Meanwhile, the embedding of the drug in other parts of popular culture continues apace.
‘The Vicodin Song’, by singer-songwriter Terra Naomi, has been watched on YouTube more than half a million times. It’s an appropriately sleepy ballad which begins: And I’ve got Vicodin, do you wanna come over?
The most popular comment on the thread underneath the YouTube video reads: ‘When I listen to this I think of Dr House :)) This song is really cool.’18 Many of the 2,000-plus comments, however, aren’t about the song or the show. They’re about how much Vicodin you can take recreationally without hurting your liver. It’s a vigorous debate:
FreeWhoopin1390: Well vicodin (aka hydrocodone) gives you a good calm high. It’s a super chill high to be honest. Now some people might try and tell you that 20–25 mg gets you high, let me start by saying those people are idiots. 20–25 mg will give you a relaxed small buzz for the first time. If you want a really good calm high that lasts for a while take 35–40 mg. I say 40 for the first time but that’s just me. Word of caution tho, do not exceed 4000 mg of tylenol [paracetamol] which is in vicodin, in 24 hours.
Thebluefus: If you get 40 mg of hydrocodone by taking vicodin you have reached the max for tylenol. You don’t need that much to get high, especially as a first time. Just two vicodin will get you the feeling. Don’t be stupid.
FreeWhoopin1390: Are you fucking stupid? The max for tylenol is 4000 mg a day. I take 50 mg of hydrocodone at once (they are 10/500). Which means they have 10 mg hydrocodone and 500 mg tylenol. Which means I am taking 2500 mg of tylenol. Which is nowhere near the max daily dosage. But thank you for sharing what you don’t know.
There are also catfights about the respective virtues of Vicodin and Oxycontin and a discussion of the regional variations in street prices. From time to time someone interrupts to say that they take Vicodin for real pain and that these junkies should be ashamed of themselves. But there are also commenters who were legitimately prescribed the drug who are now junkies themselves. They may resent being a slave to Vicodin or they may enjoy the high; perhaps a bit of both. What should we make of a comment like this?
1awareness: Bragging about pills is lame. I’m using them to make fibromyalgia feel less intense. I also have seizures which cause a lot of pain. I enjoy Vicodin.
These are commenters who describe themselves as Vicodin ‘users/abusers’, a term that neatly captures the ambiguity of prescription drug abuse. All mood-altering drugs, from Scotch whisky to crack cocaine, can be abused: you can harm yourself by taking too much of them. But the vast majority are supposed to intoxicate, even when consumed in ‘safe’ quantities. The Vicodin abuser, on the other hand, is hooked on a drug that the manufacturers insist isn’t designed to alter moods. To further complicate matters, if the abuser is in real pain, it can be hard to tell whether he or she is merely over-medicating or enjoying an extra recreational buzz on top of the pain relief – Dr Gregory House likes to keep his colleagues guessing on this point. But that sort of confusion doesn’t make Vicodin dependence any less difficult to manage; it just means that, like so many 21st-century addictions, it is difficult to categorise and therefore difficult to treat.
As if these problems weren’t bad enough, it was revealed at the beginning of 2012 that several drug companies were working on hydrocodone pills that were potentially ten times as strong as Vicodin. The new pills would be ‘safer’ than Vicodin, according to Roger Hawley, chief executive of Zogenix, because they wouldn’t contain the paracetamol that harms the liver. Maybe so; but their time-release formula would also allow abusers to crunch them up for one hell of a hit. Zohydro, as Zogenix plans to call the drug, is scheduled for release in 2013.
This is just a guess, but it wouldn’t surprise me if, all over America, clued-up Vicodin users are already telling their doctors that their pain is getting worse and maybe they could use something a little stronger …
The addictive qualities of cupcakes, iPhones and Vicodin aren’t immediately obvious. Someone encountering a cupcake for the first time since childhood doesn’t think: uh-oh, I’d better be careful not to develop a sugar addition that triggers an eating disorder and end up washing the sick out of my hair. Likewise, people buying their first smartphone don’t worry about developing an obsessive-compulsive relationship with a computer game, and until recently the recreational use of painkillers was almost unheard of. In other words, as unqualified consumers we’re increasingly tempted by products about whose effect on our brain we know virtually nothing. We may not even notice the burst of tension-relieving pleasure they provide – at least, not until we realise that we can’t live without them.
Using substances and manipulating situations to fix your mood isn’t new. It’s the pace, intensity, range and scale of this mood-fixing that is unprecedented, irrespective of whether it involves drugs, alcohol, food or sex.
Put simply, both our need and our ability to manipulate our feelings are growing. We’re always searching for new ways to change the way we feel because, to state the obvious, we’re not at ease with ourselves. That’s a very broad-brush statement, so let me try to be more specific. Our ancestors were unable to insulate themselves from fear and despair in the way that we try to: certain forms of unhappiness, such as grief at the death of children, were more familiar to them than they are to us. Nor did they possess many fixes to address those feelings – and, in any case, experiences of such intensity aren’t easily fixed, even in the short term. We, on the other hand, struggle with small but inexorable and cumulative pressures in our daily lives. These produce a free-floating anxiety that is susceptible to short-term fixes.
The hi-tech world that ratchets up the pressure on us also yields scientific discoveries that speed up the flow of pleasure-giving and performance-enhancing chemicals in our brains. Indeed, producers and consumers collude vigorously in this process, which helps us cope with commitments that we feel are beyond our control. (Note, incidentally, how the verb ‘to cope’ has invaded so many areas of human activity: sometimes it seems that we need a ‘coping strategy’ just to go to the bathroom.) The jokey phrase ‘retail therapy’ has entered the language for a good reason. We, as consumers, know that the instant gratification of a purchase goes beyond simple pleasure at acquiring something new – it can change the way we feel about everything, albeit only for a short time. Manufacturers are well aware of it, too. They know they are the purveyors of fixes, and that the moment their fixes fail is the moment they start losing market share.
The problem is that these increasingly complex interactions between producers and consumers are also increasingly unpredictable, especially in their effects on the human body. It’s not possible to predict with any accuracy the sorts of relationships that people will form with the substances and experiences thrust at them. Neuroscientists are learning new things about our reward systems all the time, but they’ll admit privately that the attempt to turn these discoveries into drugs that target specific mental disorders have been shockingly hit-and-miss. Meanwhile, the rest of us know only one thing about those reward systems: how to stimulate them.
In other words, we are sitting