RUSSELL: Proposed drug ban offers safe painkiller alternative

A Food and Drug Administration advisory panel voted June 30 to recommend that the FDA ban the use of prescription drugs that combine acetaminophen with narcotics, citing patient safety concerns.

Were a ban to be enacted, prescription painkillers, such as Vicodin, would be pulled from the market.

I support this recommendation wholeheartedly.

Acetaminophen, the active ingredient in over-the-counter pain relievers, such as Tylenol, is commonly paired with a more powerful, controlled pain medication, such as hydrocodone.

Those in the medical field have observed interaction between acetaminophen and narcotics, and the two are often combined in a single pill in order to use less of a narcotic to give effective pain relief to patients.

The combination is so effective that Vicodin is the most commonly prescribed medication in the United States.

Combining the two drugs in one pill simplifies treatment for the patient, but it comes at a cost. The combination doesn’t give the patient the option to consume one drug without the other.

This would be fine, save for two difficulties.

One, acetaminophen is toxic to the liver in high doses.

Two, acetaminophen is in everything. Well, not everything, but many over-the-counter drugs, such as cough syrup or cold remedies, have acetaminophen in them.

This creates a problem for individuals taking prescription painkillers who also desire, for instance, cold relief.

Taking acetaminophen from multiple sources at once puts one at risk of a prolonged, agonizing death from liver failure brought on by acetaminophen overdose.

Unfortunately, these combination painkillers owe half of their widespread adoption to puritanical attitudes toward recreational drug use. Combination painkillers like Vicodin are available to be prescribed by a larger number of medical workers than those with narcotics alone.

The Drug Enforcement Administration’s justification for this is that combination painkillers carry a lower “abuse potential” than narcotic-only drugs.

That’s one way to put it.

Another is that the DEA has set up its regulatory scheduling such that it is easier for doctors to prescribe medicine that is more dangerous to patient health.

If you were the patient, which medicine would you prefer?

Combination painkillers contain such a high ratio of acetaminophen to narcotics that recreational doses risk permanent liver damage from overdose.

I fully support the DEA’s educational efforts to discourage recreational narcotics use, but attempting to discourage misuse of prescription drugs by making the already dangerous activity more dangerous is disingenuous.

As if this situation weren’t frustrating enough, a savvy recreational narcotics user can simply hop on Google and come up with a five-step guide on how to remove the hazardous acetaminophen from medication within an hour, using nothing more than common household items (don’t try this at home).

If this ban were enacted, any problems created by it could be blamed solely on the DEA, whose overbearing and dangerous nannying needs to stop.

I can think of nothing worse than millions of Americans nationwide suddenly finding themselves in agonizing pain because the DEA decided they couldn’t be trusted to take their medicine properly.

Acetaminophen-narcotic combinations risk the health of medical patients while only creating a minor nuisance for those with other uses in mind. The painkiller these combinations create is useful and can be achieved without dangerous drugs like Vicodin.

The solution is simple: Give patients prescription narcotics, and skip the liver poison. Stop treating those in pain like children, and give them the safe pain relief they deserve.

Doctors can simply instruct their narcotic-receiving patients to also buy some acetaminophen tablets or cough syrup to achieve the combination.

While some patients will no doubt fail to regulate their acetaminophen intake and kill themselves regardless, this new arrangement would at least give patients who pay attention to drug labels more flexibility in their treatment.

Finding a perfect way to treat pain remains elusive, but this is surely a step in the right direction.

The FDA’s purpose is to protect us from bad food and medicines (remember Vioxx, Fen Phen and Ephedra?). The DEA’s purpose is to jail those using and trafficking illegal drugs. As only the latter has a vested interest in creating a purpose for its own existence by keeping potentially useful drugs tightly regulated or outright illegal, I carry a good deal more trust in the FDA’s judgment.

There may be some difficulty at first, as many medical practitioners find they are not licensed to dispense narcotic-only medications, but the long-term benefits of patient freedom and the reduced risk of accidental poisoning are worth it.

- Mark Russell is a sophomore in geology from Ames.