12 Apr Congress Seeks Tighter Controls on Vicodin
Five members of Congress have introduced a bill called the “Safe Prescribing Act of 2013” that aims to restrict the prescription painkiller hydrocodone by reclassifying it as a Schedule II controlled substance.
Sold under the brand names Vicodin, Norco and Lortab, hydrocodone-based medications “are some of the most potent and addictive narcotics on the market,” U.S. Rep. Vern Buchanan (R-Fla.) said in a statement.
The sponsoring congressional members include two Democratic senators from West Virginia, Jay Rockefeller and Joe Manchin; Republican representative Buchanan of Florida; Democratic representative from Massachusetts, Edward Markey, and Republican senator from Illinois, Mark Kirk.
The sponsors believe that reclassifying hydrocodone as Schedule II would better reflect the danger of the drug in terms of both accidental overdoses and addiction.
Hydrocodone is one of several prescription painkillers in a class of drugs called opioids. These are drugs that are synthesized from naturally occurring compounds found in the opium poppy. For millennia, people have used the opium poppy to treat medical conditions, mostly pain, and issues with digestion. More recent centuries have seen opium being exploited as a recreational drug. In modern medicine, the opium poppy has led to many important narcotic pain relievers, including natural compounds like morphine and codeine, as well as such synthetic compounds as oxycodone, methadone, fentanyl and hydrocodone.
Hydrocodone is made from two naturally occurring opium compounds, codeine and thebaine, and can be used when prescribed as a cough suppressant or as a painkiller. As a painkiller, hydrocodone is usually mixed with acetaminophen. A newer form of the drug, called Zohydro, is 100 percent hydrocodone in a time-release form. It has raised concerns about abuse and possible addiction overdose deaths when used improperly.
All opioids present the danger of addiction when not used as directed. They act on receptors in the brain that produce a feeling of pleasure and euphoria. Over time, the drugs can change pathways in the brain and cause the user to crave them. This can lead very quickly to dependence and addiction. It is possible to use prescription opioids without becoming addicted, largely by following doctor orders. Those who misuse them, however, are at risk of addiction.
Drugs with hydrocodone as an ingredient are prescribed more than any other painkiller. The number of visits to the emergency room related to hydrocodone went up nearly three times from 2004 to 2010. Ten years ago, the concern was all about the opioid oxycodone and how people abused it. When the time-release form of the drug was taken off the market, hydrocodone took its place as the next opioid to be misused.
Legislators hope to curb the abuse of hydrocodone by changing its status as a controlled substance. The Controlled Substances Act was introduced in 1970 with five schedules for classifying and controlling substances. The drugs are classified by both the Food and Drug Administration and the Drug Enforcement Administration. Congress is also able to place drugs into a schedule under the Controlled Substances Act. Schedule V substances have the least potential for abuse, while Schedule I drugs have the highest potential.
Hydrocodone is currently categorized as a Schedule III substance, meaning that a physician must prescribe it. Prescriptions for Schedule III drugs cannot be refilled after six months have passed or more than five times. The new bill proposes to move hydrocodone into Schedule II, which would also require a prescription. However, the prescription for drugs in this class can be issued for only 30 days.
The hope among lawmakers is that by strengthening restrictions on hydrocodone, irresponsible doctors who overprescribe it would be prevented from giving out too much. When a patient gets more hydrocodone than necessary, not only is that person at risk for abusing it, he or she may sell it to others, putting even more people at risk.
While moving hydrocodone up to a Schedule II substance-where it will be in the company of similar drugs like oxycodone, morphine, and methadone-will not solve all drug problems, it could save a significant number of lives. Making a dangerous drug like hydrocodone more difficult to get will help to keep it off the streets and out of the hands of those who would abuse it.
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