- Generic Name or Active Ingridient: Hydrocodone
Co-Gesic addiction is a serious medical condition that could result in disability or premature death. The number of people addicted to prescription painkillers like Co-Gesic has eclipsed heroin addiction - in 2010, 1.9 million Americans were addicted to prescription painkillers while heroin addiction gripped only 359,000 people that year.
Co-Gesic addiction and prescription drug abuse has had a dramatic impact on the healthcare system. Treatment admission rates for opioids aside from heroin skyrocketed 414 percent in just ten years. In 1997, only seven individuals in every 100,000 people needed treatment for non-heroin opioid abuse; by 2007, this number had leaped to 36 people per 100,000.
This rise in addiction and treatment rates could be due, at least in part, by the widespread availability of opioid pain relievers like Co-Gesic. People in the United States take more opioid pain relievers than anywhere else on earth. While Americans represent only about 5 percent of global population, they consume 80 percent of the world's supply of opioids.
Information about this drug
Co-Gesic contains 5 mg of hydrocodone bitartrate and 500 mg of acetaminophen. Kremers Urban Pharmaceuticals Inc., packages Co-Gesic in a tablet form intended for oral use.
Hydrocodone is a semi-synthetic opioid pain reliever created from thebaine and codeine extracted from the opium poppy plant, Papaver somniferum. Hydrocodone reduces pain, soothes cough and causes a pleasant euphoria. Acetaminophen is a less potent pain reliever that also reduces inflammation and fever.
Co-Gesic addiction rates are high, at least in part, because of the widespread availability of hydrocodone. Physicians in the United States prescribe more products containing hydrocodone than any drug. In 2010, American pharmacists filled more than 139 million prescriptions for products containing hydrocodone. Hydrocodone is also the most widely abused drugs in the U.S.
Risk for Abuse
Physicians prescribe Co-Gesic to reliever moderate to moderately severe pain. Recreational users abuse Co-Gesic to get high. Abusers consume tablets containing hydrocodone whole, or crush them and snort the powder, or mix the powder with liquid and inject it into a vein. Some individuals heat the powder in a spoon then inhale the vapors.
The U.S. Drug Enforcement Agency, or DEA, ranks drugs according to their relative risk for abuse. For example, heroin is a schedule I narcotic, meaning people are likely to use it to get high. Robitussin AC is a schedule V drug because someone would probably vomit before drinking enough to get high.
The DEA classifies Co-Gesic as a schedule III narcotic - this drug has the same relative potential for abuse as anabolic steroids. To reduce the risk for abuse, Co-Gesic is available only by prescription.
Using large doses of Co-Gesic, using it improperly or consuming Co-Gesic for non-medical purposes increases the risk for developing increased tolerance, physical dependence and addiction. To use a substance non-medically means to take it to get high or to treat a condition for which it was not prescribed. In 2010, 7 million people took drugs like Co-Gesic for non-medical reasons.
Using Co-Gesic continually for a long time increases the body's tolerance to this drug. A person with a low tolerance to Co-Gesic is more sensitive to its effects. Someone who has developed a high tolerance to Co-Gesic must take larger doses more often to relieve pain or get high.
The Definition of Addiction
Co-Gesic addiction is a disease that causes dysfunction in the brain's reward, motivation and memory circuits. These neurological dysfunctions lead to certain characteristic physical, psychological and behavioral changes that result in cravings for hydrocodone and the pathological pursuit of Co-Gesic.
A doctor will diagnose a person with Co-Gesic addiction if the patient seems unable to stop using this drug consistently - the individual may have other behavioral control issues, like overeating or drinking alcohol to excess. Craving is the hallmark of Co-Gesic addiction, driving the addicted individual to secure more hydrocodone at all costs. The addict may not be able to recognize the problems with his behavior or see how his Co-Gesic addiction affects his relationships with others.
Co-Gesic addiction is a primary disease, which means it arises on its own and not as the result of another illness or injury. Co-Gesic addiction is a chronic condition, lasting for months or years and typically involving periods of relapse and remission.
