1. JohnB007

    Why have something as addictive / “rewarding” as hydrocodone in Vicodin when something like codiene phosphate @ a ratio of 500mg paracetamol / 45mg cod would work, admittedly not as well. I’m not from the USA, and was amazed as to the amount of hydrocodone was used in pain med’s. Not saying my country is better – we have lots of addicts too.

    • Good point– I’ve had a number of people tell me that hydrocodone was more pleasurable for them even than oxycodone at an equivalent dose. Codeine is converted to morphine; both morphine and hydrocodone act at the same mu receptors, but there does seem to be more euphoria in some opioids compared to others.

  2. [email protected]

    Excellent description on “Upcoming Changes in Pain Medication Regulations”. My BIG question to the writer – is WHAT is the answer? How to avoid harming those patients with non-cancer chronic pain who legitimately DO need longterm prescription of opioids in order to function in their daily lives? It now becomes MUCH harder for these patients to receive such medication. Clearly – measures other than chronic opioids would be preferable – but will not always be successful in alleviating chronic pain sufficient to allow normal function.

    • If I HAD an answer, I’d give it. It is a very complicated issue– and all I can do is try to arm individuals with the background, to help them navigate this mess as best as possible according to their own needs.

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