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FDA wants tighter restrictions on hydrocodone

Vicodin

A big change to legal drug policy is in the works. After years of pressure from public-health and addiction advocates, as well as the U.S. Drug Enforcement Administration, the Food and Drug Administration has recommended that access to drugs containing the highly-addictive opiod narcotic hydrocodone should be further restricted. The change would be designed to prevent abuse by people with prescriptions, and others who can get hold of the drugs illegally -- from unwitting relatives, or on the black market. 

The FDA wants to marke it harder for Americans to obtain brand-name painkillers Vicodin and Lortab, as well as generic versions. These typically contain hydrocodone combined with an analgesic such as aspirin or acetaminophen. They would be upgraded from Schedule III to Schedule II -- joining more powerful opium-derived narcotics such as ocycodone (the active ingredient in Oxycontin), methadone and fentanyl, as well as Adderall and Ritalin, which are typically prescribed for attention deficit hyperactivity disorder. 

Prescriptions for hydrocodone wouldn’t last as long, and they’d allow fewer refills. Patients would have to fill them in person, and fewer medical practitioners would have prescription rights (for instance, nurse practitioners might be prevented from writing prescriptions in some states).

"There are people who get a prescription for a hydrocodone product after a dental or surgical procedure," explains economics and pharmacy professor Albert Wetheimer at Temple University. "And it’s not so difficult to become addicted or at least habituated. Then there’s the situation where people get prescriptions legitimately, but then sell them. On the street these things have incredible value."

Groups representing doctors and the pharmacy industry have lobbied against the schedule-change for hydrocodone-containing painkillers. They worry more restrictive prescription rules will make it harder for patients to obtain effective painkillers when they need them.

More than 130 million hydrocodone prescriptions were written in 2011 -- representing five billion pills. Overdose deaths from opiod drugs, including hydrocodone and oxycodone, have quadrupled since 1999. 

About the author

Mitchell Hartman is the senior reporter for Marketplace’s Entrepreneurship Desk and also covers employment.

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