Without adequate treatment, Co-Gesic addiction is progressive and may cause disability or death. Substance abuse often leads to negative lifestyle changes including poor diet and irregular eating. Many infectious diseases, including HIV/AIDS, tuberculosis and hepatitis B and C are closely associated with drug abuse. Overdose resulting in death is the most significant effect of long-term opioid abuse.
Addiction versus Dependence
Addiction and dependence are similar conditions in that they can occur after using a substance, but Co-Gesic addiction is separate and independent from physical dependence on Co-Gesic. Someone can be addicted to Co-Gesic or he can be dependent on it, or both.
The human body responds to the presence of certain chemicals, including Co-Gesic, by making certain adaptations. With continuous Co-Gesic use, these adaptations become more permanent so that the body eventually relies on a certain level of hydrocodone to feel "normal." When hydrocodone levels fall rapidly, the body struggles to maintain chemical stability. Physicians refer to this as detoxification.
Detoxification causes withdrawal symptoms in an opioid-dependent person - the individual feels the battle for stability through physical and psychological symptoms. A doctor will diagnose someone as being opioid-dependent if the patient feels flu-like symptoms when she stops using Co-Gesic.
A physician may consider a diagnosis of Co-Gesic addiction if the patient displays certain physical and behavioral characteristics, such as craving and drug seeking.
Long-term use of some substances may result in dependence but not addiction, and vice versa. For example, someone may depend on insulin to keep blood sugar levels low. When insulin levels drop suddenly, the individual feels very ill but he does not experience cravings for insulin. In contrast, cocaine is associated with addiction and not dependence - when supplies run low, the cocaine addict will not feel flu-like symptoms but she will crave this drug and engage in drug-seeking behaviors.
Drug Seeking and Diversion
Cravings and drug-seeking behaviors are the hallmark of Co-Gesic addiction. Federal laws restricting the sale of Co-Gesic force addicts to engage in various forms of diversion, including "doctor shopping" to get prescriptions from as many physicians as possible. Some addicts present fake or altered prescriptions at pharmacies while others resort to theft or purchasing hydrocodone on the black market.
Many people get prescription drugs free from family or friends. It is common to keep leftover painkillers in the medicine cabinet "just in case of emergency" and then forget that the drugs are there.
Addiction: What Family Members Should Know
Family members should know that Co-Gesic addiction is a neurological disease, not an indication that a loved one has a poor moral character. Family counseling helps family members provide emotional support without blaming the addicted individual. It is important that the person battling Co-Gesic feel safe and comfortable in his home.
Co-Gesic addiction is not a choice - nobody wants to be an addict. Co-Gesic addiction is the result of a combination of genetics and environmental factors. These factors influence the development and manifestation of addiction in everyone within the home. Since family members typically experience the same biological and environmental factors that resulted in addiction in one relative, each individual in the family unit is at increased risk for developing addiction at some time in life.
A person's genetic makeup can influence the development of Co-Gesic addiction. While there is no single "addiction gene," certain interactions between specific groups of genes can make someone more susceptible to the development of addiction. Scientists estimate that genetics account for about half of a person's vulnerability. Family members who share this vulnerability must be aware of the environmental and developmental factors that raise the risk for Co-Gesic addiction.
Genetics are not the whole story - environmental factors like a person's family, friends, socioeconomic status and quality of life greatly influence the development of Co-Gesic addiction. Environmental factors include peer pressure, physical or sexual abuse, stress and parenting.
Life can be traumatic, and some people use drugs like Co-Gesic as self-medication from stress or anxiety. Others use prescription drugs to deal with significant trauma, including physical or sexual abuse.
Using drugs increases the risk for developing addiction. 10 percent of people who try drugs become addicted.
Family members should know that a tolerant attitude towards substance abuse increases the chances a teenager or young adult will use Co-Gesic. Even with strong family support, many young people succumb to peer pressure and start using drugs at an early age.
An adolescent's brain is still developing in the areas that govern her decision-making, judgment and self-control. This means a teenager or young adult is not capable of making a mature decision about drug use.
