DEA places more restrictions on hydrocodone

By DeeAnna Haney | Sep 03, 2014

The federal government has further restricted one of the most widely prescribed and highly abused drugs in the nation. The change was in response to a national epidemic of overdose deaths as a result of prescription painkillers.

The Drug Enforcement Administration recently announced the rescheduling of hydrocodone combination products such as Vicodin from a schedule III to schedule II drug in the Controlled Substances Act.

The act classifies drugs into one of five schedules based on the drug's potential for abuse and the degree of dependence it may cause. Schedule V controlled substances such as cough suppressants, are considered the lowest potential for abuse. Schedule I controlled substances, such as heroin, are considered the highest potential for abuse.

Other drugs that fall into the category of Schedule II include cocaine, meth, oxycodone and more.

The new rule limits patients to one 90-day supply of the medication and refills can no longer be made by simply calling the doctor. The prescription must be made through an in-person visit with a healthcare professional.

Most hydrocodone drugs such as Vicodin and Lortab also contain Tylenol or acetaminophen, making them easier to prescribe than other opioids. Hydrocodone combination pills have been considered Schedule III controlled substances since the Controlled Substances Act was passed in 1970, though hydrocodone itself was Schedule II. Under that rule, such medications could be refilled five times before the patient even had to see a healthcare professional again.

“Almost seven million Americans abuse controlled-substance prescription medications, including opioid painkillers, resulting in more deaths from prescription drug overdoses than auto accidents,” said DEA Administrator Michele Leonhart when the DEA made the announcement. “Today’s action recognizes that these products are some of the most addictive and potentially dangerous prescription medications available.”

The law has not come without controversy, however. Many, particularly in the pharmacy community, oppose the move, citing pain medication access barriers for those who need it most.

The American Society of Consultant Pharmacists released a statement expressing its disappointment that the DEA did not consider the negative impact the change could have on patients in post acute and long-term care settings.

"Our members are very concerned or what this could mean for frail, elderly patients with chronic pain," said Ross Brickley, current chairman of the ASCP's DEA Task Force.

The change is good news to local law enforcement who see the scourge prescription pill overdoses has had on Haywood County, with one in four deaths investigated by the medical examiner are found to be a result of prescription painkillers.

"We feel like it's going to cut down on the abuse of the drug because it's going to be harder to obtain," said Waynesville Police Chief Bill Hollingsed.

While most people think of driving while impaired as drunk driving, it just as often involves people driving while under the influence of prescription pain medications.

"An opiate is the opposite of a stimulant. It's gong to impair a driver's ability to make quick decisions. Impairment with opiates is not unlike impairment of alcohol or any other depressant," said Hollingsed.

About one-third of the driving while impaired cases in Haywood County involve prescription pain pills, and it's a major focus of the state Impaired Driving Task Force, of which Hollingsed is a member.

"It's the fastest increasing category of impairment in the entire state," he said.

That's because people assume it's OK to drive under the influence of prescription pain medication as long as they have a legal prescription, but that's not the case.

"It's illegal to drive impaired under any substance. I can legally possess a bottle of liquor, but that doesn't give me the right to drink that and get behind the wheel and drive down the street. If an impaired person crosses the center line and hits a family of five in a mini van, it doesn't matter if they are impaired on alcohol or prescription drugs. The end results are the same," said Hollingsed.

It's illegal for a person to drive with a blood alcohol level of .08 or greater. But there is currently not a law that states how much prescription or illicit drug must be in a person's system before they are considered impaired.

Police officers are now being trained to identify the signs of a person who is under the influence of pain medications and a blood sample can be sent to the lab in Raleigh can identify the impairing substance.

"A person could blow a .00 and still be impaired behind the wheel," sad Hollingsed.

However wait times on those blood samples can take several months. The state driving while impaired task force hopes the state will soon allow officers to administer a roadside swab as a presumptive test to determine if a driver is under the influence of illicit or prescription drugs, he said.

The next step will be to bring state statutes up to date with the new federal law regarding the drugs. Though the law is now stricter federally, the state still classifies hydrocodone products as Schedule III.

Hollingsed said he hopes state legislators will support the effort to make the change in state law.

"What we need to do now is make sure that our state statutes coincide with federal statutes on the scheduling of these drugs, in particular hydrocodone and Tramadol, because that does affect what the individual is charged with and also the penalty if found guilty of selling or otherwise abusing these drugs," he said.

Congressman Mark Meadows said Hollingsed has played a large role in bringing issues regarding prescription drug abuse to light in Washington D.C. He agrees that the state laws should be updated.

"Obviously they need to be hand in hand. That way we don't have any ambiguity in terms of enforcement," Meadows said.

Sen. Jim Davis said while changing the state law to conform to federal regulatory changes may not be a main priority in the upcoming legislative session, he does want to see those laws improved.

"Law enforcement tells me it's going to give them a lot more help in controlling the problem and it seems to be a big issue for them. I'm dedicated to do whatever I can to help them in this battle," Davis said.

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