Patients who use Vicodin or other hydrocodone combination drugs will soon find getting their prescriptions a little more complicated.
In an effort to curb drug abuse, the U.S. Drug Enforcement Agency last month reclassified drugs that combine hydrocodone with another medication, such as acetaminophen or aspirin. Starting Oct. 6, those drugs will be considered Schedule II rather than the less restrictive Schedule III.
Hydrocodone alone has long been classified as a Schedule II drug. The combination drugs will now carry the same requirements and restrictions.
Currently, doctors are able to order hydrocodone combination prescriptions and refills from the pharmacy over the phone.
After Oct. 6, doctors will only be allowed to prescribe a 30-day supply with no refills. That prescription cannot be called in, except in emergencies. It must be written — meaning the patient will have to go to the doctor’s office, get the prescription and bring it to the pharmacy.
However, doctors will be allowed to write multiple prescriptions that equal a 90-day supply, staggering the to-be-filled dates so a patient can get their medication from the pharmacy each month without having to pick up a new written prescription from the doctor’s office.
It will be up to each doctor to decide whether the patient needs a full office visit in order to get a new prescription.
Gordon Smith executive vice president of the Maine Medical Association said the change had long been discussed and didn’t come as any surprise to his members.
“I didn’t get a single call or anybody complaining about it,” he said.
However, the change was not without its controversy. Proponents liked the fact it put all hydrocodone products on the same restriction level, and they believed the restrictions could help curb the abuse and illegal sale of the drugs. Opponents pointed out that the restrictive Schedule II classification has not prevented abuse of hydrocodone sold alone, and they believed the change could limit patient access to needed pain medication.
State Rep. Robert Nutting, R-Oakland, is a pharmacist and legislative liaison for the Maine Pharmacy Association. He believes new restrictions could do something to help ensure the prescriptions are truly necessary but the bad may outweigh the good.
“The inconvenience of the doctor’s office and the pharmacist and the patient, I’m not sure the good to come from it is worth all the extra paperwork,” he said. “But the federal government has decided and that’s the way it is.”
Tom Rock, a 78-year-old patient in Auburn, agreed. He’s taken hydrocodone combined with acetaminophen on and off for five years to help with pain from back problems, arthritis, carpal tunnel and rotator cuff problems. Although he sees his doctor several times a year, he’s concerned about getting to the office to get a prescription when he needs one.
“As a senior citizen, winter times are tough. Sometimes you can get out and sometimes you can’t,” he said. “Sometimes you forget. You say ‘Oh my god, I’ve only got one pill left,’ and you call (for a refill). And I know that I’m responsible for my medication. The doctor and the pharmacist really isn’t responsible to manage my medication … But sometimes when you get old and your brain doesn’t work right and you miss, you need help right away.”
He believes the change won’t do a lot to curb drug abuse but will hurt seniors who rely on the pain medication.
“I don’t understand this stuff. When you’re 78 years old, who cares if you get addicted? I mean, most of my friends are dying,” he said.
In Maine, the change has an added wrinkle. Physician assistants can prescribe Schedule III drugs, but not the more restrictive Schedule II drugs. That means they will no longer be able to prescribe Vicodin and other hydrocodone combination drugs.
For physician assistants whose supervising doctor is licensed by the Maine Board of Licensure in Medicine, there is an option. Individual physician assistants can apply to the board for the ability to prescribe Schedule II. The board has seen an uptick in those requests recently.
However, for physician assistants supervised by an osteopathic doctor, there is no such option. The Maine Board of Osteopathic Licensure is looking at ways to make allowances, but a change won’t happen for months yet, a spokeswoman for the board said.
Although the drugs will shift from Schedule III to Schedule II on Oct. 6, patients will be able to access refills on current prescriptions until April.
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