Addiction can develop at any age but the earlier the individual starts abusing drugs, the more likely his drug use will progress to something serious, such as Co-Gesic addiction.
Family members should know about the collateral damage associated with Co-Gesic addiction - everyone within the household suffers consequences of drug abuse, not just the addicted individual. Co-Gesic addiction can cause the children, parents, spouses and siblings of an addicted person to suffer financial distress, separation from loved ones, exposure to criminal activity and police intervention, homelessness and infectious diseases associated with drug abuse.
Drugs are an expensive habit, robbing the family of money budgeted for rent, groceries and childcare. Co-Gesic addiction diminishes a person's ability to work, reducing the amount of money she brings home. Hospital bills from side effects, infectious diseases and overdoses increase the household medical costs. Legal bills and imprisonment deprive the family of even more funds.
Co-Gesic addiction can dissolve families, resulting in separation or divorce, child custody battles, homelessness or loss of a family member due to imprisonment or death.
Family members should know that keeping Co-Gesic in the home without a prescription is Illegal and unsafe. Between 2004 and 2005, approximately 71,000 children went to the emergency department because of medication poisonings other than recreational use. An estimated 80 percent of these cases were unsupervised children discovering and consuming medications.
Addiction: What Parents Should Know
Parents should know that using drugs early in life increases the risk for addiction later on. Parents should also know that a certain percentage of teenagers and young adults use drugs like Co-Gesic without a prescription and are therefore at increase risk for developing an addiction as an adult.
In a recent national survey, about 3 percent of respondents between the ages of 12 and 17 years reported current use of a prescription psychotherapeutic drug for non-medical reasons. Psychotherapeutic drugs include opioid painkillers like Co-Gesic, depressants and stimulants.
Adolescents are more likely to use drugs as they age. In that same survey, 5.9 percent of 18 to 25 year olds reported using psychotherapeutic drugs like Co-Gesic in the prior month.
Parents should know that the risk for drug addiction increases during times of transition, such as moving to a new home, divorce or attending a new school. These periods of transition make a kid more vulnerable to peer pressure as he attempts to fit into his new environment.
Drug abuse interferes with brain function, especially in areas critical to motivation, memory, learning, behavior control and judgment. Consequently, adolescents struggling with substance abuse frequently have trouble at school or with family, poor academic performance, health-related problems including mood or mental disorders and trouble with the juvenile justice system.
Specialists often look for significant changes in behavior when considering a diagnosis of Co-Gesic addiction. Because it is natural for a child to gain and lose interest in hundreds of things as he ages, it may be hard to distinguish natural phases from changes in behaviors that indicate a substance abuse problem.
Disruption of brain function results in characteristic signs parents can look for when concerned about Co-Gesic addiction in a child. Signs of addiction include a loss of interest not attributable to normal developmental phases someone experiences as he moves from childhood to adolescents. An addicted child loses interest in important things, such as childhood friendships, life-long hobbies or playing with a favorite pet.
An adolescent battling Co-Gesic addiction may show a decline in his grades, perform poorly at sports he used to excel in or do poorly at an after-school job he once loved. He may seem to have no energy and unmotivated, even for a teenager. The addicted adolescent disappears to engage in drug use, and then has trouble explaining his absence.
Parents should know that Co-Gesic addition is expensive, especially for a teenager or young adult working at jobs paying entry-level wages. An adolescent battling Co-Gesic addiction will have financial problems advanced for his age as he tries to pay for his addiction. Parents should remain vigilant for money or items missing from the home.
Caring for a Family Member with an Addiction
Family plays a critical role in recovery from Co-Gesic addiction. Family members are often the first to recognize behavioral changes that indicate drug abuse and are sometimes the first to intervene. Many addicted individuals seek treatment in response to pressure from family members. It is common for a family member to locate the treatment facility the addicted individual eventually attends; some institutions allow family members to arrange for treatment on behalf of a loved one. As with any chronic condition, family members are an important part of supportive care during recovery.
