New Rule for Hydrocodone Prescribing

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Those of you who take the prescription pain reliever hydrocodone (also prescribed and sold as Norco and Vicodin) are about to have a new experience in obtaining your medication.  If you are taking hydrocodone, it is likely because other alternatives have failed or have unacceptable side effects or risks. Effective October 6, 2014, these medications will move from Schedule 3 to Schedule 2 on the list of controlled substances.   This means that refills, faxed and telephoned prescriptions for this widely used analgesic will no longer be accepted.

Physicians will have only one option for prescribing hydrocodone:  a paper prescription with a “wet” signature (personally signed by the physician or mid-level prescriber) obtained at the doctor’s clinic and taken and presented to the pharmacy.  The impact on convenience and access to this medication for those who depend upon it for chronic pain management and do not abuse or divert it is obvious.

The laudable goal of this change is to address prescription drug abuse and overdoses.  But concern about the unintended consequences of this new Drug Enforcement Administration policy on legitimate prescribing and use has been set aside for the priority to curb abuse.  Other efforts to crack down on diversion (a good thing) have resulted in an increased use of heroin due to its lower cost and greater availability (clearly not a good thing).  Yet we do more of the same thing and expect a different result.

Your doctor and pharmacist did not ask for this policy.  In fact, most of us have objected individually and collectively through organizations like the AMA.  Our concerns have not been effective enough to convince the DEA to consider other approaches.

If your care is adversely impacted by this change, either by inconvenience or a change to other treatment that may be less beneficial with more risk, your complaint needs to be expressed to the government agencies whose good intentions are affecting your care.

Providers have no choice but to comply with the new rules, but no doubt will bear the brunt of the dissatisfaction.  We have tried; now it will be up to you.  You and your doctor will need to come up with a way to provide optimal care within this new requirement to avoid compromise in your care.