- Generic Name or Active Ingridient: Hydrocodone
- Drug-seeking behavior
- Inability to abstain from Xodol use consistently
- Impaired behavioral control
- Inability to recognize negative impact of Xodol abuse
- Dysfunctional emotional response
Xodol addiction is on the rise, along with other types of substance abuse. There are about 1.9 million Americans addicted to prescription drugs like Xodol; in comparison, approximately 329,000 Americans are addicted to heroin.
One component of Xodol, hydrocodone, is the most widely prescribed and the most abused drug in the United States. In 2010, pharmacists filled more than 139 million prescriptions for products containing hydrocodone, like Xodol.
General Information about Xodol
Physicians prescribe Xodol to patients suffering from moderate to severe pain. Some people abuse Xodol because it produces a pleasant, euphoric effect.
Xodol contains hydrocodone and acetaminophen. Xodol may contain 5 mg, 7.5 mg or 10 mg of hydrocodone bitartrate. Xodol also contains 300 mg of acetaminophen, a less potent analgesic.
The hydrocodone component of Xodol acts directly on your central nervous system, or CNS, to relieve pain and produce euphoria. Acetaminophen interferes with the production of certain chemicals associated with pain. Together, these two compounds relieve pain better than either drug could alone.
Hydrocodone is a semi-synthetic opioid that relieves pain and soothes cough. Hydrocodone acts similar to codeine, affecting the central nervous system and smooth muscles, like the muscles in your digestive tract. Hydrocodone may cause drowsiness, changes in mood, and may cloud your thinking.
Potential for Abuse
The Drug Enforcement Agency classifies controlled substances by their relative risk for abuse. In this system, a schedule I narcotic is associated with a high rate of abuse and has no medical value, while a schedule V carries therapeutic value but almost no risk for abuse. For example, Heroin and PCP are schedule I drugs while the cough medicine Robitussin AC is a schedule V medication.
The DEA has classified hydrocodone as a schedule II drug, meaning it carries a relatively high risk for abuse but that it does present medicinal value. The DEA requires doctors write a prescription for hydrocodone, and that pharmacologists mix hydrocodone with another less powerful analgesic to reduce this risk for abuse. Xodol complies with this mandate by combining hydrocodone with acetaminophen. As a result, the DEA classifies Xodol as a schedule III narcotic, assigning it a lowered risk for abuse.
Drug abuse increases the risk for dependence and addiction, especially with long-term use or the consumption of high doses. Addiction is less likely in those patients using Xodol for a short time to relieve pain. An individual may show significant signs of physical dependence after using Xodol for several weeks, but some people may develop minor physical dependence after using opioids for only a few days.
The Definition of Addiction
Addiction is a neurological disease that causes dysfunction in the brain's reward, motivation and memory circuitry in a way that results in certain physical, psychological and behavioral patterns. Addiction is a primary disease, arising on its own and not as the result of another illness or condition. Addiction is a chronic condition, often involving cycles of relapse and remission. Without adequate treatment, Xodol addiction is progressive and may result in disability or premature death.
Addiction versus Dependence
Anyone who uses Xodol can become physically dependent upon it or addicted to it, or both. Xodol addiction and opioid dependence are closely associated through substance abuse but addiction and dependence are two separate and independent medical conditions. A doctor diagnoses a patient as being opioid-dependent if he feels flu-like symptoms when he stops taking Xodol; she might say that patient is addicted if he craves Xodol and engages in drug-seeking behavior when he supplies run low.
Dependence and Tolerance
The human body responds to the toxins in some substances, like alcohol or Xodol, by altering its own chemistry to achieve a safe chemical balance. Long-term use causes some of the chemical alterations to become more permanent - the body relies on a certain level of the substance to feel "normal." If these levels were to fall unexpectedly, the body struggles to regain chemical stability. The individual experiences this battle for stability through unpleasant withdrawal symptoms.
Doctors call this process "detoxification." Detoxification causes withdrawal symptoms in an opioid-dependent person. Detoxification from Xodol can be brought about by missing a dose, taking an insufficient dose or by taking a drug that lowers opioid levels.
