Last fall, the FDA approved a powerful new painkiller that states across the country argue could increase heroin and prescription drug abuse. Now, officials in Vermont, Massachusetts, and elsewhere are working to limit or even ban Zohydro, which has approximately five times the amount of hydrocodone contained in other pills on the market. The drug was approved despite the recommendations of a panel of experts put together by the FDA.
Over the last 20 years, prescription drug overdoses have increased threefold—today, more people die of opioid overdoses than from car crashes— and officials argue that the introduction of a time-release painkiller that could easily be abused could have serious consequences.
While the states duke it out over regulations, it’s important that athletes—who are often prescribed necessary painkillers to deal with injury or recover from procedures—take care to make sure they are using their prescriptions correctly, and limiting their own addiction risk.
The good news: “Most doctors undertreat pain, rather than over treat pain,” says Dr. Linn Goldberg, a professor and head of the Division of Health Promotion & Sports Medicine at Oregon Health & Science University. According to Goldberg, doctors trained in pain management will often prescribe enough medicine to treat the pain, but also give patients a little wiggle room to increase their dosage if necessary, with directions like, take 1-2 pills every 4-6 hours.
But sticking to that range is “critically important,” Goldberg says. “Overdosing or taking other medications that increase the narcotic effect kills. It can depress the respiratory center of our brain, located in the brain stem.”
Unlike antibiotics, there’s no reason to stick to prescription medicine once pain has abated. Though doctors do prescribe prescription painkillers for long-term pain management, that doesn’t usually apply to sports injuries. “Typically an injury or surgery has a finite course and medications should not be prescribed beyond the typical recovery period,” Goldberg says. “That is why we place refills on medications or have the patient discuss the need for more pain medications.”
It’s also okay to talk to your doctor about which drugs are best for you—and to request less medication for pain. Certain drugs are more addictive than others—opioids and narcotics specifically—and the FDA classifies drugs into “schedules” based on their addictive qualities. Schedule II narcotics, for example, have a higher likelihood of addiction, and include morphine and codeine. Last year, the FDA also recommended that hydrocodone products—which include vicodin—be reclassified as schedule II drugs, increasing control over them.
No matter your prescription, it’s important to look out for signs that you’ve been taking too much, like impaired judgment, sleepiness or confusion. “What is critical is that when taking opioids, not to drink alcohol and not to take other medications that will depress the respiratory center or ones that are additive to the harmful effects, such as sedatives,” he says.
But when in doubt about side affects, dosage amounts, or even if you should be prescribed a certain drug, always consult your doctor.