Zohydro, the Next OxyContin?

in science on 2014-02-26 20:34 (#3EX)

Pharmaceutical company Zogenix has received US FDA approval to launch a new hydrocodone-based analgesic in March. The drug is intended only for chronic pain, not as an short term or as-needed analgesic. CNN is reporting a coalition of groups are lobbying for the FDA to revoke their approval before the medicine is even available.

The concerns echoed by all groups are broadly about the drug's potency and abuse potential. They say they fear that Zohydro -- especially at higher doses -- will amplify already-rising overdose numbers.

"You're talking about a drug that's somewhere in the neighborhood of five times more potent than what we're dealing with now," said Dr. Stephen Anderson, a Washington emergency room physician who is not part of the most recent petition to the FDA about the drug. "I'm five times more concerned, solely based on potency."

A number of other news outlets are hyping the potency of Zohydro, going so far as calling the drug ten times more powerful than a 5mg Vicodan. A fairer comparison may be to OxyCodone, since they have similar opioid levels. Zohydro ER will be available in 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, and 50 mg strengths.

Chemistry Pipedotters can find the structural formula for hydrocodone bitartrate on RxList.

Should the FDA allow such a potent medication on the market? Or would moving opioid analgesics to Schedule II mitigate the potential for abuse?

4 comments

If used as prescribed (Score: 3, Insightful)

by jonh@pipedot.org on 2014-02-26 21:11 (#78)

If I had bone cancer , or liver cancer , for example, I would be wanting access to any chronic pain medication I could get my hands on (although I'd probably be asking for fentanyl as first choice).

If the primary purpose of medicine is to reduce suffering, then I'm not sure I'd be comfortable with witholding drugs from people who need them because there's a chance they might be abused.

And if we want to extend suffering reduction to drug addicts and their families as well, then giving them access to measured doses would go a long way to helping reduce the chance of accidental overdose.

(And if you absolutely must take opiates/opioids, for heaven's sake don't get drunk at the same time, otherwise you will pass out and die from respiratory arrest...)

Re: If used as prescribed (Score: 3, Insightful)

by eviljim@pipedot.org on 2014-02-27 04:38 (#7C)

(And if you absolutely must take opiates/opioids, for heaven's sake don't get drunk at the same time, otherwise you will pass out and die from respiratory arrest...)

I take tramadol daily for chronic back pain after an injury, have been drunk a few times, and haven't died yet, not even once. I am a bit of a lightweight though so my "drunk" is probably an Australian's "tidly"

Two sides to this: (Score: 3, Interesting)

by hartree@pipedot.org on 2014-02-27 00:55 (#7A)

On the one hand, there is a good deal of abuse of these opioids. Their use needs close supervision to keep abuse down, and also trying to prevent accidental overdose.

On the other hand, drug enforcement laws enacted in the face of this abuse sometimes interfere with the legitimate treatment of chronic pain. There's a shortage of pain management specialists as they have to put up with more paperwork outside scrutiny and hassle since they have to prescribe such large amounts of opiates. A lot of young MDs make the decision to go into other areas due to that.

These are powerful drugs that should be available in the cases they are needed without causing difficulty for either the physicians or the patients who need them.

I wish they'd just stop faffing around (Score: 4, Insightful)

by insulatedkiwi@pipedot.org on 2014-02-27 09:52 (#7E)

and legalize proper opiates already. It's some stupid equivalency game, opioids are the best treatment for chronic pain (until they find a way to get true endorphins past the brain cell barrier) but they're illegal because they make people feel good, so we'll create something that's close, it gets banned, rinse and repeat.

Protestant morals and fascist population control seem to go hand in hand.