Using Xodol for a long time may increase the body's tolerance to this drug. An individual with a high tolerance to Xodol must use stronger doses more frequently to relieve pain or to get high. Conversely, a person with low tolerance to Xodol experiences a more profound effect after taking this drug.
A doctor will diagnose an individual as suffering from an addiction if the patient experiences cravings or engages in drug-seeking behaviors when he runs out of Xodol. Addiction to Xodol or other substances requires long-term treatment provided by professionals who have received special training in drug rehabilitation techniques. These rehabilitative professionals look for certain characteristics when identifying addition, including:
Drug Seeking Activity
Cravings and drug-seeking behaviors are the hallmarks of Xodol addiction. Drug-seeking behaviors include "doctor shopping" to gain as many written prescriptions as possible, or presenting phony prescriptions to pharmacies. Some individuals tamper with prescriptions to increase the strength or number of tablets. Others appear just as the doctor's office is closing for the day, pressuring staff members to write a prescription quickly so they can go home on time.
Many people get Xodol from the medicine cabinets of friends and family members, with or without permission. A significant number of people do not throw away prescription painkillers after they no longer need them, just in case they experience pain from a future injury or illness. Others purchase Xodol from drug dealers.
The DEA classifies all these activities as "diversion," named for the way these events divert prescription drugs from therapeutic use to illicit non-medical uses. To use a drug non-medically means to use it to get high or to treat a condition other than the doctor intended.
Some drugs are associated with physical dependence but not addiction, while other medications pose a risk for addiction but not physical dependence. For example, a person may depend on medications to control blood pressure; if the individual forgets to take her medicine, her body responds by increasing blood pressure but she would not feel cravings for her anti-hypertensive nor would she engage in drug-seeking behaviors. On the other hand, a person who is addicted to cocaine craves this drug and looks for cocaine when her supplies run low.
Xodol can produce addiction, dependence and increase tolerance.
Addiction: What Family Members Should Know
Family members should know that Xodol addiction is a disease, not a character flaw. Anyone can become addicted to Xodol; it is important that family members not blame the individual for her disease. Family members should engage in counseling to learn how to support an addicted loved one without enabling her substance abuse.
Relatives of the addicted individual share a risk for developing an addiction at some time in life - while nobody is born an addict, scientists think heredity determines whether a person is vulnerable to addiction. There is not one specific "addiction gene," but the interactions between a set of genes may make a person more susceptible.
Other factors influence the development and manifestation of addiction, such as environmental stress, hypersensitivity to stress or poor coping mechanisms. Stressful home or work environments that include excessive arguments, violence or substance abuse increase the likelihood that an individual will self-medicate with drugs or alcohol. Environmental stresses within the home increases this risk for everyone living there.
Some people may be hypersensitive to environmental stress and feel anxious about relatively insignificant events. These individuals are more likely to abuse drugs or alcohol on a regular basis, in an effort to calm nervousness. Scientists believe hypersensitivity is genetic, passed from parents to children.
Parents may also pass along poor coping mechanisms to their children. A child who watches a parent deal with stress by drinking or doing drugs is likely to do the same when he gets older. Family counseling can improve coping mechanisms, teaching children and adults how to better deal with stress.
Xodol addiction causes collateral damage that affects and imperils everyone associated with the addicted individual, especially those living in the same household. Xodol addiction affects everyone differently, but collateral damage can include loss of income, separation or divorce, forcible removal of children from the home, infectious disease, arrest and prison time, overdose and death.
Family members should know that it is illegal to keep Xodol in the home without a prescription. It is also illegal to give, share or sell prescription drugs to others, even if they complain of similar symptoms or claim to have a prescription for the same drug. Allowing a family member to keep a controlled substance such as Xodol in the home without a prescription increases the risk for police raid, arrest and conviction. This may result in forfeiture of the home.
An addict tends to keep large amounts of drugs in the home. This increases the risk other people within the home, especially children, will discover the drugs and accidently consume a toxic dose. In cases of suspected overdose, take the individual to the hospital immediately. Toxic overdose could result in death.
Addiction: What Parents Should Know
Parents should know that teenagers and young adults are frequently using prescription drugs such as Xodol for non-medical purposes. Responding to a recent national survey, more than a tenth of 12 to 17 year olds admitted to abusing illicit drugs at that time.
