A crackdown on narcotic painkillers is on the way, and it can’t come too soon for those impacted by the prescription drug epidemic in the US.
The US Drug Enforcement Administration (DEA) announced on August 21, 2014 that it is moving hydrocodone combination products (also known as HCPs) from Schedule III to the more restrictive Schedule II classification. The ruling also has additional government support, and follows a recommendation by the Assistant Secretary for Health of the US Department of Health and Human Services (HHS). The change was also supported by the DEA’s own evaluation. The final rule goes into effect in early October 2014.
For the millions of patients who rely on hydrocodone-based drugs such as Vicodin or Lortab for relief from severe pain, the new rules will sharply reduce how many pills a doctor can prescribe for them at one time, according to USA Today. Prior to the change, doctors could prescribe a six-month supply with up to five refills, but they will now be limited to a three-month supply under schedule II. Doctors will also need to write those prescriptions in 30-day increments that can only be filled sequentially. This means patients using prescription pain meds will have to visit their doctor every three months for a new prescription. The change will affect manufacturers and pharmacies too, requiring tighter security and added recordkeeping.
The ABCs of HCPs
Hydrocodone Combination Products are drugs that contain both hydrocodone, which by itself is a Schedule II drug, and specified amounts of other substances, such as acetaminophen or aspirin. These include opioid painkillers like codeine, oxycodone and morphine. Hydrocodone-based prescription meds are big business, and while they help many, their popularity has also led to rampant abuse.
Hydrocodone, oxycodone and morphine fall into a category of painkillers known as opiates because they are chemically similar to opium. They are extremely powerful and can create a physical dependence. Users who try to stop can suffer intense withdrawal symptoms, from muddled thinking to stomach cramps, heart palpitations and nausea.
How Drugs Are Classified
All drugs are not created equal. The Controlled Substances Act (CSA) places substances with accepted medical uses into one of four schedules, with the substances with the highest potential for harm and abuse being placed in Schedule II, and substances with progressively less potential for harm and abuse being placed in Schedules III through V. You might be asking why the most dangerous or potent medications aren’t categorized as Schedule I, but it turns out that designation is reserved for those controlled substances with no currently accepted medical use and lack of accepted safety for use (LSD and heroin fit in this category).
Substances placed under the control of the CSA since it was passed by Congress in 1970 are scheduled or rescheduled by the DEA, as required by the CSA and its implementing regulations, found in Title 21 of the Code of Federal Regulations. Scheduling or rescheduling of a substance can be initiated by the DEA, by the HHS Assistant Secretary of Health or on the petition of any interested party.
When Congress passed the CSA in 1970, it placed HCPs in Schedule III even though it had placed hydrocodone itself in Schedule II. The rescheduling of HCPs was initiated by a petition from a physician in 1999. The DEA submitted a request to HHS for a scientific and medical evaluation of HCPs and a scheduling recommendation. Current analysis of HCPs by HHS and the DEA showed the high potential these drugs have for abuse that can lead to severe psychological or physical dependence.
The Problem of Hydrocodone Abuse
Opiate painkillers are among the most abused prescription medicines in the US, DEA Administrator Michele Leonhart said in a statement. Adding non-narcotic drugs such as aspirin to narcotic painkillers doesn’t make them less addictive, according to Leonhart.
Today, Americans are taking more prescription medications than ever, with nearly 16 million prescriptions written for painkillers like hydrocodone, oxycodone and tramadol each year, according to IMS Health.
The “Monitoring the Future” surveys, compiled by the National Institute on Drug Abuse (NIDA), looked at 8th, 10th, and 12th graders from 2002 to 2011, finding that twice as many high school seniors used the HCP Vicodin non-medically as used the more tightly controlled OxyContin, a Schedule II substance.
Opioids have become popular targets of abuse because extended-release opiate pills can be crushed to produce an increased high. As a result, many drug companies are working to develop tamper-resistant technologies to combat abuse.
Getting Help
If you or a loved one is struggling with opioid abuse, call us today. We’re available 24 hours a day, seven days a week and can provide information on treatment programs, help with insurance and answer questions about the treatment process.