FDA On Removing Vicodin, Percocet From Market & Limiting APAP: Merged Thread

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I'd imagine that most opiate/other drug scripts are filled by generics... But, I wonder how they feel about this. I can't imagine that they'd want to be bumped up to CII status, due to prescribing limitations and a greater fear of CII's. But a forced drop in active non-opiod per pill would be something that could potentially lead to more use, either through prescribed use that could take a bite out of the CII's market and through increased recreational use...

Still, I don't see anything other than the cheapest option, black box warning, happening.

I highly doubt increased recreational use. It seems most recreational users of prescription opioids not only do not frequent forums like this (or other drug user sites on the internet like Erowid), they also don't know about the danger of APAP. In this regard, if a Hydrocodone only tablet becomes very popular (even half as much as Vicodin), I doubt abuse levels would rise. It's similar to the premise that if we legalize all drugs, everybody will want to use Heroin and Cocaine. People who want to use Vicodin are using it now; similar to Heroin and Cocaine. Usage levels won't change considerably, only the safety of those already and those who will continue to use.
 
Usage levels won't change considerably, only the safety of those already and those who will continue to use.

If there is no rescheduling it will likely get worse, probably see a rise in seizures from people trying to get high off tramadol or tapentadol.
 
A couple years ago , I had a LASIK-type surgery, PRK, which is a bit more invasive and has some pain management intended for aftercare.

As the doctor whipped out her prescription pad, I asked what kind of pain medication I was being prescribed.

"Darvocet." she replied.

I stood up.

"Don't even bother writing it," I said. "I'm gonna go get me some heroin."

And that's just what I did. The look on her face was fucking priceless. :D

JF, your my fucking hero=D
 
I highly doubt increased recreational use. It seems most recreational users of prescription opioids not only do not frequent forums like this (or other drug user sites on the internet like Erowid), they also don't know about the danger of APAP. In this regard, if a Hydrocodone only tablet becomes very popular (even half as much as Vicodin), I doubt abuse levels would rise. It's similar to the premise that if we legalize all drugs, everybody will want to use Heroin and Cocaine. People who want to use Vicodin are using it now; similar to Heroin and Cocaine. Usage levels won't change considerably, only the safety of those already and those who will continue to use.
I don't know, I think a hydrocodone only pill, especially in an extended release form would lead to more abuse. Especially if it replaces the apap versions. For the people that do know, and the hardcore pill poppers do know, it'll allow them to stay on longer before jumping to OC and eventually heroin.
But yeah, I'd agree that the average recreational user probably doesn't know the dangers of apap, and probably doesn't care if they do know.


This just somewhat reminds me of the perfect storm that OxyContin was/is...
 
does anyone know the time frame abouts in which a change like this would actually happen? like do they talk about it for a few years first?
 
I don't know, I think a hydrocodone only pill, especially in an extended release form would lead to more abuse. Especially if it replaces the apap versions. For the people that do know, and the hardcore pill poppers do know, it'll allow them to stay on longer before jumping to OC and eventually heroin.
But yeah, I'd agree that the average recreational user probably doesn't know the dangers of apap, and probably doesn't care if they do know.


This just somewhat reminds me of the perfect storm that OxyContin was/is...

On the one hand I agree; but I see Vicodin as the perfect storm rather than OC. The Oxycodone vs Methadone as the primary opioid analgesic to prescribe for bad pain problems of all shapes and sizes goes back to the '70s when Appalachia and the South/MidWest got its first real taste for Oxycodone in Tylox and Percodan. Then Methadone replaced Oxycodone as a less abused opioid, but was killing people easier, then OxyContin came out and the media epidemic hysteria created an actual OC epidemic in areas that had previously had Oxycodone addiction problems. (and since then, early 2000's, Methadone made a big comeback over OxyContin over the hysteria of addiction, theft, etc. Today, Methadone is getting a lot of bad press so doctors are swinging back to Oxycodone).

Vicodin, due to its unique scheduling status, replaced Darvon as the go-to opioid for everyday average American's minor pain complaints. The main difference being Propoxyphene is self limiting with the side effects and toxicity, whereas Hydrocodone is a very euphoric opioid at low doses, it is low cost, widely prescribed, protected by the unique legal status, and doesn't have a limitation with dosing aside from the APAP (which has either been ignored or bypassed with CWE). Plus it has such a wonderful reputation with doctors and patients (unlike Darvon, Methadone and Oxycodone).

Just my take on it. I'm horrified by the next generation of narcotic combination pills (Oxycodone + Niacin, Oxycodone + Naltrexone, Morphine + Dextromethorphan, etc).
 
On the one hand I agree; but I see Vicodin as the perfect storm rather than OC. The Oxycodone vs Methadone as the primary opioid analgesic to prescribe for bad pain problems of all shapes and sizes goes back to the '70s when Appalachia and the South/MidWest got its first real taste for Oxycodone in Tylox and Percodan. Then Methadone replaced Oxycodone as a less abused opioid, but was killing people easier, then OxyContin came out and the media epidemic hysteria created an actual OC epidemic in areas that had previously had Oxycodone addiction problems. (and since then, early 2000's, Methadone made a big comeback over OxyContin over the hysteria of addiction, theft, etc. Today, Methadone is getting a lot of bad press so doctors are swinging back to Oxycodone).

