In a recent final ruling the DEA chose to move hydrocodone combination products from schedule III to schedule II. Hydrocodone products are a type of narcotic painkiller that is commonly prescribed to patients recovering from surgery or experiencing chronic pain.
Although hydrocodone may be useful in the treatment of pain, it is one of the most prescribed opioids in the U.S. and has contributed significantly to the problem of opioid abuse and misuse. The DEA is hoping to curb some of this abuse by rescheduling hydrocodone products like Anexsia, Lorcet and Vicodin which can easily become addictive.
The move from schedule III to schedule II means these drugs will be more restricted and difficult to obtain. The new restrictions should help deter people from using excessive amounts of hydrocodone for nonmedical reasons and also work to reduce addiction to prescription painkillers.
The Decision for Rescheduling
The abuse of hydrocodone painkillers has been an issue for some time as the number of people addicted to these kinds of drugs continues to grow in the U.S. After a scientific review, the FDA made the recommendation in December 2013 that the DEA take a step toward reducing abuse of hydrocodone by moving it to schedule II.
The FDA concluded through their review that hydrocodone products meet the criteria for control under schedule II of the Controlled Substances Act. After considering the move, the DEA made the final rule in October of this year to reschedule the drugs and help limit the risks of potentially addictive prescription painkillers.
The difference between schedule II and schedule III is related to how addictive a drug is considered. Schedule III drugs have less potential for abuse and addiction than schedule I or II drugs and have a useful medical purpose.
Schedule II drugs still have a useful medical purpose but have more of a risk of a patient developing addiction. Drugs like morphine are currently classified as schedule II.
Changes in Access to Hydrocodone
The change for hydrocodone not only puts the drug in a new classification but also changes the restrictions on how patients can obtain their medication. As a schedule II drug it will be a bit more difficult for patients to easily get a refill of their hydrocodone products.
They will no longer be able to quickly phone in or fax requests for refills and their doctor will have to issue them a new prescription if they need more of the medication. If there is an emergency then a small supply can be provided until they receive a new prescription.
Patients will have access to a reasonable amount of medication with up to a 30 day supply but if they require any additional medication they will no longer be able to obtain a refill. The FDA concluded that these restrictions were necessary after reviewing hydrocodone's potential for abuse, its liability to cause physical or mental dependence, and the dangers it might pose to public health.
The Department of Health and Human Services or HHS recommended both rescheduling for hydrocodone as well as other actions to target abuse prevention. They identified a need to work with prescribers and patients to ensure that patients are given the right number of doses of hydrocodone to avoid any unused medication that might be abused.
The HHS also plans to continue monitoring the use and abuse of hydrocodone products following the rescheduling to assess the impact of the change on public health. The DEA and the FDA want to allow continued access to these kinds of drugs for those that have a legitimate need for painkillers while balancing the risk of abuse and misuse.