Sunday, January 27, 2013

1 of 19

From the New York Times: FDA Likely to Add Limits on Painkillers

I was 1 of 19 who voted to reschedule hydrocodone, a Schedule III prescription opioid used to treat and manage pain, to the more restrictive schedule II.

14 generic companies make 81 versions of this narcotic combination drug most know as Vicodin and as House's drug of choice. Hydrocodone is THE most commonly prescribed medication in the United States. It is supposed to be prescribed for moderate pain related to acute conditions.

I have opined about the need for prescription opioid control before. Indeed, this is a topic I have struggled with in my professional--and personal--life.

My decision came after considering close to three inches of documents, two days of scientific and public testimony, and my own experience the past twenty years studying both the under-treatment of chronic pain and the ravages of prescription drug abuse. Amidst much rhetoric and appeals to improving the education of prescribers, dispensers, and patients about this product, my decision ended up based squarely on the science.

For me, though, this was truly a Sophie's choice--there will be unintended, adverse consequences no matter how the Food and Drug Administration eventually decides. If rescheduled, restricted access for those with legitimate medical need may result in poorly managed pain; if kept in its current schedule, hydrocodone will continue to contribute to the burgeoning epidemic of opioid abuse.

This is not a new problem. Education has not worked, professional regulation has not worked, nor have the current incarnations of prescription drug monitoring programs, to curb the abuse, diversion, and deaths due to unlawful use of opioids. Upscheduling hydrocodone is no panacea, but at least it has the potential to blunt the rise of abuse and, most of all, made it tougher for our young people to access. Peace...

1 comment:

  1. Every time I go to a doctor who wants to give me a prescription pain killer I ask, "Is it habit forming?" I'm usually told some variant of "You won't have any problem with these." Then upon getting home and looking it up on the Internet I find they can indeed become habit forming. So I take them for a day or two and then go back to Aspirin, which is itself no panacea.