Vicodin, due to its unique scheduling status, replaced Darvon as the go-to opioid for everyday average American's minor pain complaints. The main difference being Propoxyphene is self limiting with the side effects and toxicity, whereas Hydrocodone is a very euphoric opioid at low doses, it is low cost, widely prescribed, protected by the unique legal status, and doesn't have a limitation with dosing aside from the APAP (which has either been ignored or bypassed with CWE). Plus it has such a wonderful reputation with doctors and patients (unlike Darvon, Methadone and Oxycodone).

Just my take on it. I'm horrified by the next generation of narcotic combination pills (Oxycodone + Niacin, Oxycodone + Naltrexone, Morphine + Dextromethorphan, etc).

Why would they make oxycodone with niacin? just wondering what the benefits would be.
 
Why would they make oxycodone with niacin? just wondering what the benefits would be.

Acurox. Oxycodone/Niacin combo tablet. In a ratio of 30mg Niacin for every 5mg Oxycodone. An abuse deterrant; Niacin in large doses causes very unpleasant effects that are similar to the IV user phenomenon known as a 'Dirty Rush' or 'Dirty Hit' similar to how 'Cotton Fever' feels. This is to deter oral abuse of Acurox. A gel or some other agent is used to deter nasal and IV abuse.

Acura’s (ACUR) lead product candidate, Acurox, is an immediate-release formulation of oxycodone containing niacin as an aversive agent to prevent “swallowing excess quantities of tablets.” Acurox also employs non-pharmacological mechanisms to deter nasal ingestion and to limit the potential for conversion into a form suitable for intravenous administration.

http://seekingalpha.com/article/86471-acura-acurox-a-revenue-deterrent-formulation-of-oxycodone
 
Government involvement is just a bad idea period....I do think we need it but not so much that personal responsibility is 'their" job. Just my two cents..This will backfire...somehow or another for those that truly rely on it the way it is to save the few morons that cant read.
 
Just my take on it. I'm horrified by the next generation of narcotic combination pills (Oxycodone + Niacin, Oxycodone + Naltrexone, Morphine + Dextromethorphan, etc).
hey the last one has the potential to somewhat keep down tolerance/dependence. though i think ive read on BL that DXM is nowhere near as useful as ketamine or other nmda antagonists in reducing tolerance

a morphine/ketamine tablet should be being tested imo
 
^^The problem is that ketamine has a piss-poor oral bioavailability--it really has to be administered via SC/IM for the optimal therapeutic effects and pharmacokinetics. I don't understand why ketamine is not the first-line analgesic/anaesthetic in emergency/surgical medicine anyway.
 
^^The problem is that ketamine has a piss-poor oral bioavailability--it really has to be administered via SC/IM for the optimal therapeutic effects and pharmacokinetics. I don't understand why ketamine is not the first-line analgesic/anaesthetic in emergency/surgical medicine anyway.
it used to be. people complained of side effects after awakening related to dissociation. some even had out of body experiences and the trippy stuff that goes with it. basically people more sensitive to the drug were K'd out for a little bit of time after awakening :P and doctors consider this to be a "negative side effect"
 
So if they take Hydrocodone and Oxycodone medications off the shelf that contain APAP like Vicodin and Percocet, then does that mean all the people that currently have a prescription to Vicodin or Percocet like product then does that mean their pain dr. will be forced to switch them to like an Oxy IR 5mg or 10mg? Or do you think they will make Hydrocodone Only pills 5mg, 7.5mg, 10mg?
 
it used to be. people complained of side effects after awakening related to dissociation. some even had out of body experiences and the trippy stuff that goes with it. basically people more sensitive to the drug were K'd out for a little bit of time after awakening :P and doctors consider this to be a "negative side effect"

^^I have a surgery coming up, and I think I'm going to ask for ketamine and see what the anesthesiologist says.

but I'm not worried about this whole mess. it will sort itself out over time. no one wants to see hydrocodone disappear (well maybe some assholes). but they'll make some changes that don't change much. release a new "non-addictive" drug that will be super addictive and the cycle will repeat itself.
 
This could be a good step, this could be a bad step based on resceduling and what not. I try to educate my uninformed friends that you're not supposed to take more than 3,000mg acetaminophen w/out causing liver damage and they don't listen so I see it as a good thing.
 
propoxyphene has been taken off the market, but it's not really banned. I don't know when the date was for this, but I think it was soon.


Is Nucynta actually going on the market? As I understand Johnson & Johnson might not bother marketing it if it can't get CIII. I imagine they're doing what we tried doing with Lacosamide.
 
All this time and money spent on scheduling, putting "deterrents" in to prevent abuse, etc.....

and CP'ers stay in pain and I get high as often as I want.

If I was just master of the universe, everything would be perfect.

I am worried we'll see hydro go CII and street availability and and price will rise.
 
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