LA Times Essay on Vicodin Pain Pills by Greg Critser
Uploaded by eCheater on Jul 30, 2005
Just when really serious things like war, disease and a bummer economy threaten to make the media business a rather dreary realm, enter the downfall by drugs of Rush Limbaugh. The drama has spawned comparisons (he's the "new Elmer Gantry"), compassion (he's an addict and we should show mercy even if he didn't show it to others) and vengeful rebuke (talk about hypocrisy!). Yet the truth about Limbaugh's fall may be more mundane than anyone wants to admit, Limbaugh included. Beyond the cultural politics swirling outside his detox room door, one truth is clear: What you don't know can hurt you, especially when it comes to a little pill called Vicodin, one of the painkillers Limbaugh is said to have used.
Anyone who's had a tennis injury, root canal or — at least on the Westside — a bad hangnail knows Vicodin is good stuff. Not only does it kill pain but it also, as "Permanent Midnight" author Jerry Stahl said about heroin, "makes you feel so good, you feel like calling the phone company and telling them what a good job they're doing." Between 1988 and 1998, the number of prescriptions written per year for first-time users — most of them middle- and upper-middle-class — of Vicodin and similar powerful painkillers grew from 500,000 to 1.6 million. Some of the people who got those prescriptions have undoubtedly become addicted to the euphoria they produce.
And yet this aspect of Vicodin is little appreciated by the prescription-writing medical community. That is because critical, objective information about the drug — the kind we are accustomed to in these days of long FDA reviews and dramatic advisory committee meetings — is thin at best.
Hydrocodone (the chemical name of Vicodin's primary ingredient along with acetaminophen) is one of hundreds of older drugs that were introduced before 1962, when Congress passed a landmark amendment to the Food and Drug Act that gave the FDA much more power to oversee safety and efficacy testing. But buried in a series of tests done in the 1930s are a number of troubling facts.
First, a primer: Hydrocodone was first manufactured in the early 1920s by the German pharmaceutical company Knoll. As its name denotes, hydrocodone is the codeine molecule with a hydrogen atom attached. At the time, Knoll believed hydrogenizing codeine might make it less toxic and easier on the stomach. At about the same time, the U.S....