Like many chronic conditions, recovery from Co-Gesic addiction may take months or years. Unlike many diseases, Co-Gesic addiction can cause behavioral changes that can be difficult to live with. Family members must prepare themselves for turbulent times with periods of relapse and remission.
Because Co-Gesic addiction brings collateral damage onto the entire household, family members have a right to intervene. An intervention can be informal, including the addict and one or two close family members, or an intervention can be a formal event planned by professional interventionists. An intervention is an emotionally charged situation that can result in anger and resentment if handled poorly.
It may be wise to ask for professional help when considering an intervention, especially if the addicted individual has a history of violence, serious mental illness or suicidal thoughts. An intervention may take unexpected twists if the addicted person is using multiple mood-altering substances or is in severe denial that could lead to anger.
The purpose of an intervention is to persuade the addicted person to seek treatment; an intervention is not the time for family members to "unload" on the addict. When deciding who will attend the intervention, choose people the addict likes and respects. Avoid those who might sabotage the intervention.
It is possible to intervene and halt the progression of Co-Gesic addiction at any time. It is not necessary to let someone hit rock bottom before intervening. When a person hits rock bottom, he may find social isolation, homelessness, prison, infectious diseases and death there.
Each participant should jot down what he would like to say before the intervention, mentioning specific incidences where Co-Gesic addiction has caused problems for him. Discuss the toll Co-Gesic addiction has inflicted. He should also decide on consequences he would take if the addicted individual refuses treatment. Consequences could include requiring the addict to move out of the house or stay away from the children. Finally, the participant should express care and hopeful expectations for recovery.
Each person must decide on consequences he'll take if the addicted person does not accept treatment, such as requiring the addicted person move away from the children.
Participants should choose a date and location for the intervention. Immediately before the intervention, one or more participants invite the addict to the location without telling her the reason for the trip. During the intervention, each participant reads his notes in a calm and reassuring manner. The group then presents the addict with the option for treatment and requires she accept it on the spot, or face the consequences mentioned by each participant.
If the addict accepts treatment, family members must provide supportive care including driving the individual to appointments when necessary, taking over childcare and other personal responsibilities while the addict is in treatment, or housing the person as she attempts recovery.
As with any chronic illness, family members should expect cycles of remission and relapse. Relapse does not mean recovery efforts have failed. During relapses, each family member should encourage the individual to return to treatment by reinstating the consequences decided upon during the intervention or with new consequences appropriate to the situation.
Signs of Addiction
Co-Gesic addiction is a neurological disease, resulting in specific behavioral changes; doctors look for these characteristic changes when considering a diagnosis of Co-Gesic addiction. Unfortunately, the behavioral manifestations of Co-Gesic addiction frequently separate addicts from those friends and family members who could best recognize the differences in the addict's behaviors. Doctors look for these behavioral changes when diagnosing addiction.
Behavioral, Cognitive and Emotional Changes
Co-Gesic addiction causes neurological changes that alter the way a person acts, thinks and feels. These changes allow addiction to perpetuate itself, separating the addict from those who could intervene.
An addict takes high doses or uses Co-Gesic more often than she intends. She may express a desire to quit and might try to overcome Co-Gesic addiction several times but seem ultimately unwilling or unable to stop.
She loses an excessive amount of time looking for Co-Gesic, getting high or recovering from drug abuse. This has a significant negative impact on her ability to work, interact with others or take care of personal responsibilities.
The Co-Gesic addict continues to use this drug, despite the harmful effects of drug abuse. With continued use, she loses interest in any activity that does not result in getting high.
The neurological changes associated with Co-Gesic addiction changes the way a person things. She becomes preoccupied with Co-Gesic to the point of being unable to think of anything else. Drug abuse alters her view of the risks and benefits of Co-Gesic, so that she can only see its attributes and none of its detriments. In time, she begins to blame her problems on other people or events, rather than seeing her troubles as a predictable consequence of drug abuse.
