The FDA Approved WHAT?
In a bold and possibly rash move, the FDA approved a new “abuse-proof” form of a powerful opioid painkiller.
On November 20th, the FDA gave the green light to Hysingla ER, an extended-release version of the popular opioid hydrocodone. Hydrocodone is the chemical name of the blockbuster drug Vicodin.
Okay, so the government approved a hard to abuse painkiller. What’s wrong with that? If anything, we should be singing Hysingla’s praises. I’m not so sure. A closer look into Hysingla and its development reveal a troubling history.
Not All It’s Cracked Up to Be
Hysingla is the latest form of extended-release hydrocodone. Following Vicodin’s huge spike in popularity (it’s currently the most prescribed and abused painkiller in the U.S.), it became clear something had to be done.
Vicodin exposes its legitimate and recreational users to a host of negative side effects. These include liver damage, due to acetaminophen, and addiction. So, drug companies began working on a pure form of hydrocodone that was also “abuse-proof.”
Fast-forward to 2013. The FDA, despite numerous doubts about its safety, approved Zohydro ER. Legislators, police officers, addiction professionals, and even the FDA’s own advisory board claimed Zohydro presented a danger to users due to its high levels of hydrocodone (the highest strength contains fifty milligrams of the opioid).
Once Zohydro hit the market, Massachusetts Governor Deval Patrick declared a public health emergency. It was reactions like these that prompted the pharmaceutical company Perdue to develop Hysingla.
Not everyone is so sure this new drug is safe, though. Jane Woodcock, the director of the FDA’s Center for Drug Evaluation and Research, wrote the following –
“Prescription opioids with abuse-deterrent properties will not completely fix the prescription opioid abuse problem, but they can be part of a comprehensive approach to combat the epidemic.”
How is Hysingla “Abuse-Proof?”
No matter what side of the Hysingla debate you’re on, we can all celebrate a drug that’s difficult for addicts to abuse. Surely we can all agree on that, right?
Well, it turns out Hysingla isn’t actually that abuse-proof. In fact, Hysingla is difficult to crush. That’s it. It doesn’t turn to gel when mixed with water. It isn’t impossible to inject. It’s simply difficult to crush.
Hysingla may need some better abuse-deterrent methods. Otherwise, it’s destined to join the ranks of the many other “abuse-proof” drugs which aren’t too hard to abuse.
”Abuse-Proof” Pills Aren’t Abuse-Proof
Since the mid-2000’s there’s been a push to develop abuse-proof alternatives to popular opioid painkiller drugs like OxyContin, Percocet, Roxicodone, and you guessed it, Vicodin.
These pills were simply too popular with addicts. People were overdosing left and right. A painkiller epidemic was born.
So, Perdue and other pharmaceutical companies began to develop “abuse-proof” forms of many opioids. The only drawback, though, was that these abuse-deterrent pills were still abusable.
OxyContin formulas started to turn to gel when mixed with water. Enterprising addicts figured out a way to extract the drug from the gel. Roxicodone pills were supposedly “un-crushable.” Once again, enterprising addicts learned how to crush them.
Not to mention, as a specific pill became harder to abuse, addicts would simply switch to one that wasn’t so hard. This is why, by the mid and late 2000’s, we saw people switching from oxy to Dilaudid.
This presents a powerful lesson. As long as opioid drugs are available, people will figure out ways to abuse them. It doesn’t matter if they’re “abuse-proof” or not.
So, what’s the answer? Well, there isn’t an easy answer. Knowledge of the destructive effects of addiction helps. Shifting the focus of addiction from a moral failing to a medical condition helps. Increased access to substance abuse treatment helps.
Now put all those things together and we can hope to see a real solution to American’s painkiller epidemic.