- Generic Name or Active Ingridient: Hydrocodone
Ingredients in Tussionex
Tussionex treats the stuffy or runny nose, sneezing, and cough caused by the common cold. Tussionex is a brand name product containing hydrocodone and chlorpheniramine. Tussionex is available only with a prescription to reduce the risk for abuse and the development of drug dependence requiring detoxification.
Hydrocodone is an opioid pain reliever made from derivatives of the opium poppy plant. Hydrocodone is the most frequently prescribed opioid in the country. The U.S. Drug Enforcement Agency associates hydrocodone with more drug abuse than any other legal or illegal opioids.
Hydrocodone poses a high risk for abuse because of its pleasant neurological effects; this interaction with the nervous system can also cause the development of dependence that will someday require detoxification. Hydrocodone soothes a cough by working with the body’s nervous system, suppressing the cough reflex in the brain’s breathing centers. Other neurological effects include sedation, relaxation, and a pleasant, euphoric feeling.
The hydrocodone in Tussionex has physical effects elsewhere in the body to cause various symptoms during chronic use and detoxification. For example, opioids act on intestinal muscles to cause constipation; Tussionex detoxification may cause diarrhea.
With continuous use, Tussionex can cause some of these neurological and physical changes to become more permanent, altering how the individual thinks, feels, and behaves. In time, some of these alterations negatively affect his ability to work, take care of responsibilities, and interact with others. Chronic drug abuse may result in job loss and financial crisis, divorce or loss of child custody, homelessness, illness, illegal activity and incarceration, overdose, or death.
The other active ingredient in Tussionex, chlorpheniramine, does not produce euphoria and is therefore not associated with abuse but long-term chlorpheniramine use can affect the individual.
Chlorpheniramine is an antihistamine - it lowers histamine levels in the body that can cause sneezing, itching, runny nose, and itchy, watery eyes. The body produces histamines as an allergic reaction to environmental invaders, such as pollen, animal dander, and cold or influenza viruses.
Opioid Dependence and Tussionex Detoxification
Anyone who uses Tussionex can become dependent on hydrocodone, whether the individual uses Tussionex as prescribed or for non-medical reasons. To consume a drug non-medically means to use it to get high or to treat a problem other than the one the doctor had intended to resolve when she wrote the prescription. Each year, about 5 million in the United States use Tussionex and other drugs for non-medical reasons.
The body acclimates to the presence of some toxic compounds, including the hydrocodone in Tussionex. With continued use, the body begins to depend on a certain level of hydrocodone to feel normal - the individual become opioid-dependent. About 1.9 million Americans are dependent on opioids like the hydrocodone in Tussionex.
When opioid levels fall drastically, the opioid-dependent body struggles to regain stability and cleanse itself of the toxic effects of hydrocodone. Doctors refer to this as Tussionex detoxification.
Tussionex Withdrawal Symptoms
An opioid-dependent person experiences Tussionex detoxification through unpleasant withdrawal symptoms. These symptoms tend to appear in two phases, with the first set of withdrawal symptoms beginning a few hours after the final dose of Tussionex. Initially, the person might feel agitated, anxious, and have trouble sleeping. She may experience achy muscles, watery eyes, a runny nose, and sweat or yawn excessively. Later, the patient might develop stomach cramps, vomiting, and diarrhea. She could also exhibit dilated pupils and goose bumps.
These symptoms will last five or more days and will frequently intensify towards the end of detoxification. Unless interrupted, withdrawal symptoms fade as the body completes the detoxification process and reaches an opioid-free state. Withdrawal symptoms do not return unless the individual relapses to Tussionex abuse.
Someone can use non-opioid drugs to reduce the intensity of withdrawal symptoms without disrupting the detoxification process. He can stop withdrawal symptoms completely by taking more Tussionex but relapse reverses the effects of detoxification and returns the individual to an opioid-dependent state.
Benefits of Tussionex Detoxification
Detoxification cleanses the body of the toxic effects of Tussionex. This clarifies the patient’s thought processes in a way that further aids in his recovery. Detoxification is a single step in the recovery process and, by itself, does not change the habits and behaviors that lead back to drug use. Most opioid-dependent people benefit from some amount of rehabilitation to learn to how to live without drugs.