While many people take Co-Gesic non-medically to relax, feel euphoria, or to self-medicate for anxiety, Co-Gesic addiction actually causes the reverse effect. A Co-Gesic addict experiences increased anxiety, emotional pain and the emotional opposite of euphoria, dysphoria.
Co-Gesic addiction recruits the brain stress systems, increasing the individuals' sensitivity so that situations always seem more stressful to the addict.
Co-Gesic addiction may cause the person to have trouble identifying her feelings, distinguishing between feelings and describing her feelings to other people.
Anyone can develop a substance abuse problem but there does appear to be some gender differences in the development and recovery from CO-Gesic addiction. Men are twice as likely to abuse illegal substances such as heroin, cocaine or marijuana, and men are more likely to become addicted to these drugs. This high rate of abuse takes its toll - many more men than women die from prescription painkiller overdose each year.
Researchers have come to mixed conclusions regarding the gender differences in treatment outcomes for substance abuse problems including Co-Gesic addiction, depending on the criteria of the study and type of treatment facility included in the study. For example, females were less likely to complete treatment at outpatient non-methadone or nonhospital residential facilities, but women had better results than men do in facilities that provided a combination of types of care.
Adequate and professional treatment can help the person stop using Co-Gesic, avoid relapse and return to her normal life. When left untreated or undertreated, Co-Gesic addiction may result in disability or premature death. In 2010, more than 23 million people in the United States needed treatment for drug or alcohol abuse. Of those that needed help, only about 11 percent of those who needed it got it in a specialty facility staffed with professionals who received extra training in substance abuse treatment.
There are two phases of treatment: detoxification and rehabilitation. Detoxification is the physiological process of lowering opioid while the rehabilitation phase addresses the behavioral aspects.
Someone can engage in detoxification at home or in a medical facility. The detoxification process starts when the individual skips a dose, takes an inadequate dose or uses a drug that lowers hydrocodone levels rapidly.
Detoxification from opioids results in physical and psychological withdrawal symptoms lasting five or more days, with the worst symptoms occurring on or about the fourth day. Without intervention, symptoms fade by themselves and do not return unless the individual becomes physically dependent again.
The individual can reduce the severity of the detoxification process by taking multiple medications to address each symptom. He may stop the detoxification process by taking drugs that mimic the effects or hydrocodone or he may take more Co-Gesic. Relapse stops the detoxification process, leaving the individual free from withdrawal symptoms but still dependent on Co-Gesic.
Some people try to overcome dependence on Co-Gesic alone, without professional guidance or medicine to ease symptoms. This practice is known as self-detoxification or "going cold turkey." Cold turkey refers to the skin's appearance during detoxification: pale, cold, clammy with goose bumps, resembling a plucked bird.
Those who attempt self-detoxification face several days of grueling physical symptoms and demoralizing psychological symptoms. Without help, many of these people return to drug abuse.
The Thomas Recipe
Some people create homemade treatment plans including medicines and supplements to reduce withdrawal symptoms. One such remedy is The Thomas Plan, which includes Valium or Xanax for anxiety and insomnia. Imodium slows diarrhea while Vitamin B6 and supplements along with hot baths soothes muscle aches and restless leg syndrome. The Thomas Recipe calls for L-Tyrosine for a burst of energy to help overcome malaise.
The Thomas Recipe eases symptoms but this treatment plan does not shorten detoxification or reduce the risk for complications.
While the detoxification process is not life threatening, severe withdrawal symptoms may cause dangerous complications. The individual may vomit and inhale stomach contents, known as aspiration, which may cause fluid in the lung and lung infection. Excessive vomiting, diarrhea and sweating may cause dehydration and electrolyte imbalances.
Relapse to Co-Gesic is the primary complication of detoxification, especially for those individuals who attempt to overcome opioid dependence without medicine to reduce withdrawal symptoms. Any amount of detoxification reduces the body's tolerance to hydrocodone; as the result, someone may overdose on a smaller amount of Co-Gesic than she took before experiencing even moderate withdrawal symptoms.
