![](media/image1.wmf){width="1.0in"
height="0.9909722222222223in"}**Hydrocodone**

Hydrocodone in an analgesic and antitussive agent structurally similar
to codeine. When the CSA was enacted in 1971, hydrocodone substance was
placed in schedule II. Products containing hydrocodone in specified
amounts and in combination with other active ingredients were placed in
schedules III and V. At that time, hydrocodone was primarily utilized as
a cough suppressant with limited prescriptions. Today, hydrocodone
products are increasingly utilized for pain management and are the most
frequently dispensed opioid pharmaceuticals in the United States.

The **National Forensic Laboratory Information System (NFLIS)** is a DEA
database that collects scientifically verified data on analyzed drug
seizures from state and local forensic laboratories. It also includes
data from the **System to Retrieve Information from Drug Evidence**
**(STRIDE)**, which provides information on analyzed seizures from DEA
laboratories. Hydrocodone continues to be the most frequently
encountered narcotic analgesic in forensic laboratories. The following
table shows hydrocodone data from 2000 through
2006.![](media/image2.png){width="0.20833333333333334in"
height="0.15625in"}![](media/image2.png){width="0.20833333333333334in"
height="0.15625in"} 

+-----------------------------------------------------------------------+
| ***NFLIS/STRIDE***                                                    |
|                                                                       |
| ***ANALYZED HYDROCODONE SEIZURES***                                   |
+-----------------------------------------------------------------------+

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  ***Source***   ***2000***   ***2001***   ***2002***   ***2003***   ***2004***   ***2005***   ***2006***   ***Total***
  -------------- ------------ ------------ ------------ ------------ ------------ ------------ ------------ -------------
  NFLIS          4,084        6,517        10,176       13,145       17,688       22,415       25,136       99,161

  STRIDE         259          314          335          511          449          598          654          3,120

  Total          4,343        6,831        10,511       13,656       18,137       23,013       25,790       102,281
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![](media/image2.png){width="0.20833333333333334in" height="0.15625in"}

**IMS National Prescription Audit *Plus*™**, a provider database managed
by IMS Health, estimates total U.S. dispensed prescriptions through all
channels of distribution from 2000 to 2006 (extracted 09/10/2007). Data
for 2006 indicates that hydrocodone prescriptions have steadily
increased. From 2000 thru 2006 there was nearly a 48 percent increase in
the number of prescriptions dispensed for hydrocodone products in the
United States (from about 88 million to 130 million).

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  ***IMS Total Prescriptions***

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  ----------------------------------------------------------------------------------------------------------------------
  ***DRUG***    ***YR2000***   ***YR2001***   ***YR2002***   ***YR2003***   ***YR2004***   ***YR2005***   ***YR2006***
  ------------- -------------- -------------- -------------- -------------- -------------- -------------- --------------
  HYDROCODONE   88,000,000     96,000,000     102,000,000    110,000,000    114,000,000    124,000,000    130,000,000

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![](media/image2.png){width="0.20833333333333334in" height="0.15625in"}

DEA establishes **Aggregate Production Quota** **(APQ)** for the maximum
amount of schedule I and II substances which may be manufactured in the
United States for legitimate national scientific, medical and export
needs, and for the maintenance of stocks. The APQ for hydrocodone has
increased over 100 percent since 2000 (from 21,417 kg in 2000 to 46,000
kg in 2007).

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  ***Aggregate Production Quota (Kgs)***

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  ---------------------------------------------------------------------------------------------------------------------------------------------------
  ***DRUG***    ***YR2000***   ***YR2001***   ***YR2002***   ***YR2003***   ***YR2004***   ***YR2005***   ***YR2006***   ***YR2007***   ***Total***
  ------------- -------------- -------------- -------------- -------------- -------------- -------------- -------------- -------------- -------------
  Hydrocodone   21,417         23,825         25,702         30,622         34,000         37,604         42,000         46,000         261,170
  (sale)                                                                                                                                

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According to the 2005 **International Narcotics Control Board (INCB)
Report**, the United States manufactures nearly 100% of the total
hydrocodone manufactured worldwide. It also constitutes 99% of the world
consumption of hydrocodone.

The **National Survey on Drug Use and Health** (formerly the National
Household Survey on Drug Abuse) is a Substance Abuse and Mental Health
Services Administration (SAMSHA) database that measures drug use by
people living in households. Data is listed for 2000 through 2006.
Information is collected for Vicodin, Lortab, Lorcet, and other
hydrocodone products for lifetime use (i.e., it was used at least once
in their life).

