06 Jul Will FDA Restrictions on Vicodin and Other Opioids Lower Addiction
Today, around 47 million Americans are taking pills made with Hydrocodone to manage some form of chronic pain. Known as opioids, these painkillers have become the focal point of a swirling debate. On one side are patients who are living with barely manageable chronic pain for whom the drugs are a godsend. On the other side are the families of those addicted to opioids, drug enforcement agencies and even the Center for Disease Control and Prevention (CDC). According to the CDC, abuse of prescription opioids is an epidemic problem in this country.
The winds of debate started blowing harder last week when an FDA advisory panel suggested tightening restrictions on Hydrocodone prescriptions. Under the recommended policy, opioid pain relievers like the popular drug Vicodin would only be available to patients in limited amounts and only after visiting a physician in person. No more calling in refills without an office visit.
Opinions about the proposed changes vary widely. The U.S. Drug Enforcement Agency (DEA) agrees with the suggested policy since it moves toward their own recommendations for stricter controls, including placing opioids into Schedule II drug category, the most controlled drug category. While many see the suggested scheduling change as a positive step toward reducing opioid addiction, others remain unconvinced.
Those less enthusiastic about reclassifying opioids point out that it is not those with a doctor’s prescription who are most likely to become addicted to the pills. The majority of recreational prescription drug users obtain their pills from friends or family members, not through the family doctor. A scant one percent of patients with no drug abuse history ever form an addiction to opioids.
Deaths from prescription drug abuse are heart-rending and have been rising. Nonetheless, drug overdose deaths connected to opioids are overwhelming among recreational users and not chronic pain patients. Many fatalities are linked to misuse of opioids such as crushing and injecting or snorting the pills or mixing the drug with alcohol. These abuses are practiced by those using opioids for non-medical reasons and not by those who take the drugs to control otherwise debilitating pain.
Patients with legitimate long-term pain may have more trouble getting pain medication if the panel’s recommendations are enacted. Pain patients worry that insurers who are not eager to pay for opioid therapy will find numerous loopholes such as limiting doctor visits in order to control costs. This has created more than a note of panic among pain patients. On the other hand, many concerned over the epidemic of addiction see stricter controls as the only way to dry up the supply.
The fear is that the new controls would limit access to pain relievers for those who are at the lowest risk for abuse while doing nothing to stem prescriptions for short-term use. Short-term prescriptions tend to be the ones which get stashed in the medicine cabinet for a rainy day and wind up fueling abuse. More hearings are scheduled in the near future.
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