Proposal to Increase Restrictions on Opioid Prescribing Prompts Debate
A proposal by the Drug Enforcement Administration (DEA) to
more tightly control prescriptions of drugs containing hydrocodone is
prompting debate among doctors, according to NPR. A committee of the FDA will meet January 24 and 25 to consider the DEA’s request.
Emergency room visits related to hydrocodone, the key ingredient in
Vicodin and other painkillers, have soared since 2000. Vicodin, which
also contains acetaminophen, is subject to fewer regulations than pure
hydrocodone.
For almost a decade, the DEA has called for stricter regulation of
Vicodin, in order to reduce abuse of the drug. The DEA wants to change
the way drugs that combine hydrocodone with other products are
classified, to require patients to have more interaction with doctors in
order to obtain prescriptions for them.
Andrew Kolodney, who leads Physicians for Responsible Opioid
Prescribing, wants opioids to be used only for patients who really need
them, such as cancer patients. “This epidemic has been fueled by
overprescribing of opioids, particularly for chronic noncancer pain,
whether it’s low back pain, headaches,” he told NPR. “I think that’s
really created a public health crisis.”
His group wants the Food and Drug Administration to rewrite labels on
opioids to state that physicians should write prescriptions only for
severe pain, and at much lower doses. The group wants prescriptions for
the drugs to be written for a maximum of 90 days at a time. “The way to
begin to turn the epidemic around is by getting doctors to prescribe
more cautiously,” Kolodney said.
Lynn Webster, President of the American Academy of Pain Medicine, is
concerned these changes may prevent many patients from obtaining drugs
they need. “We have millions of people who are totally disabled because
of their pain,” he said. “Many people who do not have access to
aggressive pain management may simply not be able to survive.”