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Hydrocodone in an analgesic and antitussive agent structurally similar to codeine.? When the CSA was enacted in 1971, hydrocodone substance was placed in schedule II.? Products containing hydrocodone in specified amounts and in combination with other active ingredients were placed in schedules III and V.? At that time, hydrocodone was primarily utilized as a cough suppressant with limited prescriptions.? Today, hydrocodone products are increasingly utilized for pain management and are the most frequently dispensed opioid pharmaceuticals in the United States.
The National Forensic Laboratory Information System (NFLIS) is a DEA database that collects scientifically verified data on analyzed drug seizures from state and local forensic laboratories.? It also includes data from the System to Retrieve Information from Drug Evidence (STRIDE), which provides information on analyzed seizures from DEA laboratories. Hydrocodone continues to be the most frequently encountered narcotic analgesic in forensic laboratories.? The following table shows hydrocodone data from 2000 through 2006.
IMS National Prescription Audit Plus?, a provider database managed by IMS Health, estimates total U.S. dispensed prescriptions through all channels of distribution from 2000 to 2006 (extracted 09/10/2007).? Data for 2006 indicates that hydrocodone prescriptions have steadily increased.? From 2000 thru 2006 there was nearly a 48 percent increase in the number of prescriptions dispensed for hydrocodone products in the United States (from about 88 million to 130 million).
DEA establishes Aggregate Production Quota (APQ) for the maximum amount of schedule I and II substances which may be manufactured in the United States for legitimate national scientific, medical and export needs, and for the maintenance of stocks.? The APQ for hydrocodone has increased over 100 percent since 2000 (from 21,417 kg in 2000 to 46,000 kg in 2007).
According to the 2005 International Narcotics Control Board (INCB) Report, the United States manufactures nearly 100% of the total hydrocodone manufactured worldwide. It also constitutes 99% of the world consumption of hydrocodone.
The National Survey on Drug Use and Health (formerly the National Household Survey on Drug Abuse) is a Substance Abuse and Mental Health Services Administration (SAMSHA) database that measures drug use by people living in households.? Data is listed for 2000 through 2006. Information is collected for Vicodin, Lortab, Lorcet, and other hydrocodone products for lifetime use (i.e., it was used at least once in their life).
National Survey on Drug Use and Health
Monitoring the Future (MTF), a National Institute on Drug Abuse (NIDA) funded study conducted by the University of Michigan,
measures prevalence of drug use among eighth, tenth, and twelfth graders.? In 2002, a question was added regarding the annual prevalence of the nonmedical use of Vicodin.? The table below provides this data.
Annual Prevalence of Nonmedical Use of Vicodin
Monitoring the Future (2002-2006)
(Data Expressed in Percent of Students)
? 8th Grade
The American Association of Poison Control Centers (AAPCC) data suggest that hydrocodone products are involved in a number of toxic exposures that have resulted in 334 deaths from 2002 through 2005.? In 2005, hydrocodone was associated with more exposures that resulted in death than any other narcotic analgesic. ?In addition, of the 22,165 exposures reported to the American Association of Poison Control Centers (AAPCC) in 2005, 5,200 were for individuals less than 20 years of age.? Data for hydrocodone exposures reported to AAPCC from 2002 thru 2005 are provided in the tables below.
Serious Outcomes Associated With Hydrocodone Exposures
*Major effect: the patient exhibited signs or symptoms as a result of the exposure that were life-threatening or resulted in significant residual disability or disfigurement.
**Moderate effect: the patient developed signs or symptoms as a result of the exposure that were more pronounced,? more prolonged or more systemic in nature than minor effects.
The Drug Abuse Warning Network (DAWN) is another SAMSHA database which collects data on drug-related emergency department (ED) visits from a nationally representative sample of hospitals from selected metropolitan areas within the United States. In 2002, the last year national data is available, hydrocodone with acetaminophen was the tenth most reported drug among the top 150 controlled substances.
National Estimates Of Abuse Incidents
The DAWN database also collects data on drug-related deaths reported Medical Examiner (ME) Offices in 32 metropolitan areas.? In 2002, the last year national data is available; hydrocodone was the eighth most reported drug among the top 20 controlled substances.
NATIONAL REPORTS OF DRUG-RELATED DEATHS
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