***National Survey on Drug Use and Health***

***Hydrocodone Products***

  ----------- ----------- ----------- ------------ ------------ ------------ ------------ ------------ -------------
  **YEAR**    **2000**    **2001**    **2002**     **2003**     **2004**     **2005**     **2006**     **Total**

  **USERS**   6,708,000   9,453,000   13,952,000   16,808,000   17,734,000   18,875,000   20,755,000   104,285,000
  ----------- ----------- ----------- ------------ ------------ ------------ ------------ ------------ -------------

**Monitoring the Future (MTF),** a National Institute on Drug Abuse
(NIDA) funded study conducted by the University of Michigan,
![](media/image2.png){width="0.20833333333333334in"
height="0.15625in"}measures prevalence of drug use among eighth, tenth,
and twelfth graders. In 2002, a question was added regarding the annual
prevalence of the nonmedical use of Vicodin. The table below provides
this data.

***Annual Prevalence of Nonmedical Use of Vicodin***

***Monitoring the Future (2002-2006)***

(Data Expressed in Percent of Students)

  ----------- ------------ ------------ ------------ ------------ ------------
              ***2002***   ***2003***   ***2004***   ***2005***   ***2006***

  8^th^ Grade 2.5          2.8          2.5          2.6          3.0

  10^th^      6.9          7.2          6.2          5.9          7.0
  Grade                                                           

  12^th^      9.6          10.5         9.3          9.5          9.7
  Grade                                                           
  ----------- ------------ ------------ ------------ ------------ ------------

The **American Association of Poison Control Centers** **(AAPCC)** data
suggest that hydrocodone products are involved in a number of toxic
exposures that have resulted in 334 deaths from 2002 through 2005. In
2005, hydrocodone was associated with more exposures that resulted in
death than any other narcotic analgesic. In addition, of the 22,165
exposures reported to the American Association of Poison Control Centers
(AAPCC) in 2005, 5,200 were for individuals less than 20 years of age.
Data for hydrocodone exposures reported to AAPCC from 2002 thru 2005 are
provided in the tables below.

Poison Control Center Data for Hydrocodone

  --------------------- ------------ ------------ ------------ ------------ -------------
                        ***2002***   ***2003***   ***2004***   ***2005***   ***Total***

  Hydrocodone Exposures 17,386       19,538       22,594       22,165       81,683
  --------------------- ------------ ------------ ------------ ------------ -------------

***Serious Outcomes Associated With Hydrocodone*** Exposures

  ---------------- ------------ ------------ ------------ ------------ -------------
                   ***2002***   ***2003***   ***2004***   ***2005***   ***Total***

  **Deaths**       66           82           86           100          334

  **Major          531          606          751          808          2,696
  Effect\***                                                           

  **Moderate       2,033        2,301        2,868        2,832        10,034
  Effect\*\***                                                         

  **Total**        2,630        2,989        3,705        3,740        13,064
  ---------------- ------------ ------------ ------------ ------------ -------------

\*Major effect: the patient exhibited signs or symptoms as a result of
the exposure that were life-threatening or resulted in significant
residual disability or disfigurement.

\*\*Moderate effect: the patient developed signs or symptoms as a result
of the exposure that were more pronounced, more prolonged or more
systemic in nature than minor effects.

![](media/image2.png){width="0.20833333333333334in" height="0.15625in"}

The **Drug Abuse Warning Network (DAWN)** is another SAMSHA database
which collects data on drug-related emergency department (ED) visits
from a nationally representative sample of hospitals from selected
metropolitan areas within the United States.  In 2002, the last year
national data is available, hydrocodone with acetaminophen was the tenth
most reported drug among the top 150 controlled substances.

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  ***DAWN ED***

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  ***National Estimates Of Abuse Incidents***

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  ---------------------------------------------------------------------------------------------------
  ***DRUG***           ***1998***   ***1999***   ***2000***   ***2001***   ***2002***   ***Total***
  -------------------- ------------ ------------ ------------ ------------ ------------ -------------
  HYDROCODONE          13,611       15,252       20,098       21,567       25,187       95,715

  ---------------------------------------------------------------------------------------------------

The DAWN database also collects data on drug-related deaths reported
Medical Examiner (ME) Offices in 32 metropolitan areas. In 2002, the
last year national data is available; hydrocodone was the eighth most
reported drug among the top 20 controlled substances.

![](media/image2.png){width="0.20833333333333334in"
height="0.15625in"}![](media/image2.png){width="0.20833333333333334in"
height="0.15625in"}  ![](media/image2.png){width="0.20833333333333334in"
height="0.15625in"}![](media/image2.png){width="0.20833333333333334in"
height="0.15625in"} 

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  ***DAWN ME***

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  ***NATIONAL REPORTS OF DRUG-RELATED DEATHS***

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  -------------------------------------------------------------------------------------------------------------
  ***DRUG***           ***YR1998***   ***YR1999***   ***YR2000***   ***YR2001***   ***YR2002***   ***TOTAL***
  -------------------- -------------- -------------- -------------- -------------- -------------- -------------
  HYDROCODONE          294            447            548            592            618            2,499

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