Primary Care Physician
Dr. Orrange received her BA in Biology at the University of California, San Diego, and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health. She received her MD from the USC Keck School of…
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Preventing Prescription Drug Abuse: A Closer Look at Hydrocodone
Posted in Prescription an... by Dr. Sharon Orrange on May 07, 2013
Hydrocodone is the number one drug prescribed in this country for any reason. That should be astounding to you. Should we make it harder to get? That has been a discussion for years that heated up January 2013 when the FDA's Drug Safety and Risk Management Advisory Committee voted 19 to 10 in favor of reclassifying hydrocodone-containing drugs (Vicodin, Norco, Lortab as examples) from schedule III to schedule II drugs.

What does this mean? Rescheduling from schedule III to schedule II means you cannot receive refills of this drug without a new triplicate prescription written out by your doctor. Some schedule II drugs you may know include Oxycontin, Morphine, or Fentanyl patches.

There is no question a prescription for a schedule II drug is harder to get. Electronic prescribing, done by most physicians now, is not allowed for schedule II drugs so you have to visit your doc to get an actual triplicate prescription. Schedule II drugs are tracked more carefully so that if multiple doctors are prescribing it or patients are refilling them at different pharmacies we will know this. Refills are not allowed on schedule II drug prescriptions so you get thirty days at a time. Trust me this is a hassle for patients, pharmacists, and physicians…but is this what it will take to stop the overuse of these drugs?

Would rescheduling curb abuse? We have no idea. Many doctors feel the burden of refilling triplicate prescriptions for schedule II drugs is too much to handle in their practices and they may shy away from prescribing them at all. Does the burden of making hydrocodone a schedule II drug make us appreciate more how potent this medication is, and how we should take it more seriously than we do? The abuse and misuse of these medications in this county cannot be ignored, so will this kind of measure be effective in curbing this problem?

Weigh in.

- Dr. O

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7
Baloney. If they are only allowed to be refilled every 30 days, then why say on the bottle, take 1 every 6 hours 4 times a day? Does that bottle last 30 days, No it does not! I take the liquid hydrocodone and It only lasts me 30 days because I only take it once a day.
They have now changed the 7.5/500's to 325s so there is only half acetaminophen in it.
How stupid can be really be? Do they not know how to read the prescription? The directions are right on the bottle in black and white. Why overdose if you can read? I don't know what a "triplicate" prescription is, but my doctor calls in my prescription once a month. If only these drug addicts would leave the hydrocodone to people who truly need it, it would not have to be rescheduled to a class 2.
By respectful  Jan 24, 2014
6
I find it offensive that a doctor would not prescribe a medication to a patient in need because it is "inconvenient" for them. I think you just blew my pain docs cover, lol. Seriously, if we need the medication, doesn't the doctor have an obligation to treat the patient appropriately?

A friend recently told me about morphine ER, I have stenosis, inverted herniation affecting 4 discs, bulging discs in neck, herniations in lower; I'm a mess. I asked the doc about this instead of staying on hydrocodone. He gave some nonsensical explanation for not prescribing it. Maybe hassle is to blame. Why would a doctor want a patient to stay on hydrocodone when they have chronic and severe pain? It makes no sense to me.(BTW, I have done physical l and aqua therapy to full completion, walk, stretch; all that I am told).
Maybe you can explain it to me. Thank you for the article.
By jptexas  May 30, 2013
5
I don't think rescheduling is going to curb abuse. Those who are looking for a "high" from these types of medications are going to find it no matter what schedule you classify it under. If they can't buy the medications they seek from US sources then the drug cartels will (and probably already have) start selling them like they do heroin and cocaine and such, with the supply coming from other countries. Unlike pain medications, drugs like heroin and cocaine are illegal to possess in the US, but it is still sold and used in the US and will continue to be as long as there is enough demand for it to be profitable. As a chronic pain patient I understand the need for controls and oversight of medications like these, but it is ALWAYS the patients who truly need these medications that wind up having to pay the price in the end. I'm so tired of having to suffer because someone else makes a bad choice and then I (along with millions of others) have to suffer the "punishment".
By ShannonA  May 17, 2013
4
I know this is not politically correct these days, but the older I get, I'll take pills over tolerating hideous chronic pain ANYTIME, not matter HOW MUCH of a hassle it is. I'm SO over "You'll just have to live with it." BALONEY!!!

An ER physician once told my husband, "We have more medicine than you have pain, sir." Now THAT is what I consider to be a helpful attitude. Life is meant to be enjoyed, not just endured.
By madbookworm  May 11, 2013
3
Is hydrocodone a synthetic drug and related to codeine?
By promisegirlfarmgmail  May 09, 2013
2
One possible consequence would be an increase in the scripts for oxycodone and other Tylenol containing opiate drugs. My understanding is that hydrocodone is about .7 to .8 to 1 in effective pain control, meaning if there (and I know there is not) a 8 mg pill of oxycodone it would take a 10 mg pill of hydrocodone to achieve the same pain relief. Currently, hydrocodone scripts can be refilled and in my state called in or faxed to a pharmacy, i.e. much less time consuming for the medical provider and the patient and an incentive to substitute hydrocodone vs oxycodone. If made a Schedule II and pharmacy "A" doesn't have enough in quantity, the patient has to shop for one that does or not get the balance of the pills when the pharmacy's stock comes in, losing the remainder of the script. I suspect part of the reason for hydrocodone over oxycodone is convenience. If hydrocodone is made a Schedule II, look for more scripts for oxycodone and less for hydrocodone.
By EasyM  May 08, 2013
1
It is a hard question. Some of US NEED pain meds because we have legitimate pain issues. But pain or no pain, if taken long enough one will become technically addicted, there's NO ONE who could avoid that. so how does a person who really needs it deal with it to those who seek it and mis-use it? isn't it unfair to those who do need it? there must be some fine line that is acceptable between those of us who need it, and those who mis-use it.
By Triniti  May 07, 2013
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