Hydrocodone Rescheduling

Changes coming for some pain medicines

On August 22, 2014, hydrocodone combination products were officially rescheduled by the US Drug Enforcement Administration (DEA).  Following many months of hearings, public comments, and a decision by the FDA to recommend up-scheduling, hydrocodone combination products (HCP) were moved from their previous spot in Schedule III under the federal Controlled Substances Act to the more restrictive Schedule II. The new rules in the Federal Register may be viewed here.  The DEA's statement can be read here.  This rule comes after discussion for more than 10 years by government agencies and groups for people with pain, people with drug abuse problems, and healthcare providers.

Many patient advocates and physician groups are extremely concerned about the effects that this change will have on those people living with chronic pain who benefit from HCP therapy as part of their treatment plan. Additionally, we are concerned about the potential negative effects that these restrictions will have on healthcare professionals who are diligent in their efforts to alleviate patients’ pain and suffering.

The NFMCPA encourages you to contact your physician soon if these changes will affect you.

The DEA's rule goes into effect on October 6, 2014.  It will cause some big changes to how some pain medicines are prescribed. We want you to know about these changes, so that you can work with your healthcare providers to keep from running out of medicine.

What medicines are affected?

There are 65 brand names of these medicines on the market, as well as their generic versions. Here are some of the brand names, as well as a way to know if your medicine is affected if it is a generic medicine.

   •  Vicodin, Vicodin ES, Vicodin HP

   • Lortab, Lorcet, Lorcet Plus

   • Norco

   • Zydone

   • Vicoprofen

   • Cough medicines including hydrocodone

   • Any other medicine that includes the word “hydrocodone” and one of the following:

      Aspirin
      ASA
      Acetaminophen
      APAP
      Ibuprofen

If you have refills left on your prescription

After the new rule goes into effect on October 6, pharmacies will not be able to refill prescriptions for these medicines. If you already have a prescription, and it has refills left on it, those refills will be canceled on October 6, and you will need to get a new prescription from your prescriber.

Also, after the rule goes into effect, your prescriber will not be able to call in a prescription for these medicines to the pharmacy. If you are going to keep taking these medicines and need a new prescription, you will need to get a new written prescription from your prescriber.

This means that, if you are going to need a refill after October 6, it would be a good idea for you to talk to your prescriber now, so the two of you can decide how to get you the prescription you will need.

Some prescribers might decide that they need to have you come in for an office visit before writing a new prescription. Others might decide that they can just write a prescription and have you pick it up at their office.

Other details for your prescriber

The new rules will no longer allow refills, but there is a way that you can get prescriptions with enough medicine to last for three months. Your prescriber will need to know about how to do this, and will need to write your prescriptions in a certain way to make this happen. If your prescriber does not know about this, he or she can find the rules by clicking here.

A final word

The DEA is making this new rule because a lot of people don’t use their pain medicines the way they should be used. Sometimes, people use pain medicines without having a prescription for them. That is very dangerous, and they can die if they do that.

When they are asked, most people who use pain medicines without a prescription say that they got the medicine from a friend or a relative. Sometimes they say they got it for free, sometimes they say they bought it, and sometimes they say they stole it.

Because a lot of people want to get these medicines without a prescription, it is very important that you keep them in a safe place. If you have a place where you can lock them up, please use it. If you don’t have a place like that, please hide your pain medicines in a place where no one would think to look for them. And importantly, don’t tell anyone else where they are, because you might not know who wants to get them.

If you have medicines left over, for any reason, please get rid of them as soon as possible. The DEA and your local police or sheriff’s department usually have special “take-back” days in April and October of each year. At other times, you can mix your extra medicines with something unpleasant, like used kitty litter or used coffee grounds, put them into a sealed plastic bag, and then put them into your household trash. Just be as sure as you can that no one will be able to get them out of your trash and use them without a prescription.

Further information:

The American Academy of Pain Management sent a letter to its members to guide them in working with their patients during these changes. A link to this letter can be found here. 

The NFMCPA will continue to work for improved care for those affected by life-changing pain, and to help in efforts to curb prescription drug abuse, misuse and diversion.