Over two-thirds of healthcare practitioners in a new survey believe the rescheduling of hydrocodone will reduce access to the painkillers for a large number of patients with legitimate pain conditions.
Over half also believe hydrocodone rescheduling will lead to the increased use of other drugs that are less appropriate, according to the survey conducted by Pain Insights, a New Jersey based marketing and research company that specializes in pain management.
“It was a mixed picture regarding potential benefits and concerns,” said Bill Kolek, President of Pain Insights. “There was a concern expressed regarding balance, an effort to maintain appropriate access to appropriate pain management while guarding against inappropriate use.”
Hydrocodone combination products (HCPs) were rescheduled on October 6th by the U.S. Drug Enforcement Administration from a Schedule III medication to a more restrictive Schedule II.
The rescheduling made the drugs harder to obtain. It limits patients to an initial 90-day supply and requires them to see a doctor for a new prescription each time they need a 30-day refill. Prescriptions for Schedule II drugs also cannot be phoned or faxed in by physicians.
About 130 million prescriptions were being written annually for HCPs – the most widely prescribed drug is the U.S. — which the DEA calls “some of the most addictive and potentially dangerous prescription medications available.”
Pain Insights’ online survey of 236 healthcare practitioners — all of them prescribers of hydrocodone — was conducted in July and August, before the rescheduling took effect. The findings revealed a very mixed reaction to the DEA’s crackdown on hydrocodone prescribing and its possible effect on patients.
- 68% believe rescheduling will reduce access to hydrocodone for legitimate pain patients
- 64% said the rescheduling was likely to have a negative impact on legitimate pain patients in lower socioeconomic status
- 61% said it was likely that rescheduling hydrocodone would result in the increased use of drugs that are less appropriate
- 58% think rescheduling will burden patients and put pressure on practitioner time
“There was a concern about resources constraints. We know primary care physicians, pain patients can take a lot of their time and rightly so, regarding initial assessments and follow-ups. Because Schedule II requires more visits, it can put a burden on the time in the office and also there is potential cost to the patient and logistical concerns with increased visits,” Kolek told National Pain Report.
But while there was concern about the “burden” that rescheduling placed on patients and physicians, most practitioners agreed that rescheduling would help reduce drug diversion and overprescribing.
- 70% said rescheduling would promote better monitoring of patients that are prescribed hydrocodone
- 62% believe rescheduling would result in more appropriate patient selection for hydrocodone
- 58% said rescheduling is likely to lead to a reduction in opioid diversion
- 46% believe rescheduling is likely lead to a decrease in opioid related deaths
When asked how rescheduling would change their prescribing practices, Kolek said many practitioners indicated it would have a “significant potential impact” on their prescribing of hydrocodone. Some said they would only prescribe Schedule III medications or over-the-counter pain relievers. A small number said they might prescribe Zohydro, a new extended release version of hydrocodone that is already classified as a Schedule II drug.