Vicodin is a combination of the drugs acetaminophen, also known as Tylenol, and the opiate hydrocodone. Opiates are a class of drugs derived from the opium poppy plant that include morphine, oxycodone, methadone, heroin, fentanyl and others. They are generally effective pain killers, but can be addictive. Addiction to opiates such as Vicodin causes particular symptoms and signs in the addict.
Acute Intoxication
According to the 2009 edition of "Principles of Addiction Medicine," acute intoxication with hydrocodone produces an effect on mood and level of consciousness that ranges from euphoria to tranquility to mild sedation to unconsciousness. The pupils will be constricted and are described as pinpoint. The respiratory rate decreases, as does the blood pressure and heart rate. In the case of an overdose, breathing can cease, leading to death within minutes. The drug also decreases the work of the gut, leading to constipation. It can also cause decreased libido and in women it can affect ovulation and menses.
Tolerance
Tolerance refers to requiring larger doses of a drug in order to achieve the desired effect. The body and brain need the right concentration of a chemical, protein or fluid and will try to maintain that concentration. For example, in some people the normal value of potassium is 4 mEq/L, a measure of the concentration of a chemical in the blood. If that person eats a food with a high concentration of potassium such as bananas, raising the potassium, the body will respond to the elevated potassium level by excreting potassium into the urine.
In drug abuse with hydrocodone, the drug mimics natural chemicals in the brain called endorphins, according to "Principles of Addiction Medicine." When the drug is administered regularly, the levels of naturally occurring endorphins drop, to rebalance the right concentration in the brain. As a result more of the drug is needed both to achieve the euphoria and even to feel normal.
Withdrawal
Withdrawal is a result of tolerance. Without the drug, there will be abnormal levels of brain chemicals, particularly endorphins. "Principles of Addiction Medicine" notes that within five hours a person will experience craving for the drug, anxiety and fear. After about half a day, the pupils will dilate, a person experiences, sweating, a runny nose, insomnia, anxiety, restlessness, yawning, tearing and stomach cramps. One to three days later symptoms include tremor, vomiting, diarrhea, high blood pressure and heart rate, muscle spasms, fever, chills, goosebumps and occasionally seizures.
Acetaminophen Side Effects
In addition to symptoms of drug intoxication and withdrawal, a person addicted to Vicodin can suffer the effects of Tylenol overdose. The most dangerous effect of high doses of Tylenol is liver damage, according to "Harrison's Principles of Internal Medicine." Symptoms include yellowing of the eyes and skin called jaundice, abdominal pain, increased abdominal girth, tremors, and confusion. The worse case scenario is liver failure, which will require intensive care and a liver transplant.
References
- "Principles of Addiction Medicine"; Ries et al.; 4th Ed; 2009
- "Harrison's Principles of Internal Medicine"; Fauci et al.; 17th Ed 2008
