Newsbrief:
DEA
Moving
to
Restrict
Vicodin
2/20/04
How's this for a Valentine's Day present for America's tens of millions of pain sufferers? The Washington Post reported February 14 that the Drug Enforcement Administration (DEA) wants to make it more difficult for them to get access to some of the most commonly prescribed opioid pain relievers. The agency is plotting a move against hydrocodone, with plans to move the drug, commonly sold as Vicodin, Lortab, and more than 200 generic brands, from the Controlled Substances Act's Schedule III to the much more restrictive Schedule II. "Hydrocodone is one of the most abused drugs in the nation," said Christine Sannerud, deputy chief of the drug and chemical evaluation section of the DEA. "The agency thinks it would be wise to move it to Schedule II, because that would help a lot in terms of reducing abuse and trafficking," she told the Post. If hydrocodone is one of the most abused drugs, it may be because it is one of the most widely prescribed. Last year, it was prescribed more than 100 million times to millions of patients who use it to treat pain from arthritis, AIDS, cancer, and a variety of chronic conditions. The DEA cites a 50% increase in emergency room mentions of hydrocodone in the last five years, but that increase has been coupled with a 25% increase in the number of prescriptions written. And with 118,000 mentions in 2002's Drug Abuse Warning Network (DAWN) numbers, hydrocodone accounted for only half the mentions that simple analgesics like aspirin did. The move is part of the DEA's larger effort to crack down on opioid prescribing, which has so far focused on persecuting Oxycontin and prosecuting physicians, especially pain management specialists, it accuses of overprescribing it. Now, the agency wants to treat Vicodin as restrictively as it treats Oxycontin. The impact of reclassifying doing so would be dramatic. Because Schedule II drugs cannot be refilled, patients would have to visit their doctors more often. Likewise, doctors could no longer phone in prescriptions and would face greater penalties if accusing of improper prescribing, while pharmacists would have to do significantly more paperwork and keep the drug in a safe. The move has drawn criticism from pain patient advocates and health care professionals. "Rescheduling the drug will bring more hoops and barriers to getting access to the drugs, and it may prevent some minimal amount of abuse," said Richard Payne, president of the American Pain Society. "But my concern is that it will come at the cost of denying access to thousands of patients," he told the Post. Susan Winkler of the American Pharmacists Association warned of "ripple effects" if hydrocodone is rescheduled. "Our members and doctors would have increased liability if [hydrocodones] are rescheduled, and that will inevitably reduce prescribing," she said. "We urge the DEA to make sure their decision is based on science and will make the situation better, not worse." And John T. Farrar, a pain specialist at the University of Pennsylvania and consultant to the FDA advisory panel on analgesics, told the Post restricting doctors' ability to phone in prescriptions would hurt patient care. "There's really no substitute that doctors would be allowed to call in," Farrar said. "That means many patients would probably be getting other Schedule III drugs that are less effective for their pain, while drug abusers will just find another source." Visit http://www.PainReliefNetwork.org -- the newly redesigned and expanded web site of the Pain Relief Network -- for extensive information on this issue and to learn about the upcoming pain patient "March on Washington.
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