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.”