Sincerely,
A Perplexed Aficionado of Percocet
An excellent question, APAP, if I did ask it myself. First, a brief discussion about hydrocodone (involving only a bit of math), and its packaging. There is so much more of course that can be said. But not always heard, depending on the length and severity of your addiction. Just ask Google.
- Hydrocodone, late of Rush Limbaugh notoriety, seems to be available in a variety of dosages, and always mixed with acetaminophen, from 325 mg to more than twice that amount. For comparison, one Extra Strength Tylenol pill contains 500 mg of acetaminophen. As pharmacists and poison control centers are wont to say, 4 grams, or 4000 mg, is the most acetaminophen you want to dump on your liver a day, to avoid the necessity of an immediate liver transplant or the likelihood that Wal*%r$ns will not refill your script. Unless you're a rock star, sports hero, or very fiscally fit, that uniquely tailored liver replacement may be difficult to collect in a timely, life-saving manner.
- While your prescription may suggest taking 1 or 2 pain pills every 4 to 6 hours for your distress, if for any reason you take more than 5 or 6 of the pills with 750 mg of the acetaminophen in a day, you are downing a toxic dose of pain relief. There's not enough hydrocodone there to kill most folks via respiratory arrest, as over use of opiates is notorious for doing, but the acetaminophen excess can overload your liver's metabolic capabilities and leave poisonous residues behind to wreak further hepatic havoc.
- The DEA controls the hydrocodone compound in its schedule III manner, while acetaminophen is a weaker, over the counter, unscheduled analgesic. If people want to mix generic Tylenol with another medicine, they don't need a prescription for it. But if they want to take the hydrocodone for pain relief without acetaminophen, very special arrangements must be made. NB: the DIY ones found on the web involving cold water do not actually work.
- Overdosages of many opiates can lead to foolishly sleepy behavior, and more fatally, respiratory arrest. The antidote to the opiate induced apnea is a small shot of one of several drugs, including naloxone, a.k.a. Narcan. It's generally best to administer this antidote intravenously, and there is also a fresh and true adage that "Any junkie can hit a vein", i.e. Narcan administration ain't hard to do. In a life threatening situation, an associate of the unconscious opiate user could spike a load of Narcan into the user, an act akin to pushing an Epi-Pen into someone who had just escaped a swarm of Africanized bees.
- Returning now to the judgment of Big Pharma to sell the formulations that mix opiates with acetaminophen, one can simply assume that in their benevolence, the manufacturers mix the compounds because clinical trials have shown the mixture to have greater efficacy than either compound taken alone. The pill taking population then has one less choice to make with their hop headed muddled minds - whether or not to include a Tylenol with their Vicodin.
- Alternatively, Big Pharma (along with the rest of the world) recognizes and appreciates the affects of opiates. These can be found for sale to the public without the acetaminophen in the form of non-FDA, non-DEA approved imports from, say, Afghanistan, or more safely and in better lit locals like the corner apothecary.
