Efforts to reschedule hydrocodone combination products such as Vicodin, Norco, Lortab have been in progress for more than a decade. In August 2014, the drug enforcement administration (DEA) published a final rule to move all hydrocodone combinations from Schedule III to Schedule II at the federal level. Hydrocodone combinations are the most prescribed drugs in America, not just the most prescribed opiate but the most prescribed drugs overall. They are prescribed more than amoxicillin, ace-inhibitors, and statins.
Switching hydrocodone combination products to schedule II creates challenges for both healthcare providers and patients. Adam Kaye, Pharm.D. and Steve Leuck, Pharm.D. provide a real-world perspective on how rescheduling of hydrocodone combination products have affected their practice and patients.
How has rescheduling affected healthcare professionals?
It has had a big impact on healthcare professionals. There are many patients who use hydrocodone appropriately and it’s not a problem to refill their prescription every 6 months. Patients are now required to obtain a new prescription every month, causing many patients to stop using this drug due to the inconvenience.
For example, at the pharmacy where Dr. Adam Kaye practices, they noticed a big reduction in the number of hydrocodone combination prescriptions since October 6. The number of phone calls regarding hydrocodone combination products like Norco has dropped tremendously. But this has also caused more powerful CII prescriptions being prescribed as well. To read further on a perspective of rescheduling hydrocodone combination production by Dr. Kaye read “Should Vicodin and other Hydrocodone Products be Switched to Schedule II”.
On the contrast, at the pharmacy where Dr. Steve Leuck practices, the change has been “fairly smooth”. The number of hydrocodone combination productions has not changed at all. He prepared for the change 30 days ahead of October 6, 2014, implementation date by:
1) notifying all of their regular physicians and patients,
2) moving all of their hydrocodone products from the CIII-IV locker to the CII locker
3) placing hydrocodone on a perpetual inventory.