There is less social stigma associated with prescription drugs than illegal ones like heroin, and doctors widely prescribe opioid painkillers. Consumers, especially young ones, may mistakenly think these prescription drugs are harmless.
Xodol addiction is characterized by certain behavioral changes. These changes may be more difficult to spot in a child because children naturally gain and lose interest in many activities as they grow; it is normal for children to go through these phases.
When considering whether a child is addicted to Xodol, parents should remain alert for certain warning signs, including an unusual loss of interest in things that were once important. The child may suffer an abrupt decline in academic or athletic performance or suddenly start doing poorly at an after-school job she used to enjoy. The child may be unmotivated or lethargic at levels remarkable even for a teenager.
An addicted child leads a complicated life. She must find time to get high; parents should remain alert for a child who sneaks away and then has trouble explaining her absence. Xodol addiction is an expensive habit and most teenagers and young adults do not have access to high paying jobs. An addicted child has financial problems too advanced for her age, as she struggles to pay for her addiction. Parents should remain aware of money or other items missing from the home.
Caring for a Family Member with an Addiction
Family support is important to recovering from Xodol addiction, as with any chronic neurological disease. Recovery includes multiple trips to the doctor's office, regular counseling sessions, expensive medications and time away from work and family. Rehabilitation is a difficult and time-consuming process, difficult for any one person to do without the help of caring friends and family.
Family members can develop a care plan with or without the consent of the addicted individual. Family members should encourage the individual to seek and complete treatment, and develop ways to help him do that. It is common for a family member to locate the treatment facility the addicted person eventually chooses.
It is okay to talk about addiction with other family members, rehabilitation counselors or other people who have gone through similar circumstances. Family members can gather to discuss the addicted person's progress and treatment plan. The addicted individual does not have to participate in these discussions. She may even be angry when she first learns that her family is discussing the illness but this negative reaction will fade in time.
While Xodol addiction causes collateral damage, recovery efforts can positively affect the family. Every person involved in recovery discovers new strengths in himself and the members of his family. Each individual can share in recovery efforts by expanding their own personal and domestic roles within the family. For example, small children can take over simple household tasks so that an addicted parent may attend meetings while an aunt takes over bill payment to help her sister buy food instead of drugs.
The progression of addiction can be halted at any time; family members should not let their loved one hit rock bottom before encouraging treatment. Rock bottom might include divorce, loss of child custody, homelessness, jail, infectious disease or death. Early treatment reduces the risk for relapse and decreases the associated collateral damage.
Counseling gives family members the tools they need to support a loved one with a Xodol addiction without enabling his substance abuse. Recovery can only start when the addicted individual recognizes the damages substance abuse causes.
Signs of Addiction
The neurological changes associated with Xodol addiction alter a person's behaviors in certain characteristic ways. A person who is addicted to Xodol might engage in anti-social, abnormal or illegal activities, such as belonging to gangs or selling drugs.
Someone with a Xodol addiction seems to be at the pharmacy all the time, filling prescriptions for himself or for another family member. He prioritizes those activities that involve Xodol or hydrocodone over those that do not, like spending time with family.
Xodol addiction makes people behave unpredictably or have violent outbursts. The Xodol addict may seem argumentative or perpetually in an emotional crisis. He may have serious financial or legal troubles but be very vague about the nature of these problems.
Xodol addiction may cause the individual to withdraw from friends and family, neglecting social commitments or taking care of a child. She may disappear for long periods and be unable to explain her absences. She might even get divorced from what appeared to be a close relationship. Unfortunately, this aspect of Xodol addiction separates the addict from those who can best indentify the behavioral changes that indicate addiction.
Behavioral, Cognitive and Emotional Changes
Xodol addiction alters the neurological system on a cellular level in a way that changes how a person behaves, thinks and feels.
An addicted person uses Xodol more frequently and in higher doses than she intends. She may express a desire to quit or cut down, but seem unwilling or unable to stop using Xodol. She loses excessive time looking for Xodol, getting high or recovering from drug use. Xodol addiction causes her to continue abusing this opioid, despite her awareness of the negative consequences associated with drug abuse.
