Last Friday, the Food and Drug Administration (FDA) voted to increase restrictions on prescription drugs that contain hydrocodone (such as Vicodin).
Such drugs are now listed as schedule II controlled substances. The purpose of the decision is to decrease drug abuse by making the drug more difficult for addicts to attain.
If a drug becomes a schedule II drug then it can only be prescribed by hand written prescriptions. No phone calls, no fax, no E-prescribe. Therefore, if you have pain and call your doctor outside of business hours, the only option is to go to the ER.
If you leave town and forget your pain meds you are out of luck and will have to go to an ER. This decision will undoubtedly impact healthcare costs.
Dr. Silverman Comments
You don’t effect positive change by tying doctors’ hands. Regulation of already legal and appropriate behavior as an attempt to stop the illegal behavior is unwise.
There are many opioid drug related deaths a year but so few from Vicodin. Oxycodone (a pure drug with no Tylenol) and Methadone (the government’s own free narcotic for addicts) are responsible for the majority of deaths.
Why would the FDA panel recommend schedule II status for Vicodin? This is typical bureaucratic behavior cloaked in symbolic gesture. When the math is done the FDA will declare a massive success as they will have dropped the percentages of:
- New addicts
- Deaths from overdose
- Fraudulent prescriptions of all of the schedule II drugs
This type of governmental bureaucratic behavior is abhorrent. It does little to change the trends and will cost the system millions of dollars that should be spent treating addiction. When will our enforcement mentality change? If 10 percent of the cost of implementing this change were applied to treatment, can you imagine the number of addicts we could help?
I prescribe schedule II narcotics regularly for post-op pain control. I understand the addictive potential and I am crystal clear with my patients about it. I will not give refills. Instead, I instruct my staff to call in a prescription one time for Vicodin if they still have residual pain to help them wean off the stronger drugs. Now it looks like my patients will have to drive hundreds of miles across the state for that 30 pill Rx that I have made part of the weaning routine.
This is terrible decision. The public has no idea what they are in store for in terms of care delivery.
Related Sources:
Nytimes.com