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Hydrocodone Prescribing and Quotas

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For many years, hydrocodone was the most prescribed drug in the United States—overall, not just among controlled substances—and available only in immediate-release form, mostly in combination with acetaminophen. These combination drugs, which were the vast majority of what was offered, were Schedule 3 opioids. However, in its pure form, hydrocodone was always a Schedule 2 substance.

Hydrocodone also was arguably the most abused pharmaceutical, partly because it was prescribed in such large numbers. As a controlled substance, therefore, it’s not surprising that a portion of the prescriptions was abused. In October 2014, hydrocodone combination products were rescheduled as Schedule 2, making refills impossible and requiring a trip to the prescriber for a new prescription. The reason for the rescheduling is hard to argue against: because of its abuse history and potential, hydrocodone should have been moved to the most restrictive class long ago. [Read more…]

The Swinging Pendulum of Opiate Prescribing

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In the several decades I have been in the business of following the diversion of pharmaceuticals, I have noticed a pendulum effect regarding this issue. In almost everything important in life, balance is usually paramount; extremes are rarely the answer. However, finding balance is difficult and requires work. Balance requires careful thought, weighing the pros and cons, and taking an action that can be accepted by most individuals because getting everyone to agree is virtually impossible. This holds true regarding the prescribing and dispensing of prescription drugs, especially controlled substances.

Sometime in the early 1990s, it was thought that our nation’s pain sufferers were being undertreated for pain. I think this was likely an accurate assessment, as I saw that my mother-in-law, a chronic pain patient, had been told by her health care provider to never take a controlled substance because she would become addicted if she did. So she, and likely millions of others, tried to get by with aspirin and other OTC drugs to relieve their excruciating pain. [Read more…]

Paying for Abuse-Deterrent Formulations: A Good Idea?

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With multiple pharmaceutical manufacturers now entering the market with abuse-deterrent formulations (ADFs) of opiate pain relievers, insurance carriers are getting up in arms at the costs of these drugs. This additional cost aims to make it much harder (or virtually impossible) to break down a drug for injection or snorting, two of the main methods used by addicts.

I have talked about these types of drugs in prior articles. In August 2010, OxyContin was the first one that came to market; its considerable abuse background makes it an ideal prescription drug to evaluate for success or failure. August 2015 will mark 5 years since the launch of the reformulated OxyContin, and the abuse level continues to be far less than before the crucial formula change. Someone mentioned to me the other day about hearing that some folks on the street had found a way to easily and quickly compromise the new drug and turn it into the OxyContin of old. I hear this from time to time or even see it claimed on some blog or in a comment by an anonymous source. [Read more…]

Op-Ed: More support for abuse deterrent drugs

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Below article was submitted to and published by The CT Mirror

Paul Gileno’s piece is spot on and something that is often forgotten in the prescription drug abuse issue that has swept our nation. He brought up the issue of Abuse Deterrent Formulations (ADF) for certain prescription drugs that are highly abused. The ADF are much more difficult to break down for snorting or injecting, making it far less desirable to the typical addict.

The reformulation of OxyContin® probably represents the best example considering it was a major drug of abuse until reformulated with an ADF in August 2010. Once the old formulation was no longer on retail pharmacy shelves, the abuse and diversion of OxyContin® took a huge plunge downward. In addition, street values also plummeted and the attraction to this once highly sought after drug became far less with the formulation change. [Read more…]

DEA Allows Rx Returns

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Recently, US Attorney General Eric Holder announced a new Drug Enforcement Admini- stration (DEA) regulation that allows hospitals, pharmacies, clinics, and other authorized entities to provide drop-off locations for outdated or unused prescription drugs. Nursing homes will also be allowed to collect medications turned in by their residents, and the general public will have the option of mailing in their medications to authorized collection companies. Holder and the DEA feel that this new regulation, which went into effect in October 2014, will help to curb the rising prescription drug problem in America.

It’s interesting, no matter what you think of this move by the DEA, that it has is being done well after the peak of the prescription drug epidemic in the United States. I’m not saying that there still isn’t a huge problem, but our federal government always seems to be 1 or 2 steps behind the times! [Read more…]

How BIG is the problem?

Year after year, state and local law enforcement statistics indicate that pharmaceuticals are almost 30% of the overall drug problem in the United States, running a close second only marijuana abuse. However, until recently, law enforcement, health care professionals, and the general public have placed little emphasis on this huge problem.

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Pharmaceutical Diversion Education (PDE) is designed to assist a wide range of the population in understanding the potential abuse and addiction that can be associated with prescription medication.

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