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Hydrocodone
Hydrocodone is second among the list of top prescribed opioid painkillers, but it is also high on the list of most abused. In 2011, the abuse or misuse of hydrocodone was responsible for more than 97,000 visits to the emergency room. In 2012, the Food and Drug Administration (FDA) rescheduled it from a Schedule III drug to a Schedule II drug, recognizing its high potential for abuse and addiction.

Hydrocodone can be prescribed under a different brand name. These brand names include Norco, Lortab, and Vicodin. Hydrocodone can also exist in other formulations where it is combined with another non-opioid pain reliever such as acetaminophen, or even a cough suppressant.

When opioids like hydrocodone are taken as prescribed, for the indication prescribed, and for a short period of time, then the risk of abuse and addiction is small. Problems have surfaced over the last decade however, due to its wide overuse and misuse in the setting of chronic pain.

The elderly are at an increased risk for opioid related overdose because several different classes of medications can interact with opioids and older patients are often taking multiple prescribed medications at a single time. One class of drug that is commonly prescribed in this patient population is benzodiazepines. Benzodiazepines by themselves put older people at risk for falls and fractures due to associated side effects related to dizziness and sedation. Opioids by themselves put older people at risk of respiratory depression and impaired ability to operate vehicles and other machinery. Combining these two drugs together not only increases a person's risk of the aforementioned adverse effects, but it can increase a person's risk of overdose and death.

Statistics show that hydrocodone ranks in at number 4 on the list of most commonly abused drugs in the United States and that more than 40% of drug related emergencies occur due to opioid abuse. Twenty percent of opioid abusers, another statistic reports, were prescribed the medication they abused.

Hydrocodone was declared the most widely prescribed opioid between 2007 and 2016, and in 2015 the International Narcotics Control Board reported that greater than 98% of the hydrocodone consumed in the entire world was consumed by Americans.

Suboxone

Suboxone is a combination medication that has been approved by the FDA in 2002 for treatment of opioid dependence. It is a combination medication that contains two separate drugs: buprenorphine and naloxone.

Buprenorphine works as a partial opioid agonist. It is given in combination with Naloxone because Naloxone works as an opioid antagonist, meaning it will block the effects of the opioid medication. This combo drug can help by reducing a person’s withdrawal symptoms while they are discontinuing opioids after a period of chronic use.

While Suboxone is indicated for the treatment of opioid dependence, it does contain an opioid which means a person may be at risk of developing dependence to it as well.

Edit for State and Local Legislation - Update

A new bill, SB 482, took effect October 2, 2018 requiring doctors and other healthcare professionals who wish to prescribe opioids to check the Controlled Substance Utilization Review and Evaluation System, also known as CURES, before doing so.