This has a significantly negative impact on her personal, social and professional life, as she stops fulfilling responsibilities at home and at work. Addiction narrows her behavioral repertoire until she eventually participates only in activities that result in getting high.
The addicted person is preoccupied with substance abuse. Addiction alters his perception of the relative benefits and risks associated with Xodol so that he sees only the positive aspects of drug abuse and none of the detriments. He may blame other people or events for the problems in his life, rather than attributing his troubles to drug abuse.
While many use Xodol to medicate themselves from emotional pain, addiction actually increases anxiety, emotional pain and causes the emotional opposite of euphoria - dysphoria. Addiction increases sensitivity to stress, especially in those who are hypersensitive to stress.
Xodol addiction often makes it difficult to identify feelings or describe emotions to other people. Addiction may also blur the line between emotional arousal and bodily sensations.
Symptoms of Addiction
Xodol addiction causes certain telltale physiological and emotional symptoms.
When a doctor considers a diagnosis of Xodol addiction, she looks for physical symptoms such as an unexplained gain or loss in weight or a change in sleeping patterns. The physician will note whether the patient looks sickly, has an unusual body odor, or poor hygiene. The patient may have a nagging cough, bloodshot eyes, large or small pupils, tremors or slurred speech.
Doctors will also interview the patient to learn about psychological symptoms, such as an inability to abstain from Xodol use or cravings for this drug. The patient may have trouble controlling his behavior in other ways, such as drinking heavily or participating in criminal or anti-social activity. He may be unable to recognize his own significant personal problems or troubles in his relationships. His emotional response may be dysfunctional; he may erupt in anger over minor circumstances or show no emotion during significant emotional events.
Men abuse illegal drugs about twice as often as women do but females are more apt to abuse prescription drugs like Xodol. Women are also more prone to combine opioids with alcohol, pot or other drugs.
Men get high in social settings whereas women tend to be solitary drug users. Female addicts have smaller social circles than their male counterparts do. This could be because there is a social stigma against female drug abusers, but drug abuse among men is well accepted.
Males and females start using drugs for different reasons. Men begin abusing drugs to get high. Women often start abusing drugs after receiving a prescription to relieve pain.
Addicted women report lower expectations for their lives, feeling incapable or unworthy of a normal life. These women tend to have less education, fewer marketable skills and less job experience than do addicted men.
Women may face more barriers to recovery than men do, such as being able to afford quality treatment or finding someone to watch their children while they participate in treatment.
Xodol addiction can result in disability or premature death, especially if left untreated or undertreated. In 2008, 14,800 people died from toxic overdose of prescription drugs, more than from heroin and cocaine combined.
Treatment consists of two components: detoxification and rehabilitation. Detoxification lowers opioid levels. The detoxification process usually takes five or more days and includes intense physical and psychological withdrawal symptoms.
Rehabilitation focuses on the behavioral aspects of Xodol addition. The rehabilitation process typically includes behavior modification and counseling to help the individual learn how to live without drugs.
Some people try to overcome dependence on Xodol alone, without the help of anti-withdrawal drugs or the help of medical professionals, in a process doctors call "self-detoxification." This process is commonly known as "going cold turkey," a reference to the bumpy, pale, cold and clammy appearance the skin takes on during detoxification - much like a plucked bird.
Withdrawal symptoms are not usually life threatening but excessive flu-like symptoms may cause dangerous complications. One such complication is aspiration, or vomiting and then breathing stomach contents into the lungs. Aspiration may cause fluid in the lungs or lung infections. Another complication is dehydration caused by excessive vomiting or diarrhea.
Relapse is the most common complication associated with detoxification. Without anti-withdrawal drugs to ease symptoms, many individuals return to Xodol to make the withdrawal symptoms disappear. Xodol addiction is characterized by cycles of relapse and remission.
The Thomas Recipe
The Thomas Recipe is a homemade treatment plan that incorporates anti-withdrawal medications to ease symptoms. The Thomas Recipe calls for Xanax or another medicine to calm anxiety and promote sleep. Imodium curbs diarrhea. Vitamins, supplements and hot baths soothe muscle aches and body pains.
