Hydrocodone Combination Drugs

There is a drug abuse epidemic here in America. The Centers for Disease Control and Prevention (CDC) has drug overdose listed as the leading cause of death by injury since 2011. The most common drugs Americans overdose on are prescription opioids, like with hydrocodone combination drugs.

Hydrocodone is an opioid which is found in painkillers like Vicodin, Lortab, Vicoprofen, and Zohydro. Most drugs containing hydrocodone are mixed with something else, like acetaminophen (also known as Tylenol) or aspirin. These are often referred to as hydrocodone combination drugs.

Hydrocodone Combination Drugs Classification

Pure hydrocodone is classified by the Drug Enforcement Administration (DEA) as a Schedule II drug. This means that it has a high potential for abuse, with use potentially leading to severe psychological or physical dependence. A Schedule II drug is considered potentially dangerous to the user.

Drug preparations which contain both another drug (like aspirin) and less than 15 milligrams of hydrocodone per pill have been listed under Schedule III by the DEA. This drug classification states that the drug has a moderate to low potential for physical and psychological abuse and that the hydrocodone abuse potential is lower than that of a Schedule II drug.

Because a Schedule II drug is considered more likely to cause addiction, prescribers are required to follow much more stringent rules when prescribing it than when prescribing a Schedule III drug. For example, OxyContin (oxycodone) is a Schedule II drug and Vicodin (hydrocodone and acetaminophen) is currently listed as a Schedule III drug. Here are a few of the differences a patient faces when attempting to obtain and refill a prescription:

  • Obtaining a bottle of Vicodin is fairly easy. The doctor can call the pharmacy and tell them they are sending their patient over for some Vicodin. The doctor also has the option of faxing in a prescription. These are both valid methods of prescribing a Schedule III drug.
  • Obtaining a bottle of “Oxy” requires the patient walking into the pharmacy with a written prescription. There are no “refills” for a Schedule II drug like OxyContin; specifically, a doctor has the option to write a series of prescriptions that are dated on the same day with a “do not fill until…” notation. This can be done for up to a 90 day (3 month) supply. After the 90 days has been reached, the patient has to return to their doctor for re-evaluation and a new prescription. Vicodin doesn’t require this; when the prescription is first written or called in, the doctor can define how many refills the person may obtain.
  • Additionally, where only a doctor can prescribe Schedule II substances, a nurse or physician’s assistant is able to provide a prescription for a Schedule III drug.

These deliberate inconveniences are meant to discourage abuse, addiction, and illegal sale of the drugs obtained.

Tighter Restrictions Help Prevent Hydrocodone Abuse

According to a report published by the federal government, hydrocodone combination drugs (like Vicodin) will be moved from Schedule III to Schedule II effective October 6th, 2014. This act comes on the heels of a 49% increase in prescriptions in the last ten years for narcotic painkillers in emergency rooms across America.

Some states have suffered from prescription drug abuse and addiction more than others. For example, in 2011, Florida was known for its “Pill Mills.” These are pain clinics which prescribe painkillers like hydrocodone and oxycodone for just about any ailment – real or imaginary. At the height of pill mill distribution, prescription drug related deaths in the state of Florida alone were at 1,268 for 2011, effectively making prescription medication a bigger killer in Florida than illegal drugs.

However, recent drug abuse and overdose statistics are not what originally spurred this change in drug scheduling. Back in 1999, a petition requested that the DEA reschedule hydrocodone products. After much study and medical evaluation, the Department of Health and Human Services along with the DEA recommended to the Food and Drug Administration (FDA) that hydrocodone combination drugs be rescheduled to Schedule II. Years later, in 2013, an FDA advisory committee recommended this change.

Physicians for Responsible Opioid Prescribing, an advocacy group which has worked hard to get hydrocodone’s scheduling changed, had this say: “Had FDA responded in a timely and appropriate manner to DEA’s urgent request, thousands of overdose deaths and tens of thousands of cases of opioid addiction might have been prevented.”

Benefit for Pain Patients

This imminent change in drug scheduling can be perceived in two ways. One is that it’s inconvenient for a chronic pain patient (like someone with cancer) to visit a doctor every 90 days to obtain the same pills they have been using for an extended period of time.

However, this change may actually be a boon for pain patients. Statistics show that more painkillers than ever have been prescribed in emergency rooms during the last ten years – with very little increase in pain-related conditions reported. In some cases, treating a problem with a painkiller may mask a real medical condition.

By making it more inconvenient for a busy doctor to simply write a prescription and never see the patient again, it’s possible the person complaining of pain may receive a proper and more comprehensive examination which locates the disease or injury that is causing his or her pain. This is obviously a much more effective measure than receiving a prescription to a potentially addictive medication and leaving the condition one is suffering untreated.

There is also the hope that, by blocking access to these drugs, fewer addicts will be created and more addicts will seek treatment. Per a US government survey, the number of drug users in America has been on the rise over the last 10 years. In 2012 for example, 23.9 million Americans had recently abused a drug. Not surprisingly, 17% (over 4 million) was attributed to opioid painkillers.

Reducing these numbers could save thousands of people from addiction and death by overdose. With effective drug education, as well as comprehensive and broad scale detoxification and rehabilitation, millions of people can avoid the pitfalls of addiction and live drug-free lives.

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