HYDROCODONE'S MOVE TO SCHEDULE II
FDA Expected to Tighten Restrictions on Vicodin

TOUGHER TO PRESCRIBE The FDA is expected to reclassify opioid pain relievers such as Vicodin as Schedule II drugs

Prescribing the popular painkiller Vicodin after surgery might soon get a bit more difficult if, as expected, the FDA reclassifies hydrocodone, the active ingredient in Vicodin, as a Schedule II narcotic. Schedule II, the most restricted category, is reserved for drugs with a high potential for abuse, such as codeine, fentanyl and Dilaudid. Hydro-codone, the nation's most widely prescribed drug, is now listed on Schedule III (New York reclassified it to Schedule II earlier this year). If the FDA approves the change nationwide, your patients would be able to get fewer hydrocodone pills at one time, and there'd be more restrictions on refills. Here's what the move would mean to you.

• No more phoning in scripts. Patients would have to present the script to the pharmacist when picking up their prescriptions. Calling, faxing or e-mailing a pharmacy for a Schedule I or II substance is prohibited. Your doctors would no longer be able to phone in prescriptions for Vicodin except in the case of an emergency, where a limited supply can be phoned in. Keep in mind, however, that you must produce a written script within 7 days if you phone in an emergency script. If the script isn't produced within that time frame, the pharmacist must notify the DEA. Further, physician's assistants and nurse practitioners wouldn't be permitted to prescribe the medications in the states in which they have limited prescribing powers.
• No more refills. The new rules would ban prescribing of more than a month's supply of hydrocodone-containing drugs and prevent refills without a new doctor visit. "The patient has to come back and get a script every time," says Bobbie Jean Sweitzer, MD, the director of the Anesthesia Perioperative Medicine Clinic at the University of Chicago.

Citing the drug's high potential for abuse and addiction, many feel that more stringent rules for Vicodin are long overdue. "Vicodin is just as likely for abuse and addiction as the more potent Schedule II drugs," says Dr. Sweitzer. "[It] was probably misclassified from the beginning."

This wouldn't be the first time the FDA reclassified a drug. The FDA moved Soma muscle relaxants, previously a non-controlled, non-scheduled drug, to a Schedule IV in December 2011, due to its high potential for abuse and addictive qualities.

— Lauren Roberts