LYCOS RETRIEVER 
Hydrocodone: Escalating
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Hydrocodone diversion and abuse has been escalating in recent years. In 2006, hydrocodone was the most frequently encountered opioid pharmaceutical in drug evidence submitted to the National Forensic Laboratory Information System (NFLIS) with 25,136 exhibits; the System to Retrieve Investigational Drug Evidence (STRIDE) analyzed 654 exhibits in 2006. In the 2005 Drug Abuse Warning Network (DAWN) combination products were associated with more emergency room visits than any other pharmaceutical opioid with an estimated 51,225 emergency room visits. Poison control data, medical examiners’ reports, and treatment center data all indicate that the abuse of hydrocodone is associated with significant public health risks, including a substantial number of deaths.
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Hydrocodone is an effective antitussive (anti-cough) agent, and as an opiate it is ... an effective analgesic for mild to moderate pain control. Five mg of hydrocodone is equivalent to 30 mg of codeine when administered orally. Early comparisons concluded that hydrocodone and morphine were equipotent for pain control in humans. However, it is now considered that a dose of 15 mg (1/4 gr) of hydrocodone is equivalent to 10 mg (1/6 gr) of morphine. Hydrocodone is considered to be morphine-like in all respects.
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Hydrocodone, like all opiates, is physically addictive. Abruptly discontinuing its use could cause seizures or convulsions unless withdrawal is done gradually, under medical supervision. This gradual withdrawal is best accomplished in residential addiction treatment programs to guard against any medical complications.
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[T]he inexpensive synthetic narcotic painkiller, Hydrocodone, is similar to OxyContin and Oxycodone, and has been the most frequently prescribed drug for workers' compensation patients since 2001. Hydrocodone has ... been among the top five drugs in terms of total cost, this year rising to third on The Hartford's Top 25 list.
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Hydrocodone has been encountered in tablets, capsules and liquid form in the illicit market. However, tablets containing acetaminophen are the most frequently encountered products. Hydrocodone is not clandestinely produced and diverted pharmaceuticals are the primary source of the drug for abuse purposes. In 2006 alone, the DEA has documented the diversion of millions of dosage units of hydrocodone from illicit Internet sources. Doctor shopping, altered or fraudulent prescriptions, bogus call-in prescriptions, diversion by unscrupulous physicians and pharmacists, and drug theft are ... major sources of the diverted drug.
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URINE EXCRETION RATE:Hydrocodone is metabolized by O- and N- demethylation and reduction of the 6-keto group. About 26% of a single dose is excreted in a 72 hour urine collection that consists of unchanged drug (12%), norhydrocodone (5%), conjugated hydrocodone (4%), 6-hydrocodol (3%), and conjugated 6-hydromorphol (0.1%).
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