morphine, Hydromorphone (Dilaudid), Fentanyl, are all C-II and compound-free.
There are no branded products containing Hydrocodone without some sort of additive like APAP, an antihistimine, or atropine, each of which have unpleasant or unhealthy side-effects if taken in sufficiently large or prolonged doses. Some compounding pharmacies, however, will make special preparations of Hydrocodone/APAP products with much lower APAP content, but at a substantial cost for their service.
The process does not just apply to opiates. Butalbital, a barbituate and primary component of the migraine treatment medications Fioricet and Fiorinal are combined with caffiene (for vascular constriction and to speed delivery) and APAP (Fioricet) or Aspirin (Fiorinal). While Aspirin can eventually do a number on the GI tract, it does not pose a comparable risk to large APAP doses, which is why Fioricet is not a federally controlled substance, but Fiorinal is. Go figure.
There actually is a method to the madness that is born out of efficacy and some fashion of logic intended to better serve patients.
I hope this is helpful.
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tray1
Enthusiast
Reged: 11/22/03
Posts: 241
Loc: US
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I stand corrected, I in fact did not notice the OTC.
Tray
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zeuzjuz
Pooh-Bah
Reged: 12/16/01
Posts: 1155
Loc: the milky way
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Me neither, oops... 
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//zeuzjuz
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Spectre13
Enthusiast
Reged: 12/10/03
Posts: 289
Loc: ThunderHeadTippyTops
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What is so magical about hydrocodone per se that it can't be experienced per se like oxy? My subconscious suspects it may awaken heretofore suppressed brain functions (like free thought) but then again we will never know will we?
Quote:
There are no branded products containing Hydrocodone without some sort of additive like APAP, an antihistimine, or atropine, each of which have unpleasant or unhealthy side-effects if taken in sufficiently large or prolonged doses. Some compounding pharmacies, however, will make special preparations of Hydrocodone/APAP products with much lower APAP content, but at a substantial cost for their service.
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When you think it's beyond your comprehension, it probably just precedes it.
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hoop123
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Reged: 12/14/01
Posts: 258
Loc: New York
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Spectre 13,
Hi and how are you. I remember reading somewhere that if Hydrocodone was manufactured without APAP that it's scheduling would be changed from class 111 to Class 11. I don't know if this is the reason APAP is added to it. I suppose it enhances the opiate. Removing the APAP and causing the schedule change may have something to do with this not already being done. I mean they did it with percocet. But it was already a schedule 11. It makes perfect sense to me to make this med APAP free and maybe in a time released fasion. But I bet the scheduling change would occur and that would change the whole point of doing it, ie: oxy. No marketing here. So as long as some APAP stays in it the scheduling will remain the same. As Zeus said , most people would OD on the APAP before the Hydro. And as I read on another thread Hydro is the #1 prescribed med in the US. Politics is great.
Best Regards,
Hoop
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Spectre13
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Reged: 12/10/03
Posts: 289
Loc: ThunderHeadTippyTops
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Yeah, hydrocontin seems like a logical progression. Even with a scheduling change, it seems there would be a significant price advantage over oxycontin. However, with oxycontin generics on the horizon, and the very patent itself being challenged, the notion of hydrocontin may as well be moot. Dirt cheap oxycontin is on the way.
With regard to my original question, I've been on various pain meds in the past (hydro, oxy, codeine, ms, darvocet, talwin, ultram - not in that order), and for some reason, my brain is telling me that the hydro has a positive mental advantage that the others, especially oxy and ms, just don't have. It's subtle, but very there. It is for that reason I get suspicious about the glaring lack of even one pure hydro product, be it past or present.
Just one of those things that make you go hmmmmmm...
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When you think it's beyond your comprehension, it probably just precedes it.
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Caveman6666
Enthusiast
Reged: 01/15/03
Posts: 218
Loc: Earth
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Quote:
As Zeus said , most people would OD on the APAP before the Hydro.
But the headline would still read: Narcotic Painkiller Overdose, or some variation.
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