Prescribers Say Hydrocodone Rescheduling Hurts Legitimate Pain Patients

Prescribers Say Hydrocodone Rescheduling Hurts Legitimate Pain Patients

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.”

Hydrocodonebtibu75200Hydrocodone 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.

Authored by: Pat Anson, Editor

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BL

A dr can write 3-30 day rxs at a time of a Schedule II med.. It is the drs choice to have patients come in every 30 days.

http://www.deadiversion.usdoj.gov/pubs/manuals/pract/appendices/app_b.htm

Cyril Coots

At $120 plus for a doctor visit, seems this requirement will only help doctors.

Johnna Stahl

K.MacKellerann said: “Not even doing a face-to-face with my Assemblyman over the issue made for any changes.”

I reached out to a member of our State Medical Board via email earlier this week, but have not received a response. Not that I’m expecting one. But then, as a chronic pain patient, I am used to feeling and being invisible.

Belinda said: “I know my days are numbered My friends are now all gone and now family because none understood what chronic pain is.”

It is very difficult when chronic pain comes between a patient and her family and friends, but you must be an awfully strong person to have made it this far. As a chronic pain patient, I have learned that depending on others (including doctors and the medical industry) can get you in a lot of trouble — better just to depend on yourself.

All of our days are numbered, Belinda — it’s what we do with each day that can make a difference. For instance, whenever I am able to go out and about, I am always on the look out for a homeless person to offer something small, like a sandwich or a candy bar. When you think about it, homeless people must feel as invisible as chronic pain patients. Of course, in some states, you can be arrested for feeding the homeless… I wonder, could I get hydrocodone in jail?

K.MacKellerann

The major problem with this or any medications for Chronic Severe Pain is that until one has experienced it, one has no clue as to how invasive and how life altering Chronic Pain is.
We are at the mercy of agenda-driven or simply clueless people who only see the risks of Opiate use and not the benefits it brings.
Not even doing a face-to-face with my Assemblyman over the issue made for any changes. The man simply could not understand. Yet he was bound to DO SOMETHING without regard to how much damage he caused, simply because we, who live with pain all the time, are a minor group in society–and minor groups generate minor votes.
And the “Law” wonders at why people buy street drugs after idiots like my Assemblyman make legal acquisition of them nearly impossible…

Jason Warner

@Ken McKim I don’t know why, but I just cannot post anything on YouTube. I wanted to express that I am really enjoying the well thought out videos your are putting together. It is obvious that millions of Americans are suffering out their, more than ever, as to what I am beginning to call the DEA’S New Holocaust on Chronic Pain Sufferers. I am a disabled American and I also live daily with that all loving chronic pain. It may take a few years but I am more than willing to forge ahead with a ONE VOICE for all of us that desperately need legislation that will grant us new rights and protections that have been illegally ripped away from all of us. I am open and willing to F&*^kng fight this one as we all are the forgotten ones in this DEA War on the citizens of the United States.

Reb

IM VISion impaired so cant drive. I went to over twenty pharm in Floruda and now my pain script is expired. Im in so much pain over thirty days, and I have fed disability for several serious health conditions. I cannot sleep for pain is so bad and sicker from no sleep.. Nothing I try works for pain or sleep snd I am in agonizng suffering ive reported all over to no wvsil except further exhaustion.

Adrienne

I’m fighting for disability and at 38 doubt we’ll get it for retrolisthesis, moderate DDD, severe nerve root impingement in cervical and lumbar, etc. So I don’t have the means to pay for a doctor ($150/mo) just to get scripts nor can I work. My quality of life already sucks… contemplating moving to Oregon or looking at street methods of pain relief.

MarshaS

I really could relate to all of the comments here. BettyB — the beginning of your comments sound exactly like me. I deal with fibromyalgia, RA, osteoarthritis, spinal stenosis.,. and all that goes with these illnesses I have Vicodin and Percocet. I use Vicodin on lighter pain days and the Percocet is for heavier pain days. Some days I don’t take any. I hate that you do get treated like a drug addict at the pharmarcy. Sometimes your own dr. wonders if you need pain meds. I used to get injections for my back pain. I can’t do that anymore because I got one of those tainted injections from a couple of years ago.

Oxyman

As a legit pain sufferer, I support any means and all means to kill pain, until you truly have pain, you have no say. Any means, literally.

Marcus

I couldn’t help but notice that while this particular article is in your rotating marquis (for now), it is nevertheless not listed in your article indexes. Am I missing something here?

belinda

I know my days are numbered My friends are now all gone and now family because none understood what chronic pain is.

jaded

I only use my pain meds when I’m in pain I can’t deal with so I have Percocet, Norco and Vicodin saved up from al the times I needed them for this specific reason of knowing about the crackdown. Since I had a double mastectomy a few months ago along with my Rheumatoid Arthritis, those meds now include a few hydromorphone pills for the damage of the chemo pills. If it wasn’t for Tramadol, I’d be up the creek without a paddle and I figure a lot of people like me will be discovering it as well.

m.Reilly

No one has made any comments on how the pharmacies are treating customers since they changed the classification…. I was totally humiliated today at a CVS. The called me a lyer to my face even though I had a valid prescription… They asked who my normal pharmacy was and asked for the phone number was which I gave them….I wasn’t able to get to that pharmacy this month due to having to go out of town. CVS said that I gave them the wrong number and the script was being filled too soon….it was less than their policy of 2 days. They were extremely rude to me and treated me like I was a drug addict. This new classification is hurting all of those who need the pain meds. My doctor has no problem with me taking my meds so why should I be treated like a criminal. I knew the policy of 2days but when I asked why they wouldn’t fill it when it was only one day, the girl at the counter looked at me with a disgusted look on her face and said it didn’t matter, the pharmacist said it was too soon, that I should have enough left and that there was no way she was going to fill it. By the way, they also would not fill my anti anxiety meds (completely new script) either.

