Proposal to Increase Restrictions on Opioid Prescribing Prompts Debate

A proposal by the Drug Enforcement Administration (DEA) to more tightly control prescriptions of drugs containing hydrocodone is prompting debate among doctors, according to NPR. A committee of the FDA will meet January 24 and 25 to consider the DEA’s request.

Emergency room visits related to hydrocodone, the key ingredient in Vicodin and other painkillers, have soared since 2000. Vicodin, which also contains acetaminophen, is subject to fewer regulations than pure hydrocodone.

For almost a decade, the DEA has called for stricter regulation of Vicodin, in order to reduce abuse of the drug. The DEA wants to change the way drugs that combine hydrocodone with other products are classified, to require patients to have more interaction with doctors in order to obtain prescriptions for them.

Andrew Kolodney, who leads Physicians for Responsible Opioid Prescribing, wants opioids to be used only for patients who really need them, such as cancer patients. “This epidemic has been fueled by overprescribing of opioids, particularly for chronic noncancer pain, whether it’s low back pain, headaches,” he told NPR. “I think that’s really created a public health crisis.”

His group wants the Food and Drug Administration to rewrite labels on opioids to state that physicians should write prescriptions only for severe pain, and at much lower doses. The group wants prescriptions for the drugs to be written for a maximum of 90 days at a time. “The way to begin to turn the epidemic around is by getting doctors to prescribe more cautiously,” Kolodney said.

Lynn Webster, President of the American Academy of Pain Medicine, is concerned these changes may prevent many patients from obtaining drugs they need. “We have millions of people who are totally disabled because of their pain,” he said. “Many people who do not have access to aggressive pain management may simply not be able to survive.”

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    January 27, 2013 at 8:12 PM

    I think you had a choice whether to get an over the counter med instead.
    As for me and thousands of others who deal with chronic pain everyday it should stay between the patient and the Dr. how much is needed. I’m able at this point in time to get a three month supply, so I don’t have to run back to my Dr. every month I’m hoping that will not change.

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    January 26, 2013 at 8:55 AM

    The truth is, people with chronic debilitating pain will be able to get their medications if the pain is documented and being followed by appropriate medical care. The idea that deserving people will be damaged because criminals and addicts are curbed is fear based and reactionary. So, we should continue to do nothing to address the increased addiction and criminal behaviors around us because someone, who is probably also technically addicted to their medications albeit necessary for quality of life, is afraid they might have to prove they are in real pain? No. Not logical.

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    Fred Brown

    January 25, 2013 at 6:16 PM

    I have been a chronic pain patient for well over 17 years. I have had 4 surgeries where the first two completely failed and the second two anatomically did what the surgeon set out to do but my pain became worse after the surgeries. In no way do I blame the doctor that did the last two operations, but this can and did happen. This brings me to today where each and every day I live in chronic pain but have made the decision to live life and “walk” away from any discomfort I am having, Thinking about it serves No purpose.

    I began a web site which is for the reason that patients or caregivers are able to express new ideas, alternatives to medication in some rare cases and a host of other possibilities and discussions.

    As to hearing that a dentist prescribed a specific drug for a post “Acute” procedure pain in my opinion is a good thing. Many physicians or dentists may not prescribe anything for post procedures or if they do sometimes it can be under medicated and not strong enough.

    In my experience, it seems very unusual that an insurance company would limit only to that classification of a drug. As to the parent being “livid” when the dentist office prescribed Vicodin, I assume that a limited number of pills were prescribed with No Refills on the prescription. If it was not prescribed this way, I would question it.

    One will NOT become either dependent or addicted to this medication under the protocol that I mentioned earlier for short term use. This could be very different if the individual has had a past history of drug use which would be diagnosed as “addition.”
    Fred Brown, Founder of

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    caryl mcmains

    January 23, 2013 at 3:21 PM

    Thank you for your insight.
    When a Dentist prescribed Vicoden to my 17 yr old after removing a wisdom tooth, I was livid. The nurse refused to issue anything else, because the insurance carrier is “FORCING” her to only prescribe Vicoden and only that. Which is NOT a severe chronic pain, so why do insurance companies force it?
    In this world of who owns who.. share holders, investors and parent companies are intertwined and Pharmaceuticals seem to rule. It makes you wonder who grows the poppies and who supports the growers, and Who is really making heroin possible on a large scale.
    This opiate has become widely abused among adults as well as high school students. Heroin is now also on the rise and has become the drug of choice for many who have become addicted. It’s an epidemic in hundreds of low and high income high schools across the United States.
    It’s time to, WAKE UP America! It’s time to, say NO! It’s time to, STOP handing it out like aspirin!
    STOP Insurance companies and medical industry from being irresponsible; hold them accountable for their actions.
    I think donating 2% of their annual billion dollar profits to State Department of Health Services, Rehabilitation Center is the least they should have to do!

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