Tussionex detoxification also helps the patient remain in rehabilitation, where he engages in counseling and behavior modification that give him the skills to recognize situations that could lead to drug abuse and to refuse drugs when offered. Detoxification helps him stay in rehabilitation long enough to fully reverse the neurological effects of long-term drug abuse.
Detoxification makes the individual feel better physically and allows him to think clearly. Tussionex detoxification restores as much of his former life as possible, helping him return to work, take care of children, and enjoy healthy relationships with other people. These physical, emotional and social benefits promote abstinence and reduce the frequency and severity of drug use episodes when they do occur.
Types of Detoxification
Detoxification can also refer to the medical process of lowering opioid levels and easing withdrawal symptoms. Detoxification can occur at home, through an outpatient clinic or doctor’s office, at a hospital, or in a specialized inpatient detoxification facility.
Of those that need help for dependence on Tussionex and other substances, only about 10 percent get it at a dedicated detoxification facility, such as a hospital, outpatient clinic, or specialized detoxification center. Everyone else tries self-detoxification, working with a private doctor, getting treatment in an emergency room or general mental health institution, or detoxifies while incarcerated in a local jail or prison.
When a patient no longer needs Tussionex to soothe a cough, the physician will usually suggest the patient wean himself from this drug by taking smaller doses each day. This tapering process works well for people who have been dependent on opioids for a short time, suffer only minor withdrawal symptoms and have no other medical conditions that might complicate Tussionex detoxification.
Lingering withdrawal symptoms prevent some people from reaching an opioid-free state. These individuals might try quitting cold turkey by discontinuing Tussionex abruptly. If the individual can withstand withdrawal symptoms, quitting cold turkey brings him to an opioid-free state in just a few days.
Many people create a homemade treatment plan to reduce withdrawal symptoms during self-detoxification. Some use massage, yoga, meditation, or acupuncture to relax the body and reduce pain while others take a nutritional or herbal approach, consuming certain foods to ease withdrawal symptoms. For example, chamomile is well-known herbal remedy for diarrhea; ginger or peppermint soothes nausea.
Others take a scientific approach, incorporating prescription and non-prescription drugs into the treatment plan. For example, The Thomas Recipe suggests a patient use a prescription benzodiazepine, such as Xanax or Librium, to calm his nerves and help with sleep at night. Vitamin B6 and hot baths ease muscle aches, while Imodium curbs diarrhea. The Thomas Recipe also calls for L-Tyrosine for a burst of much-needed energy in the later stages of Tussionex detoxification.
Medication-assisted detoxification, sometimes called medical detoxification, uses powerful opioid or non-opioid medications to control the onset of detoxification and manage the severity of withdrawal symptoms. A patient may participate in medication-assisted detoxification through a qualified outpatient clinic, hospital, or specialty detoxification center. Medication-assisted detoxification is appropriate for anyone who cannot reach an opioid-free state through tapering or other forms of self-detoxification.
An outpatient clinic may offer an opioid replacement drug, such as methadone or buprenorphine, to ease withdrawal symptoms associated with Tussionex detoxification. Because these drugs are opioids that mimic the effects of Tussionex, methadone and buprenorphine reduce the severity of withdrawal symptoms. At therapeutic doses, these drugs do not get the consumer high.
Patients start out on a high induction dose of methadone or buprenorphine and gradually reduce dosages during the tapering phase until reaching an opioid-free state. Patients can sometimes accomplish this in as little as one week but it can often take a few weeks or months.
Medication-assisted detoxification through an outpatient clinic is appropriate for those who have been opioid-dependent longer than a year, require little supervision, and cannot take time away from work or personal responsibilities to enter inpatient care.
Most people associate methadone with maintenance therapy that allows patients to delay detoxification while they participate in rehabilitation. Once the patient learns how to lead a drug-free life, he weans himself from methadone.
About 100,000 Americans use a methadone maintenance program; these patients come to an approved methadone clinic each day to drink a beverage containing methadone. The effects of a methadone dose last 24 to 36 hours.
