Pubdate: Tue, 14 Oct 2014
Source: Express-Times, The (PA)
Copyright: 2014 The Express-Times


Have you ever been in pain? Real pain?

Then you probably winced a bit when you learned that the federal
government has placed hydrocodone, the most prescribed drug in the
United States, on a higher shelf at the pharmacy.

Starting last week, hydrocodone in combination with acetaminophen --
known familiarly as Vicodin, Norco, Lorcet and other trade names --
was bumped from Schedule III to Schedule II by the Drug Enforcement
Administration, on equal footing with morphine and oxycodone.

That means it should be harder for addicts and abusers to go
"doctor-shopping" for this drug, and that's a good thing. Drug stores
will have to cope with a higher level of regulation. Patients needing
relief from chronic pain will have to make more trips to the doctor
for prescriptions, a hardship for some, and that in turn will pass
along higher costs to Medicare, other insurance plans and
out-of-pocket payers.

That's not such a good thing. Not for people who live in a cycle of
acute pain to drug-induced relief and back again.

Under the new rules, doctors won't be able to order refills for
hydrocodone products, and the maximum amount will be a 90-day supply,
down from six months. No phone-in prescriptions, either. The break-in
period for these changes seems certain to create software and
regulatory headaches for pharmacists, and some stores may refuse to
fill prescriptions until things are cleared up.

Physicians and pharmacists will have cope, though, because there's no
going back. Morbid statistics make the case for tougher regulation. A
report in the Journal of the American Medical Association found that
43 percent of the 38,329 drug overdoses in reported in 2010 were
attributed to opioid pain relievers, and the numbers are on a
year-to-year ascent.

Criminal and professional regulation is a tug-of-war with no
foreseeable end. As soon as the Food and Drug Administration and the
DEA agreed on tougher rules for hydrocodone, the FDA also approved a
new drug, Zohydro, a form of hydrocodone minus the acetaminophen,
which can can cause liver damage with overuse.

Until the miracle palliative arrives with no addictive qualities and
no high, we'll be be dealing with people falling into addiction, which
has the side effect of fueling the black market for prescription drugs
and replacement street drugs, such as heroin.

The hope is that doctors will stop overprescribing opioid painkillers,
and that people in chronic need, with a doctor's guidance, will be
able to transition to less powerful, non-addictive drugs.

That's the view from the feds, anyway. An aging generation of
Americans will put the demand for pain relief to the test.
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