As of last week, the Drug Enforcement Agency changed medicines containing the popular painkiller hydrocodone from a Schedule III to a more tightly controlled Schedule II drug, putting it in the same class as similar medicines like Demerol, OxyContin and Percocet.
For patients using the widely distributed medicine, that means doctors will no longer be able to call in those prescriptions to pharmacies or include automatic refills without a predetermined date in a single perception.
It’s been widely reported the change would require patients to see a doctor before a prescription could be refilled, but Special Agent Matt Barden with the DEA said that’s not the case.
“The DEA allows for certain provisions, which are up to the doctors, care providers and pharmacies,” he said. “Doctors can write and can issue 30-day prescriptions, but they can also issue prescriptions for up to 90 days.”
Barden said the 90-day prescriptions would essentially be three 30-day prescriptions, but the subsequent refills wouldn’t be available until a certain date.
“When you get somebody that has to travel 75 or 80 miles to see a doctor just to get a prescription and they’re on a fixed income, that’s tough,” Barden said. “(This) puts the emphasis on the doctors and the care providers, because they have to kind of manage their patients and be more aware and more diligent in whether or not somebody needs these medications.”
The decision was aimed at curbing the increasing trend of abuse of hydrocodone — sometimes known as Loratab or Narco — which law enforcement officials say is one of the country’s most widely abused prescription drugs.
According to the Centers for Disease Control, nearly 20,000 people die each year from abusing prescription painkillers.
Statistics like those are why the DEA made the change in hydrocodone’s schedule, but Barden said there’s been a big misconception that the agency acted in insolation to do so.
“This change has been in the works for 15 years,” Barden said. “This was based upon the request of doctors who, in 1999, started seeing the growing abuse of the medication when it was Schedule III.”
Because of the high rate of abuse, Barden said doctors and addiction specialists have been requesting the U.S. Food and Drug Administration to address the issue for years.
“The FDA made the recommendation to the DEA, and it’s our responsibility to reschedule controlled substances,” he said. “This decision was made with a lot of thought and a lot of investigation and at the end of the day, nobody is not going to get their medicine.”
Barden said people with chronic pain such as those with arthritis and disabled veterans use the medication as part of their daily life and truly need it, but acknowledged people with legitimate aliments have suffered because of the medicine’s high rate of abuse.
According to Barden, the DEA estimates that 7 million Americans abuse pharmaceutical medications, with opioid painkillers making up a large percentage of those.
Hydrocodone Combination Products or HCPs are also the highest prescribed medication in the country. In 2012 alone, more than 125 million prescriptions were written for the drugs.
The Substance Abuse and Mental Health Services Administration is a federal agency that, among other tasks, collects and monitors data about drug abuse in the United States.
According to its 2013 National Survey on Drug Use and Health, 4.5 million Americans have admitted abusing pain medication on more than one occasion.
Those figures are further broken down to show that the highest rate of abuse tends to be among respondents ages 26-34. The same report also shows the South as the geographic area with the most reports of nonmedical abuse of prescription painkillers. Second only to the West, the South showed twice as many reports of abuse as both the Northeast and Midwest regions, according to the NSDUH.
The Mobile Bay area is no stranger to abuse of these medications. In recent months, high profile cases in Fairhope and Mobile have resulted in the arrests of pharmacists and physicians accused of prescribing and selling painkillers illegally.
That’s one reason the Mobile County Sheriff’s Office recently created a database to show what type of prescription drug related arrests are made, because according to Sgt. Johnny Thornton, those have previously been documented only as a “possession of a controlled substance” charge.
“We are starting to document the details of any arrest involving prescription drugs and include the type of drug, whether it’s a possession or distribution charge, how many pills are involved and their street value,” Thornton said. “When we target individuals, we will run into large quantities that are being distributed. It’s like a whole subculture.”
After collecting data over the next six months, the department is hoping to have a better picture of what medicines are being sold and abused — though Thornton did say Narcos and OxyContin are the usually the most common in the area.
According to Thornton, hydrocodone pills are typically valued at $5 to $10 each depending on the milligrams in the medicine and the quantity of pills being sold. He also said typical prescriptions range from 15 to 18 pills.
However, Thornton said the department has seen perceptions as high as 360 and has busted illegal dealers with hundreds of pills in their possession.
He did say the MCSO typically turns over cases involving doctors and pharmacists to the FBI or DEA, because “they follow another set of rules” and are typically more intense in prosecutions.
Despite increasing difficulty of obtaining hydrocodone illegally, Thornton said the schedule change wouldn’t make the penalties for those caught distributing or using the pills any more severe.
“It’s still a controlled substance charge, and we still have sentencing guidelines regardless of the schedule,” he said. “ On certain Schedule I drugs, it only takes four grams to be considered trafficking. With these, they’re not going to have a trafficking charge associated with them.”