When used as part of medication-assisted detoxification, the clinician will start the patient on an initial dose of 10 to 15 mg of methadone and increase dosages by 10 each day until establishing a safe dose that controls withdrawal symptoms. The patient will remain on this dose for a few days until his condition stabilizes. He will then decrease daily methadone dosages until he is no longer dependent on opioids.
Many outpatient clinics now prescribe buprenorphine, sometimes sold under the brand name Subutex, as part of a maintenance plan or as an aid to tapering. Those using buprenorphine as medication-assisted detoxification start out on high induction doses and taper dosages.
A patient places a buprenorphine tablet under his tongue where it dissolves to enter the bloodstream at the appropriate rate.
It is possible to abuse buprenorphine to get high by dissolving the tablet before injecting the solution into a vein. Pharmaceutical companies discourage improper intravenous administration by adding naloxone to the brand name buprenorphine product, Suboxone. When the patient takes naloxone under her tongue, it does not affect her. If she were to inject Suboxone, however, the naloxone would neutralize buprenorphine so that the consumer does not get high. Furthermore, intravenous naloxone use causes withdrawal symptoms in the opioid-dependent consumer.
Inpatient Tussionex Detoxification
Inpatient Tussionex detoxification uses powerful non-opioid drugs to lower oxycodone levels and relieve the ensuing withdrawal symptoms. Inpatient care also typically includes prescreening for underlying conditions that can complicate detoxification, a professional treatment plan, and close patient supervision.
Inpatient Tussionex detoxification is appropriate for anyone who suffers severe withdrawal symptoms or has an increased risk for complications. This type of care is also right for those who could not reach an opioid-free state through self-detoxification because of severe withdrawal symptoms or underlying conditions.
Anyone who suffers acute psychosis, severe depression with suicidal thoughts, or other serious mental disorders should engage in inpatient Tussionex detoxification, as should anyone whose behaviors may pose a danger to himself or to those around him. Inpatient detoxification is mandatory for those recovering from an overdose or who have other conditions that make other approaches to Tussionex detoxification unsafe.
Rapid detox rids the body of opioids while the patient sleeps. Rapid detox specialists sedate and anesthetize patients before administering the standard detoxification and anti-withdrawal drugs so the patient dozes in a comfortable “twilight sleep,” unaware of the grueling detoxification process. The patient awakens a few hours later, renewed, refreshed and ready for rehabilitation.
Our detox center: Who we are and what we do
We are a group of board-certified anesthesiologists and other medical professionals who receive advanced training in detoxification procedures. We specialize in rapid detox procedures to help patients reach an opioid state quickly and without the painful, demoralizing withdrawal symptoms that prevented success in the past. We have helped thousands of people complete detoxification since opening the doors of our fully accredited hospital longer than a decade ago.
We prescreen patients to discover any underlying conditions that might undermine success. We then create a professional treatment plan based on individual need. After completing detoxification, a patient may continue care in our qualified aftercare center.
Dependence on Tussionex is a traumatic experience. Choosing between the various forms of treatment can be difficult, so many people find it helpful to compare the various approaches to highlight the strengths and weaknesses of each.
Without the cost of anti-withdrawal drugs and professional care, self-detoxification is the least expensive of all the treatment forms but is associated with severe withdrawal symptoms and a high degree of complications. Self-detoxification does bring the patient to an opioid-free state faster than does opioid replacement therapy.
Outpatient detoxification reduces the severity of withdrawal symptoms and their associated complications, but outpatient detoxification brings patients to an opioid-free state more slowly than any other form of detoxification. Patients may become dependent on the replacement drugs, which is not usually a concern with other approaches.
Inpatient detoxification brings a patient to an opioid-free state relatively quickly: the average length of stay for detoxification is 4 days, compared with 197 days for medication-assisted therapy. Inpatient care provides greater control over the detoxification experience through medical grade drugs to reduce withdrawal symptoms and close patient supervision to decrease the risk for complications, especially relapse.
Rapid detox brings the patient to an opioid-free state in the fastest time possible, sometimes as quickly as one to two hours. Rapid detox spares the patient from demoralizing and debilitating withdrawal symptoms unavoidable in other forms of detoxification. Rapid detox puts a person in an optimal physical and psychological condition for rehabilitation.
