New narcotic raises concerns

By DeeAnna Haney | Mar 17, 2014

A new prescription narcotic that hit the market this month has sparked concern in the law enforcement and medical communities across the nation and locally.

Zohydro ER is the newest opiate painkiller, which will be the first prescription narcotic to release hydrocodone in its pure state. It's meant for patients who require daily, around-the-clock opioid treatment for management of severe pain. But if abused, it could quickly turn deadly.

Waynesville Police Chief Bill Hollingsed, a local advocate for education on the issue of rampant prescription drug abuse in Haywood County, fears that Zohydro will only add to overdose deaths.

"From what I've read about it, it's like OxyContin on steroids," said Hollingsed.

The form in which the drug is produced contains no deterrents that would prevent drug addicts from crushing and snorting or injecting the highly potent drug. Drugs such as OxyContin have been made to make it more difficult for the drug to be abused.

"It can be easily abused and the amount of hydrocodone in one capsule is enough to kill a child, which is a real concern," said Hollingsed.

Prescription pain pills are still the No. 1 cause of accidental death in the country, more than car crashes, according to research from the National Center for Health Statistics.

"People, for the most part, don't intend to kill themselves when they overdose on prescription drugs," said Hollingsed. "With the strength of this drug there is that possibility."

That is especially true for those who may already be addicted to prescription opioids and decide to use Zohydro.

"If they are used to taking a certain number of milligrams of OxyContin and they take the same number of milligrams in Zohydro, the effects will be multiplied several times over," said Hollingsed.

Dr. Bart Paschal, an oncologist in Clyde, is also concerned about Zohydro's release.

Up until now, hydrocodone drugs such as Vicodin contained Tylenol and came in fairly low doses that did not help patients with moderate to severe pain in just one dose, Paschal said. But more than two tablets at a time put a patient at risk for having too much Tylenol in their system. Zohydro was meant to address that problem.

"The idea was that if they took the Tylenol out, you could maybe prescribe three before you would have to move on to a stronger narcotic," Paschal said.

But the result was a drug that is five times more potent than Vicodin.

"I think the intentions were good to try to come up with a formulation that didn't contain Tylenol, but what happened was it turned out to be just another fairly strong narcotic like the other ones that we have," Paschal said.

The consulting board for the Federal Drug Administration (FDA) voted 11 to 2 against making Zohydro commercially available. However, the FDA ignored the strong recommendation and approved the drug in October 2013.

Paschal doesn't see the need for such a drug.

"I can't envision very many circumstances, if any, that I would prescribe this medication because there are already plenty of other narcotic preparations that fulfill the need that I have for prescribing narcotics," Paschal said. "This is not filling any niche. I agree with the 11 consultants who voted against allowing this to come to market."

A growing problem nationwide, narcotic addiction is also rampant in Haywood County. There have been numerous prescription drug overdose deaths locally — recent numbers from the Haywood County medical examiner show that about one in four deaths investigated by his office are prescription drug overdoses.

It's only a matter of time before Zohydro makes its way from the hands of the prescribed to people in the streets.

"For people on the streets who get their hands on it, which a certain percentage of all narcotics end up on the streets, they will probably want this preparation more than Oxycontin…this is going to be a dream come true for people on the street," Paschal said.

A growing problem nationwide, narcotic addiction is also rampant in Haywood County. There have been numerous prescription drug overdose deaths locally — recent numbers from the Haywood County medical examiner show that about one in four deaths investigated by his office are prescription drug overdoses.

It's only a matter of time before Zohydro makes its way from the hands of the prescribed to people in the streets.

Paschal believes that if anyone is to blame for the worsening prescription drug abuse problem, it's the companies that make the drugs.

"I place the blame on the pharmaceutical companies that are promoting the use of narcotics for chronic non cancer pain," he said.

Pharmaceutical companies have performed medical trials that purport to show that narcotics are safe.

"The problem, though, is that these trials have been very short term — 12 to 16 weeks has been the duration of those trials. Trials that go on longer show that narcotics for non-cancer pain show a worsening of the patient's quality of life and in many instances their chronic pain becomes worse over time," Paschal said.

According to the Associated Press, the maker of OxyContin recently completed testing on its own version of a drug similar to Zohydro that is also tamper resistant, which could compete with Zohydro sales.

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