Opioid overdose is a life threatening medical emergency. In 2008, 15,000 people died from prescription painkiller overdose. Transport all suspected victims of Co-Gesic overdose to the nearest medical facility immediately.
Someone can overdose on either the hydrocodone or the acetaminophen in Co-Gesic. Opioid overdose causes the serious breathing problem, respiratory depression. Symptoms of respiratory depression include slow or shallow breathing, irregular breathing problems and a blue tint around the eyes, mouth and fingertips.
Acetaminophen overdose is one of the most common poisonings worldwide and is the leading cause of acute liver failure in the United States.
Drug Replacement Therapy
Those who are not in immediate danger of overdose may participate in DRT, or drug replacement therapy. DRT drugs mimic the effects of hydrocodone, so the patient does not feel withdrawal symptoms, but DRT drugs do not get the patient high.
DRT drugs include methadone, Suboxone and buprenorphine. DRT allows the patient to skip the detoxification process until he learns how to live without drugs. After rehabilitation including behavior modification, the patient weans himself from the DRT drugs.
Supporters of DRT say it allows patients to continue working and living at home while participating in behavior modification. Opponents think it is merely replacing a Co-Gesic addiction for a DRT addiction.
Even though detoxification is not normally deadly, taking methadone can be. Methadone now accounts for one-third of opioid pain reliever deaths, even though this drug is not widely prescribed.
Many institutions now offer detoxification. During standard inpatient detoxification, physicians administer drugs to reduce hydrocodone levels plus medicine to relieve the ensuing withdrawal symptoms. Nurses monitor the patient for complications and render aid as needed.
Rapid detox is the most humane and efficient form of detoxification available today. During rapid detox, board-certified anesthesiologists administer anesthesia and sedatives alongside the standard detoxification and anti-withdrawal drugs so the patient dozes in a comfortable "twilight sleep" during the detoxification process. When she awakens and nurses stabilize her condition, she may engage in meaningful rehabilitation.
Detoxification is only the first step towards recovery. The detoxification process deals only with physical dependence on hydrocodone and does not change the behaviors associated with Co-Gesic addiction. Behavioral modification allows the person to participate in his own treatment, modify his behaviors and attitudes towards drug abuse, and encourages a healthy lifestyle.
Rehabilitation can occur in an outpatient clinic or residential facility. Participants in outpatient therapy typically visit a facility on a regular basis and engage in individual or group counseling. Residential programs are highly structured, lasting 6 to 12 months.
The goal of rehabilitation is to stop drug use and return individual to his normal life. Rehabilitation can curb criminal activity and improve the individual's functioning on the job, in his personal relationships and in his thought patterns.
Even with professional treatment, relapse rates for drug addiction are 40 to 60 percent. It is important to remember that Co-Gesic addiction is a chronic condition marked with cycles of relapse and remission. Relapse is not an indication of failure, but relapse does mean treatment should be reinstated or modified, or that the patient should participate in another form of treatment.
Co-Gesic addiction is a complex but treatable neurological disease that affects the brain function and behavior of everyone slightly differently - everyone experiences Co-Gesic addiction in a slightly different way. Consequently, no single treatment is right for everyone.
No matter what form of treatment the individual chooses, it needs to be readily available to encourage participation and completion. It is vital the individual remains in treatment long enough to restore neurological function. It is not necessary for treatment to be voluntary - many individuals remain in treatment longer when under legal coercion.
Effective treatment must tend to the multiple needs of the person, not just her Co-Gesic addiction. Rehabilitation typically includes behavior modification and individual, group or family counseling. Medications are an important part of treatment, as many people with a Co-Gesic addiction also struggle with physical, mental or mood problems that could interfere with treatment.
A trained counselor is an important asset in recovery efforts. The counselor will develop a treatment plan based on an initial assessment of the patient's condition, and then modify the plan as necessary to ensure treatment continues to fit the patient's changing needs.
Drug testing may be mandatory during treatment, as relapses do occur. Testing for infectious diseases may be required, and the counselor may provide education that helps the individual change those behaviors that increase his risk for contracting or spreading these diseases.