Complications of Tussionex Detoxification
Tussionex detoxification is not normally life threatening but extreme withdrawal symptoms, co-existing medical conditions and substance abuse issues, chronic or acute Tussionex abuse, and pregnancy can cause complications. Some complications can be serious; in some extreme cases, complications can be fatal.
Relapse is the chief complication associated with all approaches to Tussionex detoxification. Some people relapse as a response to overwhelming withdrawal symptoms during detoxification while others return to Tussionex abuse after completing detoxification. Relapse reverses detoxification and returns the individual to an opioid-dependent state.
Relapse also increases the risk for toxic overdose. The detoxification process reduces the body’s tolerance to hydrocodone, making the person more sensitive to the effects of Tussionex. During relapse, increased sensitivity and lowered tolerance makes it possible for someone to overdose on a smaller amount than he took just a few hours before, even after experiencing only minor withdrawal symptoms.
Overdose of prescription opioids killed 14,800 Americans in 2008, claiming more lives than overdoses of heroin and cocaine combined. Multi-drugs that contain more than one active ingredient, like Tussionex that contains oxycodone and chlorpheniramine, pose special risk after an overdose because toxic levels of each ingredient presents unique effects. Oxycodone overdose can cause dangerously slow breathing, coma, slow heartbeat, low blood pressure, and death. Chlorpheniramine overdose may cause serious stimulation or depression of the central nervous system.
Possible Complications to Self-Detoxification
Severe withdrawal symptoms can cause complications during self-detoxification. For example, prolonged or severe vomiting and diarrhea can cause dehydration and electrolyte imbalances. Detoxification may cause cough and other symptoms to return in a patient taking Tussionex for a chronic medical condition.
Withdrawal symptoms can aggravate previously undiagnosed health conditions to cause complications during self-detoxification. Without professional guidance and the benefits of laboratory tests or radiology, these complications can interfere greatly with self-detoxification efforts.
Possible Complications to Outpatient Care
The medication-assisted detoxification offered by outpatient clinics reduces the risk of opioid abuse but this approach to treatment poses its own complications to care. One major complication is the development of dependence on methadone or buprenorphine.
While methadone is safer than chronic drug abuse, there is still risk associated with methadone. Methadone accounts for a third of opioid pain reliever deaths even though methadone sales represent only about 2 percent of the prescription painkiller market.
Buprenorphine is safer than even methadone, but there is an associated risk for death with intravenous use. This risk for toxic overdose increases dramatically when the consumer combines buprenorphine with benzodiazepines, like those used in The Thomas Recipe.
Inpatient Detoxification Possible Complications
With prescreening, potent medications, and close patient monitoring, inpatient Tussionex detoxification provides the greatest protection against complications but the patient may experience different obstacles to care, especially any person struggling with withdrawal from multiple substances. Withdrawal from alcohol, benzodiazepines, sedatives, or anti-anxiety drugs is most likely to produce complications during Tussionex detoxification.
Rapid Detox Possible Complications
It rarely occurs, but a patient may suffer an allergic reaction to the drugs used in rapid detox. Furthermore, a patient might have trouble with breathing, blood pressure or pulse after rapid detox. Someone might experience swelling, bruising, or infection at an anesthesia injection site.
Myths about Tussionex Detoxification
The medical community has been studying opioid dependence and detoxification for many decades, unearthing a wealth of information about the physiological, psychological, and social aspects of detoxification. Despite this research, myths surrounding detoxification prevent an untold number of people from getting the help they need to reach an opioid-free state.
Self Detox Myths
Myth: Self-detoxification from Tussionex is always safe and effective because this medication is just a cough syrup and not a “real” drug.
Fact: Tussionex contains hydrocodone, which can cause significant dependence on opioids. Self-detoxification from hydrocodone produces uncontrolled withdrawal symptoms that can directly cause complications like dehydration, or indirectly aggravate underlying medical conditions to cause complications.
Myth: The Thomas Recipe is safe and effective for everyone.
Fact: Combining prescription and non-prescription medications can cause dangerous drug interactions, especially for those taking buprenorphine and benzodiazepines.
Outpatient Detoxification Myths
Myth: Tossing drug addicts in jail is cheaper than providing treatment.
