Zohydro: Why Freak Out?

If you’ve been listening to the news last Christmas, you’ve probably heard about Zohydro–the new proposed painkiller coming to market soon. And later this year, you might be hearing a lot more about it. Zohydro has sent little ripples of shock through addiction experts and those who care about the rise of prescription addiction.

So what’s the commotion all about? And why is there such a big protest against it?

What is Zohydro Anyway?

Zohydro is a prescription painkiller scheduled to come out in 2013, if the drug is approved by the FDA. Designed for the treatment of moderate to severe chronic pain, Zohydro is an extended release form of hydrocodone that releases small doses of hydrocodone around the clock.

Like Vicodin, Zohydro is another variation of the opiate hydrocodone. Unlike Vicodin, which has more acetaminophen (Tylenol) in it than hydrocodone, Zohydro is almost purely hydrocodone. In fact, Zohydro contains up to 10 times the amount of hydrocodone as Vicodin.

So What’s the Big Deal?

Addiction experts are worried that Zohydro could result in a new wave of abuse.  And they have a good reason to be worried.

Hydrocodone, powerful and addictive, already ranks number 2 among the most commonly abused medication in the United States. According to the Drug Enforcement Administration, hydrocodone is also the most frequently prescribed opiate, with more than 139 million prescriptions for hydrocodone-containing products in 2010.

If Zohydro is approved, this will be the first time that pure hydrocodone is legally available.

Do the Benefits of Zohydro Outweigh the Risks?

Drug companies that plan to market Zohydro argue that Zohydro has many advantages and could be very beneficial. While these reasons are legitimate, one should realize that the benefits may not outweigh the risks. Let’s take a look at these benefits:

Benefit #1: Single-entity hydrocodone

Granted, pure hydrocodone is a powerful painkiller. Zohydro could be a very effective medicine that works very well to relieve severe pain.

On the other side, this is precisely why Zohydro is dangerous. The more potent, the more desirable the drug becomes—and the more addicting it will be for those who use it.

Benefit #2: Twice daily dosing provides true around-the-clock relief. This means easier adherence/greater patient convenience

You don’t have to set multiple alarms to go off every four hours throughout the day to remind you to take your meds. You take it once in the morning and once in the evening. Easy to remember.  Convenient. No pain.

This is a wonderful advantage.

But it’s an advantage that comes with all extended release pain meds:

  • Oxycontin
  • Morphine (OralMorh SR, MS Contin)
  • Fentanyl patches
  • Oxymorphone (Opana ER)
  • Buprenorphine (Butran transdermal film)
  • Hydromorphone (Exalgo)
  • Levorphanol

Also, keep in mind that people can bypass the “extended release” design of the pill. By simply crushing the pills, an individual can get a whole pill of active hydrocodone in one dose.

This is how Oxycontin, the extended release form of Oxycodone, is abused.

Benefit #3: another opioid option for chronic medication rotation

Of course variety is not a bad thing. Some people respond to one opioid better than another, and tolerance to opioids can be treated by switching to another opioid.

But the truth is this: The potential for Zohydro abuse is too great in comparison with those who will actually use Zohydro for treatment purposes. Already, there are 23.5 million people in the United States who use hydrocodone for nonmedical purposes, according to the data from National Survey on Drug Use and Health in 2009.

What will the numbers be when a pure form of hydrocodone is legally available?

Benefit #4: Zohydro avoids liver problems linked to high doses of acetaminophen, which is an ingredient in products like Vicodin.

True, acetaminophen (Tylenol) has been proven to cause liver damage. However, the risk of liver damage is extremely low as long as it is not taken in high doses or more than the normal recommended amount.

“Most people are only at risk for liver damage if they take more than the prescribed amount of acetaminophen.”


Acetaminophen is also more likely to cause liver damage in people who also drink alcohol—but those who drink are already prone to liver damage regardless of their acetaminophen consumption.

The point? A low risk of liver damage should not override the potential effects of bringing a pure narcotic to the market.

How Does Zohydro Impact California?

Prescription Abuse in California:

  • California ranks 3rd in overall misuse of prescription psychotherapeutic drugs, a class including prescription pain relievers, tranquilizers, stimulants, and sedatives. (This statistic is not in proportion to the population density of CA).
  • In 2005, around 1.5 million Californians misused prescription drugs.
  • The DEA considers Los Angeles to be one of the top 3 pill mills in the country.

Zogenix, a drug company that plans to apply to market the drug, is located right in San Diego. If Zohydro is approved, the wave of addiction could soar, especially in California.

In the past five years, California has reached record highs of prescription abuse. The last thing the state needs is a pure form of one of the most powerful narcotics in the world.

Duffy’s: Standing By For You

Despite all the warnings, we know that statistically speaking, people–especially those with already established addictive personalities and behaviors—will be susceptible to taking and abusing Zohydro when it comes out.

We’re here to remind all of us–before the fact–that we don’t have to listen to our disease. We can be winners.

But if we do become addicted to Zohydro, Duffy’s already has a team of counselors ready, uniquely trained to address our disease and individual behaviors.