Chronic Pain — 25 January 2013

imagesBy Pat Anson, Editor

An advisory panel for the Food and Drug Administration has recommended tighter controls on Vicodin and other hydrocodone products, the most widely used and abused narcotic painkiller in the U.S.

The FDA panel of drug safety experts voted 19-10 in favor of reclassifying hydrocodone from a Schedule III controlled substance to a Schedule II drug, which will make it harder for pain patients to obtain or get refills for. The FDA usually follows the recommendations of its advisory panels.

“We will pay close attention to everything we’ve heard as we proceed,” FDA deputy director Douglas Throckmorton told the panel at the end of two days of hearings. “There is an unquestioned epidemic of opioid abuse, overdose and death in this country, an epidemic we need to address as a society,”

Reclassification of hydrocodone was rejected by the FDA in 2008, but the Drug Enforcement Agency asked the agency to reconsider because of rising rates of hydrocodone abuse. In 2008, federal health officials say 89,000 people went to hospital emergency rooms after overdosing on hydrocodone. By 2010, the number had grown to over 115,000, according to the Substance Abuse and Mental Health Services Administration.

“I don’t think reclassification is a panacea for the opioid abuse problem in this country, but I think it’s an important step to get doctors to rethink their prescribing practices,” said Mary Ellen Olbrisch, an advisory panel member and professor at Virginia Commonwealth University who voted for the reclassification.

Hydrocodone is often combined with other pain relievers such as acetaminophen and aspirin to make combination products like Vicodin. In 2011, U.S. doctors wrote over 131 million prescriptions for hydrocodone products, making it the most prescribed drug in the country.

As a Schedule III drug, a 30-day prescription for Vicodin can be refilled five times before a patient has to see a physician again. If hydrocodone is reclassified, a doctor could only write a single 30-day prescription for Vicodin. No refills will be allowed unless a patient sees a doctor again and a new prescription is written. The drug could also not be prescribed by nurses and physician assistants.

“Rescheduling the products to Schedule II would create significant hardships for all — leading to delayed access for vulnerable patients with legitimate chronic pain,” the National Community Pharmacists Association said in a statement.

According to the Centers for Disease Control and Prevention, opioid painkillers, such as Vicodin and OxyContin, cause 75% of prescription drug overdoses. Painkiller abuse and addiction is common and there is a lucrative black market for the drugs. At the same time, however, there are 100 million Americans who suffer from chronic pain who obtain the drugs legally through prescriptions. For many, life would be difficult, if not impossible, without access to opioid medicines.


About Author

Pat Anson, Editor

Pat is Editor in Chief of American News Report. He is a veteran journalist and a former correspondent and producer for HealthWeek (PBS), Nightly Business Report (PBS) and other nationally syndicated shows. Pat has won numerous journalism awards, including a Golden Mike award for investigative reporting.

(8) Readers Comments

  1. This will cause more harm than good if a doctor or dentist can not pick up the phone to call in a 2 or 3 day supply of hydrocodone for emergency purposes.
    There is no easy fix to this, seems this thing on opioids is being made worse by reporters and the media blowing things out of proportion.
    We cant save a drug addict from themselves, this is the life they choose, lets not make innocent pain sufferers pay the price, their life has already been torn to pieces.

    Mark S. Barletta

    BECAUSE THEY ARE BEING WATCHED! THEY ARE SCARED; THEY ARE BEING TREATED LIKE CRIMINALS! AND they do not want to lose the license they all worked so hard for!
    Is not that they can prescribe, is that they don’t want to anymore with all the restrictions, regulations, and finger pointing they are getting!!! Now with your so called PROP even more of the responsibility is on them.
    AS IT IS WITH ALL THIS DEA issues violating HIPPA regulations, having access to our medical records, prescription history, etc. Doctors and patients being “watched” by DEA, and treating both Doctors AND patients as criminals!
    What we are saying is: all that already making it almost impossible to get our medications that allow us to have a better quality of life. Now THIS!
    Do you really want to stop kids from dying of an overdose? Well, then keep a closer eye on what your kids are doing when you are not around! Talk to them! Be their friend!
    Do you ready want to get a “WAR on Drugs” going? Well, go and chase the Drug Cartels!
    How about having DEA going after them instead of us and our doctors!
    OH! That’s right. I forgot it is easier to go after the weaker right? It is also more profitable given that we all know how corrupt the “system” is.
    So you go after the “small guy”; the patients, the doctors, the pharmacists.
    Drug Cartels won’t hesitate getting anybody’s heads chopped: DEA, Law enforcement, or anyone getting in their way. So, we pay the price!