Fact: Treatment is less expensive than incarceration. A year of methadone runs about $4,700 per patient while a year of imprisonment costs about $24,000 per inmate.
Myth: Methadone rots your teeth.
Fact: Some drugs, including methadone, can cause dry mouth that promotes plaque and can lead to tooth decay and gum disease. Drinking more water prevents dry mouth while improving dental hygiene habits reduces plaque, tooth decay and gum problems.
Inpatient Detox Myths
Myth: Inpatient care is a waste of hospital space because drug addiction is incurable.
Fact: Anyone who suffers an illness deserves humane and professional medical treatment, whether or not his condition readily responds to treatment. Besides, relapse rates for drug addiction are similar to those of other chronic diseases, such as high blood pressure, diabetes or asthma: drug addiction does respond to treatment.
Myth: Spending money on treatment is a waste of valuable resources.
Fact: Communities can save money by investing in drug treatment. Experts estimate that, for every dollar spent on drug treatment programs, a community can expect a return between $4 and $7 in reduced drug-related crime rates, criminal justice costs and theft. When these experts add in healthcare costs associated with dependence, savings leap to $12 gained for every dollar spent.
Rapid Detox Myths
Myth: Detox always involves suffering.
Fact: Rapid detox is a humane approach to medical detoxification. Rapid detox patients enjoy a pleasant twilight sleep instead of enduring endless days of detoxification.
Myth: It takes days or weeks to complete Tussionex detoxification.
Fact: It takes a reputable expert one to two hours to perform rapid detox.
Detox and Pregnancy
Dependence on opioids increases a woman’s risk for anemia, infections, heart disease, mood disorders, hepatitis, pneumonia, HIV/AIDS, tuberculosis and other conditions that increase the risk for complications during pregnancy, labor, and delivery. Complications can include hemorrhage, inflammation or separation of the membranes surrounding the fetus, slowed fetal growth, premature labor and delivery, spontaneous abortion, and fetal death.
Methadone reduces these complications. Methadone maintenance is currently the only approved treatment plan for pregnant women, although a study published in the New England Journal of Medicine calls buprenorphine “an acceptable treatment for opioid dependence in pregnant women.”
A baby born to a woman who takes Tussionex during pregnancy can be born dependent on opioids and suffer withdrawal symptoms in the first weeks or months of life. An opioid-dependent newborn seems more irritable and jittery, cries more than usual, exhibits shaking, fast breathing, diarrhea or frequent stools, and excessive sneezing and yawning. These babies may also vomit and have a fever.
Methadone and other opioids may also cause these symptoms in a newborn.
Self Detox and Pregnancy
Self-detoxification may be unsafe for pregnant women. A pregnant woman should consult with a physician before attempting even tapering.
Inpatient Induction to Methadone Maintenance
A pregnant woman should start methadone maintenance as an inpatient. The doctor will start her on 10 to 20 mg of methadone and increase daily dosages until finding a dose that safely controls withdrawal symptoms; the maximum dosage for a pregnant woman is 60 mg of methadone daily. This inpatient stay usually lasts about three days. Doctors discharge the woman to outpatient care where clinicians will monitor her progress until she delivers the baby. She may then remain on methadone maintenance or attempt detoxification.
Outpatient Induction to Methadone Maintenance
A pregnant woman may choose to start methadone as an outpatient because she is unable to spend time in a hospital. This woman will come to the clinic twice a day at first, once to get a daily dose of methadone and again for evaluation. She will continue coming to the clinic twice a day until the clinician establishes an effective maintenance dose, when she will reduce visits to only once daily.
Sometimes a woman experiences breakthrough withdrawal symptoms as she nears the end of pregnancy. Her outpatient clinician will increase dosages accordingly.
Babies born to women taking methadone during pregnancy will remain under close observation in the hospital for 72 hours after delivery.
What is the best method to detox from this drug?
The best method of Tussionex detoxification depends largely on personal needs. The individual should assess the extent of his dependence, his likelihood for severe withdrawal symptoms and complications, and his own ability to refrain from drug abuse. He should then choose the least restrictive form of treatment that is still likely to deliver safe and effective care based.
- Tussionex Detox