What is Vicodin and Should I take it?

She was a writer, a wife, and a mother, and she was addicted to Vicodin. Jennifer was taking Vicodin to control the pain she was suffering from migraine headaches and fibromyalgia. At some point, though, Jennifer found herself chewing up Vicodin with her morning tea and toast. She was not using the medicine just for pain relief anymore; she was using it to function on a daily basis. 

In 2016, SAMHSA reported that 3.3 million individuals were misusing prescription pain relievers. The misuse of prescription pain relievers like Vicodin has become an epidemic that effects how healthcare professionals provide care and how patients perceive and receive that care.

What is Vicodin? Vicodin is a combination medication that contains acetaminophen and hydrocodone. Acetaminophen or Tylenol treats pain by blocking the formation of prostaglandins, which are involved in the body’s inflammatory response. Hydrocodone is an opioid painkiller that acts on the body’s nervous system to alter an individual’s psychological and emotional response to pain. Vicodin is also one of the most popular pain reliever narcotics. It is distributed the most for pain in minor surgeries. Vicodin can be highly addictive, and it can lead to use of harder pain relievers and even heroin.

There are many individuals like Jennifer battling an addiction to prescription pain relievers. If you were prescribed Vicodin, should you take it?

You do not Have to Take Vicodin

An article published in The Journal of the American Dental Association in 2016 observed that there was no evidence to show that medications like Vicodin are more effective than NSAIDs (e.g. Advil) at treating pain. A physician may prescribe Vicodin to a patient because the physician has learned that Vicodin works best at treating the type of pain that the patient has. Or– because some patients who do not receive opioid painkillers feel that their physician is “uncaring” and is not taking their pain seriously–a physician may feel pressured to prescribe Vicodin.

Whatever the reason for Vicodin being prescribed, you do not have to take it. If you feel that your pain is well-controlled on an NSAID or a combination of an NSAID and acetaminophen, discuss this with your doctor so that you can avoid Vicodin. Know that pain can be controlled effectively with medications other than opioid painkillers, and consider giving these other medications a chance before you ask for an opioid painkiller like Vicodin. There are also holistic treatments one can practice to help reduce and prevent pain.

Vicodin is Indicated for Certain Medical Issues

There is no doubt that Vicodin has been and continues to be misused, leading to addiction in some cases. This does not change the fact that Vicodin is indicated for the treatment of “moderate to severe pain” that may result from major surgery, cancer, or chronic pain secondary to traumatic injury. In fact, the issue that many healthcare providers are facing now is the under treatment of pain out of fear that patients will develop an addiction to the medications prescribed to them. Experts in many fields from dentistry to neurology to pain management know the types of pain that Vicodin can help and the types of pain for which Vicodin is virtually useless. How can you know if you should take Vicodin?

Discuss “Standard of Care” With Your Physician

Most physicians do not like the idea of “cookbook medicine” or the concept that they are using formulaic “recipes” to diagnose and treat their patients. At the same time, when considering treatment, physicians do consider what is called “standard of care.” Standard of care is defined as “treatment that is accepted by medical experts as a proper treatment for a certain type of disease and that is widely used by healthcare professionals.”

Let’s go back to Jennifer’s story. Jennifer was taking prescription painkillers, including Vicodin, for pain associated with fibromyalgia. This author is in no way questioning the severity of Jennifer’s pain. What should be questioned, though, is the use of Vicodin for fibromyalgia.

Fibromyalgia is a disease of chronic muscle pain that is improved with generalized stretching and aerobic exercise. The FDA has approved three medications for the treatment of fibromyalgia, and not one of these is an opioid painkiller like Vicodin. In fact, painkillers like Vicodin generally are not recommended for the treatment of fibromyalgia because these painkillers are considered ineffective for treating the disease.

The bottom line, then, is that Jennifer was prescribed a medication that is not considered standard of care for fibromyalgia. Physicians are expected to practice standard of care with each of their patients. However, if you feel uncomfortable with a medication or a procedure that has been prescribed to you, please do not hesitate to speak up. Start a discussion by asking your physician, “Is this considered standard of care for what I have?” You can also find additional, reliable information regarding accepted treatments for your condition on websites such as Medscape and Merck Manuals Consumer Version. When it comes to taking Vicodin or any medication, the Mayo Clinic offers the following sound advice: “In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make.”

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