The hydrocodone epidemic is affecting an increasingly younger patient population and creating a new breed of addicts.  Consider this information, according to data from a recent National Survey on Drug Use and Health (NSDUH), approximately 75 percent of new users of pain relievers are under 25 and 38 percent are under 18 years.  I see the effects of this trend in my office where I work as an addiction specialist. Many clients present for treatment of opioid dependency that developed before they realized what happened.

I am observing a different type of opioid dependent patient that is younger and well educated, and perhaps more innocent than those who aggressively expose themselves to heroin. Unfortunately, whether using hydrocodone orally or heroin intravenously, if abused repetitively an individual can end up physically dependent.

Many of the younger opioid dependent clients report a history of casually using hydrocodone for “fun” but over time the frequency of use (abuse) increased because they liked the effects produced by the drug especially when mixed with other substances, most notably alcohol. One night of fun turns into a weekend of continuous use. Within a short period of time, they begin to notice the onset of fatigue, difficulty sleeping, and irritability that begins after the weekend of fun ends. Notably, these symptoms go away within minutes after taking more hydrocodone. This may go on intermittently over time as a cycle of abuse but in many cases, due to factors such as access, environment, underlying genetic predisposition, and mental health issues, an individual who started out as an intermittent abuser becomes opioid dependent.

The reality is that opioids taken in the absence of pain can result in exaggerated feelings of pleasure especially in individuals genetically predisposed.  So, in the early stages of abuse, opioid stimulation of the brain’s reward system is the main reason why some people take drugs repeatedly. Once “the party” starts, repetitive use will actually alter the brains reward system so that it functions normally when the drug is present and abnormally when they are not. Once this occurs, an invisible line has been crossed and dependency has developed.

As the data above demonstrates, a younger population is increasingly tempted by the lure of the hydrocodone party. The danger is exposure to a cycle that ends in the development of opioid dependency. When this is combined with the impulsivity of youth, addiction becomes likely.

The American Society of Addiction Medicine (ASAM) characterizes addiction by “inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response.”