New Prescription Rules for Hydrocodone Set to Start in October

Beverly Schilke has lived with constant pain every day for more than 40 years after a flesh-eating bacteria ravaged both her legs.

"It's probably like somebody was taking a hot poker and sticking it at you all the time," said Schilke.

She has endured more than 200 surgeries.

"It's just ferocious,” said Schilke. “It just continues to go on and on until they can cut it out."

Shilke takes prescription-strength pain medication daily. It keeps her mobile and enables her to volunteer with cancer patients at UConn Health Center, many of whom also depend on pain medication.

But with new rules from the Drug Enforcement Agency, it's going to be harder for patients who use a popular pain medication to get their prescriptions.

“The only person it's going to hurt are those people who actually need the drug, need the drug to survive every single day," said Schilke.

Starting Oct. 6, new federal regulations take effect for more than 60 products containing the painkiller hydrocodone. The drug is being moved from a Schedule III to a Schedule II drug, putting it in the same class as the painkiller oxycodone.

For patients, it means doctors will no longer be able to call in those prescriptions to pharmacies and refills won't be allowed. And a new prescription will be necessary every single time.

Addiction treatment specialists are applauding the tighter restrictions.

“It is going to make it more difficult to obtain, and there are going to be more required visits, and there's going to have to be more interaction with providers,” said Jessica Hawkins, of the National Prevention Network. “That's not necessarily a bad thing."

Hawkins is among the more than 700 drug addiction treatment professionals from across the country who gathered at the Connecticut Convention Center last week. She says the drug enforcement agency's new regulations are recognition of what she calls "epidemic levels of painkiller abuse."

“We're seeing family medicine cabinets being stolen from,” said Hawkins. “We're seeing young people diverting or stealing unwanted or unused prescriptions out of the home to other people. We're seeing people who are fraudulently obtaining prescription drugs from doctors' offices."

According to the Centers for Disease Control, nearly 20,000 people die each year from abusing prescription painkillers. In 2012, more than 125 million prescriptions were written for hydrocodone combination products, making them the most prescribed medication in the U.S.

Healthcare providers agree it's a serious problem, but not everyone believes these regulations are the answer.

“We certainly understand that we need to balance that with all the theft and diversion that has gone on with opioids in the country, but we think there are maybe other ways to handle that without decreasing access to patients who need pain medications," said Lisa Holle, Professor of Pharmacy at UCHC and former Past President of the Hematology Oncology Pharmacy Association.

Holle says she sees some cancer patients at UCHC who travel as far as two to three hours for treatment. She says getting written prescriptions for pain medication every time is a burden they shouldn't have to endure.

“It really limits the ability of patients who need a medication quickly, a pain medication quickly, from being able to have access to it without having to come into a hospital or a clinic," said Holle.

“Legally you can change schedules, you can instill different mandates, etc., but i think it comes down to education and patient safety,” said Dr. Eric Grahling, a nationally recognized expert in the field of pain management.

Grahling says he understands the DEA’s decision to tighten the rules, but believes educating prescribing physicians and patients would be a more effective tool. He fears doctors already buried in paperwork and regulations may decide prescribing medications with hydrocodone is too difficult, leaving patients in pain.

"Some physicians may say, 'You know what, this is too much work. All these prescriptions we were able to call in or fax in for the last years, now we have to do written prescriptions.' They may not care to prescribe the medications," Grahling said.

Holle and Grahling say patients who use these medications should be talking to their doctors, pharmacists, and insurers now to make sure they are prepared when the new rules take effect. Rules that Beverly Shcilke says will make life harder for those who suffer with constant pain.

“These people are going to be in a hurt,” said Schilke. “There's no two ways about it."

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