BethieB

I have Rheumatoid Arthritis, Fibromyalgia, Sjogren’s Syndrome and many other diseases that are autoimmune disorders. My RA is moderate to severe, and my Fibromyalgia is severe, and I have to visit a pain clinic every month and take a $1400 urinalysys (thank God for insurance) and provide a list from my pharmacy of every medication I am on.
I am treated like a drug-seeker or potential criminal every visit. I don’t use illegal drugs, nor do I drink alcohol, but I get accused of drinking every month! I am a diabetic and even with the insulin pump my glucose is difficult to control when I’m in pain. Sugar shows up in my urine, along with Candida, and BINGO! it looks like I’ve drunk a fifth the night before unless you have some knowledge about diabetes! They don’t, and even though I have brought in articles from reputable sources (AMA, etc.) they refuse to listen. I left crying out of frustration my last visit, even though they did write my prescription.
Without my meds, I cannot move. I cannot walk to my kitchen. I am in such pain that even with meds I cannot cook or clean my home any longer and have to have a housekeeper, which I am thankful we can afford. But making it even more difficult to get some relief from these diseases from Hell is just cruel! I don’t get ‘high’ from my meds, I don’t misuse them, and I don’t sell them! I have never been in trouble with the law, and I don’t like being treated like a criminal just because I have diseases that require me to use pain medication!
I am on methotrexate (a chemotherapy medication I take once a week to prevent further damage to my joints and internal organs), and if there was something I could take that would give me relief that was not an opioid, you better believe I’d use it! But there isn’t, so I can’t.

Stop punishing me and all those like me. We already suffer enough! Just let us have what we need and stop the real drug addicts, the ones on the streets and those selling meds illegally! Leave me and other honest citizens who are actually patients alone and focus on the real criminals!

Kristi Martin

I forgot to put this into my comment. I think the FDA is not actually deciphering what is ADDICTION and what is DEPENDENCE and that is a HUGE issue because there are major differences between the two words!

Angel

The appointment load increase this has caused at my doctors office has been so crazy that it’s now difficult even to get through to ask basic care questions. This is a rheumatologist office where almost every patient is going to be dealing with chronic degenerative diseases that are debilitating. Many of the patients need these medicines. The changes where we have to come in every month is terrible for those who can’t drive themselves, who have trouble walking, and also for the staff who now have tripled the number of patients they see every month because they used to see us all once every 12 weeks instead of every 4. This is insanity.

Laura

Higher pain levels could result in more disability claims. I know for certain that I cannot afford to see my doctor as often as required. The co-pays and lost time from work are too great. Then add that I avoid driving when I am in pain. This needs to be better thought through.

Kristi Martin

I have been a chronic pain patient for 10 years and just found out that it is all related to a genetic disease, which I did all the research for. I have always had to go to my pain doctor every month for years now. I don’t mind that. I have been on the “deadly” drugs like methadone etc and actually hydrocodone works a lot better. But I am on a lot of meds due to many issues. Sometimes it is hard to go to the doctor every month because one day I am “ok” and the next day I feel like I am on my deathbed. I am just really upset because there are a lot of “quack” pain doctors and I see one right now and trying to find another one and there are no PAIN DOCTORS that even want to prescribe pain meds because of what the FDA and DEA feel they think they know what’s best. So do you know what happens, these chronic pain patients turn to the drugs off the streets because we are the ones that are desperate and truly need them. So there needs to be something done where our Pain Doctors will not be so scared to give out pain meds.

C.Morrison

Monthly appointments to receive RX for pain meds may not seem bad for most, but if you are unable to drive to the pain clinic and must find a driver for the 45 minute trip, it then is problematic.
When in pain, I have found that keeping appointments of any kind has become difficult in itself.

Why does society have such a problem with pain medication? I tackle that very subject in my “Ken Questions” segment.

http://youtu.be/ypceIXMf0Hg

Tammera Heiberger

I am a chronic pain patient and have been for 15 yrs. I have been on some very dangerous meds. Nothing has worked. I see a pain doctor every month to get my prescription. I have no problem with that. I do have a problem with profiling of people with legitimate pain. Also with doctors who do not educate themselves on alternative to all the pills. There are some very good alternative pain solutions than having to take pills! Lidocaine infusion is one. They put the lidocaine into your veins and it helps! You have to do it as a regimen. But there are people being helped more by this than all of these pills . But to just pull people who are in legitimate pain off their medication is dangerous and babaric! And those who are just getting the message to get high or to sell should have consequences!

Of course we knew this is exactly what would happen and it is exactly what PROP wants. Their ultimate goal, no matter how much they howl when it is pointed out, is to strip all opioids from people with pain. They crime is that they are successful.

p metzler

Pls regulate it 90 days is probably too long . I don’t think its that big of a deal for the people who really need it- go to your doctor. Thats what happens with everything it only takes some people to ruin it for everybody . There are already medications that require a new monthly script for and they haven’t killed anybody that I know of. Everyday someone has overdosed on these medications that seem to be so easily obtained (hydrocodone along with several others)

My son did and the refills didn’t go to waste they were refilled after his death.