While The Thomas Recipe eases withdrawal symptoms somewhat, it does not protect the individual from complications or relapse. Returning to Xodol after any amount of detoxification reduces the person's tolerance to Xodol - he could potentially overdose on a smaller dose of Xodol than he used to take before experiencing even moderate withdrawal symptoms.
It is possible to overdose on either the hydrocodone or the acetaminophen components of Xodol. Overdose is usually the result of taking too much Xodol or using Xodol in combination with other drugs that contain hydrocodone or acetaminophen.
Overdose of the hydrocodone component of Xodol may cause respiratory depression, a serious breathing condition where the lungs do not adequately exchange oxygen for toxic gases. Symptoms of respiratory depression include slow or shallow breathing, unusual breathing patterns and a blue tint around the eyes, lips and fingernails.
Hydrocodone overdose symptoms include extreme sleepiness that progresses to coma, flaccid muscles and cold and clammy skin. The individual may sometimes have a slow pulse and low blood pressure. Severe overdose may cause stopped breathing, circulatory collapse, heart attack and death.
The most serious, potentially fatal side effect of acetaminophen overdose is the serious liver damage known as hepatic necrosis. The condition may be dose-dependent, meaning larger acetaminophen doses cause more damage.
Acetaminophen overdose may cause kidney disease, hypoglycemic coma and bleeding problems. Early symptoms of liver damage associated with acetaminophen may include nausea, vomiting, excessive sweating and malaise. Signs and symptoms of liver damage may not appear for 48 to 72 hours after exposure to the acetaminophen in Xodol.
Treatment for Overdose
Xodol overdose may be fatal. Overdose requires immediate medical attention. For immediate help by telephone, call the poison control center at 1-800-222-1222.
Emergency treatment for Xodol overdose includes helping the patient breathe and using naloxone to lower hydrocodone levels. Nurses will administer oxygen and intravenous fluids, along with medications to keep blood pressure within safe limits. Nurses will pump the patient's stomach or administer charcoal to absorb and remove excess acetaminophen.
Drug Replacement Therapy
Individuals not in immediate danger of toxic overdose may participate in Drug Replacement Therapy, or DRT. During DRT, patients replace Xodol with drugs that mimic the effects of hydrocodone but do not produce the euphoric effects. This allows the person to participate in rehabilitation before attempting detoxification. DRT drugs include methadone, Suboxone and buprenorphine.
Once the individual develops tools that allow him to live drug-free, he weans himself from the replacement drug by taking successively smaller doses increasingly further apart.
Inpatient detoxification is the most common way to deal with withdrawal symptoms. During this procedure, doctors administer naloxone to start the detoxification process along with a variety of anti-withdrawal medications to deal with the ensuing flu-like symptoms. While this process eases the severity of physical symptoms, the patient must still endure five or more days of discomfort along with protracted psychological symptoms that could threaten recovery efforts.
Many consider rapid detox the most efficient and humane treatment for Xodol dependence. During rapid detox, board certified anesthesiologists administer the standard detoxification and anti-withdrawal drugs along with sedatives and anesthesia. The patient dozes in a comfortable "twilight sleep" and awakens with no memory of the detoxification process. Rapid detox eases the severity of symptoms and shortens the duration of the detoxification process, readying the patient for rehabilitation in hours rather than days.
Detoxification is only the first step towards recovery and, by itself, does little to change the behaviors associated with drug abuse. Rehabilitation includes behavior modification and individual, family and group counseling that teach you how to live without Xodol. Medications may also be included in rehabilitative care, especially for those with accompanying mental or mood disorders.
Xodol addiction is a complex neurological condition that affects each person differently, so no single treatment is appropriate for everyone. The treatment must be convenient and readily available, as it is critical to remain in treatment long enough to reverse neurological dysfunction and restore healthy behavioral patterns.
The individual's counselor will develop a treatment plan that addresses all of the individual's needs and not just his drug abuse. The counselor will continually assess and modify this treatment plan to be sure it fits the patient's changing needs. The counselor will require routine drug tests, as relapses are common. She may also request testing for infectious diseases and provide educational materials intended to reduce the patient's risk for contracting or spreading these diseases.