"Hydrocodone Rescheduling: The First 100 Days" presented at 31st Annual Meeting for AAPM
NATIONAL HARBOR, Md. and SAN DIEGO – Preliminary analysis of a survey of pain patients to gauge the effects of the rescheduling of hydrocodone from Schedule III to Schedule II was presented today by Millennium Research Institute's Principal Investigator, Steven Passik, Ph.D., at the 31st Annual Meeting of the American Academy of Pain Medicine in National Harbor, Md. The survey was conducted by the National Fibromyalgia & Chronic Pain Association (NFMCPA).
Hydrocodone has been the most widely prescribed medication in the United States, with 130 million prescriptions written annually. Hydrocodone in combination with other medications, such as acetaminophen or ibuprofen, is frequently prescribed for pain. The new Drug Enforcement Administration (DEA) regulation, enacted in October 2014, rescheduled hydrocodone from Schedule III to Schedule II, effectively limiting patients to a smaller maximum supply between doctor visits. Patients must now see a doctor or other prescriber for each handwritten prescription renewal.
These regulations were intended to reduce criminal activity and deaths caused by drug overdoses. The findings of the survey, which collected 3,000 responses within the first 72 hours online, highlight the consequences for patients, including reduced access, higher costs due to increased doctor's visits, and stigmatization.
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Approximately two-thirds of survey responders reported inability to access hydrocodone-combination prescriptions. Patients prescribed the same medication at the same dose for many years reported that they were told their doctors would no longer prescribe hydrocodone medications for them.
More than 15 percent of the responders reported negative impacts on doctor-patient relationships.
Survey respondents cited higher expenses from more frequent doctor's visits, higher medication co-pays, greater transportation expenses for extra doctor's visits and travel to multiple pharmacies, and lost income related to inability to work due to pain.
More than a quarter of respondents (27 percent) reported suicidal thoughts due to being denied their hydrocodone prescriptions.
"Millennium Health provides objective clinical tools and education for doctors to enable safe and effective care," said Dr. Passik. "We believe it is important to take an educated and balanced approach to stopping the complex public health epidemic of prescription medication abuse. It's important to detect and prevent aberrant behavior, while also providing access to treatment for those patients who are legitimately in need of these medications."
To our knowledge, this is the first report of the experiences of pain patients treated with hydrocodone since this change went into effect and more research is necessary to understand the effects. This survey was conducted online through patient advocacy websites, which may have resulted in bias. Additionally, the sample is overwhelmingly female, reflecting the demographics of fibromyalgia, and the impact on male patients is not well characterized here.
An abstract of the poster is available at AAPM's website.