The low down on hydrocodone: the active ingredient in many prescription pain relievers such as Vicodin® is a powerful drug--and dangerous when not used as prescribed.

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There is great news from the latest Monitoring the Future (MTF) Study, a survey that tracks teen drug use from year to year: Overall drug abuse is down among teens. Unfortunately, there's some bad news too: Abuse of prescription drugs remains at high levels. Of particular concern is the continued abuse of Vicodin[R], whose principal ingredient is hydrocodone, with nearly one in ten high school seniors abusing Vicodin[R] in 2006.

Taken under the supervision of a doctor, hydrocodone can be helpful in relieving acute and chronic pain. Yet the risks of abuse and addiction can be very real. As Nora D. Volkow, M.D., Director of NIDA, points out: "Hydrocodone is a powerful pain medication, but when abused--used without a prescription, from someone else's prescription, or in a different form or dosage than what a doctor would prescribe--it can lead to serious health consequences, even death, especially when combined with alcohol or other drugs."

SO, WHAT IS HYDROCODONE?

Hydrocodone is a powerful opioid (a pain reliever acting on the central nervous system) for the relief of moderate to severe pain. Hydrocodone is formulated under a number of different brand names, such as Vicodin[R], Anexsia[R], Lorcet[R], and Norco[R]. Another well-known opioid is oxycodone, the generic name for the drugs Oxycontin[R], Percodan[R], and Percocet[R]. Available by prescription only, hydrocodone is similar in potency to oral morphine (an analgesic derived from poppies) and is in the same opioid drug class as heroin. Opioids act by attaching to specific proteins called opioid receptors found in the brain, spinal cord, and gastrointestinal tract, and can effectively change the way a person experiences pain. Additionally, opioids affect regions of the brain, including the nucleus accumbens (a key structure in reward, motivation, and addiction), resulting in initial euphoria.

The high levels of Vicodin[R] abuse may be linked to its widespread availability--a fact that becomes even more troubling when considering the health risks of abusing hydrocodone and other prescription drugs. (See the sidebar "Prescription for Disaster.") According to NIDA researcher Scan McCabe and others, some of the leading sources for teens obtaining prescription opioids are family members and friends. Many people assume that if a drug is "legal" and prescribed by a doctor, it's okay to use. But hydrocodone and other prescription medicines can be as harmful as illicit...