In the last couple months, the FDA has approved Zohydro for use as a pain medication. It is an old medication – Hydrocodone – in a new package.  Hydrocodone is the opioid/narcotic medication in drugs like Vicodin, Lortab, and Norco, and up until now has always been combined with acetaminophen. It is now made into a form that is extended release and is not combined with any other drug.

The drug is meant to last for up to 12 hours and comes in strengths from 10 mg to 50 mg. The big issue is that there is no abuse deterrent design in this new product.

Abuse Likelihood

Hydrocodone is currently one of the leading drugs that is abused. It is the most prescribed pain medication in the United States, and 98% of worldwide consumption occurs in the USA. Furthermore, this medication needs to be metabolized in the body into a broken down state to be effective, and in 5-10% of the population, it has very little effectiveness.  Now, with this new formulation, it is available in a high concentration and has the potential to be easily abused.

Zohydro, in the Pain Specialist community, has received a very cold reception. It has one main benefit; it is no longer used in combination with other drugs. It has many more problems, and the manufacturer and FDA did not listen to the warnings by the specialists who might prescribe the medications. I was actually involved in a focus group evaluation by a manufacturer of either this drug or a similar drug. As with most pain specialists, this drug is likely going to be a highly abused drug that adds little to options for pain management.

Time will tell if this drug will be helpful in pain management. At this time, there are a number of other short and long acting pain medications. A generic short acting Hydrocodone without a combination drug would have been welcomed to help prevent side effects and toxicity of acetaminophen. It would be affordable and useful for short-term pain control. Any new potent pain medication should employ an abuse deterrent formulations, otherwise the increasing pain medication abuse problem will only worsen.