Will Vicodin Soon Be Harder to Obtain?

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We will find out at the end of January whether or not the U.S. Government's Drug Enforcement Agency (DEA) changes the designation of Vicodin—and all other combination products containing hydrocodone—from a Schedule III substance to a Schedule II substance.

If the decision is made to change it from III to II, Vicodin and similar products will indeed become harder for addicts—as well as non-addicts—to obtain. It will mean that all Vicodin prescriptions must be written by hand on specialized prescription pads and, generally speaking, there will be no refills. Each script must be written anew.

Drug Schedules

The DEA classifies substances according to a schedule in which a Schedule V drug is not tightly controlled because evidence suggests it has very low to no abuse potential, up to a Schedule I drug, which is regarded as having very high abuse potential and no medicinal value whatsoever. Many illegal drugs are classified under Schedule I, including heroin, cocaine, and ecstasy.

Schedule II is where all of the really powerful prescription drugs are listed: opioids such as Dilaudid, Oxycontin, and morphine, as well as central nervous system stimulants such as Dexedrine and Adderall. In fact, pure hydrocodone is listed as a Schedule II, but is almost always prescribed in combination form.

Currently, hydrocodone combination products, along with codeine, are listed as Schedule III drugs, meaning that there is some evidence of abuse potential, and the DEA's control over the drug is not very tight.

Why the Change?

The movement to have hydrocodone combination products moved into the tighter Schedule II began in 1999. It has come close many times, with the DEA being the driving force now behind moving the drug into tighter controls.

The biggest obstacle to the change is coming from another government agency, the U.S. Food & Drug Administration. The FDA has said many times that it believes the DEA's evidence demonstrating a similarity in abuse potential between hydrocodone combination products and the likes Percocet is too weak to support the move.

Most others disagree. Andrew Kolodny, MD, chair of psychiatry at Maimonides Medical Center, was quoted by MedPage Today as saying:

"The FDA doesn't need to go much further than [a handful of published journal] articles to conclude that Vicodin belongs in the same schedule as Percocet."

The meeting to decide the fate of hydrocodone combination products has been delayed due to the damage done by Hurricane Sandy. That meeting is now scheduled for the end of January.

Several advocacy groups support the DEA's efforts, while there are very few in the FDA's corner. It seems more than likely that these combination products will be made Schedule II substances, the hope being that the more difficult they are to obtain, the fewer the number of abusers the drug will create.

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