  3. I will thank you for mentioning the numbers of Chronic Pain Patients and the fact that it has already become extremely hard for for them to get their prescriptions filled, however, it sure would be great to see MORE published about this current nightmare Legitimate Chronic Pain Pain Patients have been thrust into since changes in state laws across the nation have been enacted. No provisions have been made, Doctors are in fear of doing the “wrong” thing, Pharmacist are in fear, as are many Pharmacies. You would not believe the stories that are coming from the population of chronic pain patients. The huge number of people dealing with debilitating, crippling conditions and diseases who will never improve are being forced to drive around for hours and hours trying to find a pharmacy and pharmacist who stocks or will fill their legal prescriptions. These are people who previously used the same physician for years and used the same pharmacies for years are being shoved and passed on because NO ONE knows what the right or wrong thing is. If this change happens they will be even more afraid and will result in more confusion, and again the ones who end up truly suffering are the pain patients. Who is listening to the patients? The elderly, the service men and woman and others who live every day in pain? Who is listening and considering what is best for them in the long run while these organizations and lawmakers play with their lives? I can only see nursing home placements increasing and suicides increasing particularly in the elderly population and even in younger people as part of the mess that has been created. I am not being dramatic here either this is the reality of those who hurt. Will life be worth hanging around for when you can’t function in a somewhat normal fashion? This is a realistic out come of what has already happened. Please help open the eyes of those who can not see.

  4. My pain dr has been following these rules for at least 3 years already…also with random drug testing and a contract. Not a big deal if you’re not abusing

  5. totally unreasonable.. for those with chronic pain, it is already difficult to get pain meds, If this passes, it makes it nearly impossible for those who absolutely need it to just be able to get up to get dressed, laundry etc.. . My husband has fibromyalgia, doesn’t abuse his prescriptions. He has to be in tears almost to take his, because he knows how hard it is to get more.. Tell me that’s fair!! Same thing with cold meds. I shop once a month. Have a family of 4, so when one gets a cold I go get Sudafed, cause that’s all that works.. but I can only get one box at a time. BS>> instead because of lowlifes who abuse system, and do illegal things, I /WE SUFFER>> Tired of the criminals changing life for the normal person..

  6. F**K NO! it’s already near impossible for suffering patients in need to get these meds! FK YOU FDA!

  7. Let’s do Doctors do their job. Obviously they know way more about meds than DEA does. This is unbelievable! So, DEA wants to clasified Vidodin (hydrocodone) the same as Methadone a class II ????…That’s like saying Wisky and beer are the same!!( aS far as strenght goes) , I am so fed up with DEA Stepping into our health issues!!. SERIOURSLY DEA!! Do you really really want to go after the criminal!??? Well then go straight after the DRUG CARTELS!!! That way the ones that truly do the crime, lie about, hire people to act as patients, etc etc et To put the drug on the BLACK MARKET actually have a hard time to get this meds whuch they look aT AS ONLY BUSINESS, BUT for us legitimate patients our meds mean a better quality of life. Means being able to move with less pain so that we can take a shower, clean the house,to take care of our children, work etc without being in excrutiating pain!!. Now, what does DEA DOESN’t do that!? Go after the Drug Cartels??? Oh! Right I just remembered why maybe it’s because Drug Cartel don’t mess around and wouldn’t mind chopping your heads off!!! Is that why??? … Nice job! Chicken much???

  8. This is not fair to those of us who live with Chronic pain. I have Osteoarthritis, a broken vertebrae and Fibromyalgia, sometimes when the non narcotic pain meds are not taking away the pain, I need the Hydrocodone. It is the people who abuse this drug, who make it very tough on those of us who really gain some relief from this prescription.