22 February 2014
Hydrocodone PLEASE Exploratory Essay
Hydrocodone is an opioid narcotic “first synthesized in Germany in 1920 by Carl Mannich and Helen Lowenheim”. (Hydrocodone) Since 1943, hydrocodone use has increased to the point that practically everyone agrees that something needs to change. Hydrocodone is presently a schedule III medication (drugs with an abuse risk less than schedule II). (Controlled drugs) There is currently a petition from the DEA (Drug Enforcement Administration) to reschedule hydrocodone to a schedule II medication (drugs with a high abuse risk but also have safe and accepted medical use in the United States). (Controlled drugs) “On January 24-25, 2012 the Drug safety and Risk Management Advisory committee (DSaRM) meet and voted 19-10 in favor of the rescheduling of hydrocodone”, (Rescheduling) and at present awaiting the final decision from the FDA if the schedule will change. Rescheduling of hydrocodone was first considered in 1999 when the DEA noted a rise in hydrocodone related abuse and deaths. In 2004, when the Advisory committee first met, they agreed there was not enough information to change the schedule at that time. The DEA continued to collect data. In 2009, they resubmitted a petition for reevaluation, citing continued rise in number of prescriptions and increased misuse and frank abuse of hydrocodone. In a 2009 article, (Emergency Department Visits Involving Non-medical Use of Selected Prescription Drug) the CDC demonstrated a steady rise in opioid abuse and prescription opioid related deaths from 2004-2008. They found a 111% increase in ER visits involving nonmedical use of hydrocodone, from 144,600 visits to 305,900 visits. In 2007-2008 -a single year- the volume increased 29%. (2004-2008) The Drug Abuse Warning network (DAWN) "a public health information system that tracks the abuse and misuse of opioid type medication such as hydrocodone", (2004-2008) utilized “trained reporters to collect data from hospital related Emergency room visits via chart review’. (2004-2008) DAWN's statistics reveal a steady rise in abuse and deaths related to opioid (hydrocodone) painkillers, and the average patient age is getting younger each year. Medical examiner findings parallel the results of DAWN’s research. The rescheduling of hydrocodone has become a nation-wide issue. Some feel the rescheduling of hydrocodone will hinder chronic pain patients from receiving their medications. I read several blogs by patients on this subject. They are worried about the change. Many state that without this medication, they cannot live a “normal life” and be a productive member of society. Patients are not the only group that have concerns. There are several pharmacy groups who oppose the rescheduling of hydrocodone. They feel the rescheduling of hydrocodone will create barriers for patients with chronic pain who need the medication. They also believe that hydrocodone, if rescheduled, will “go up in cost due to the requirement for secure storage, recordkeeping, and inventory management”. (APhA) Some physicians oppose the rescheduling of hydrocodone, Dr. Fudin, a Chronic Pain Management Physician, has stated that the “rescheduling of hydrocodone will not solve the abuse problem that the FDA is hoping it will. The patients that are abusing hydrocodone will just move on to something else. Plus rescheduling of hydrocodone will lead to inadequate medications for chronic pain patients”. (Fudin) Dr. Webster voices some of the same concerns. In his presentation "Rescheduling Hydrocodone: Patient and Public health Considerations", Dr. Webster stated that of those who abuse hydrocodone, 55% of them get their medications from family or friends and rescheduling hydrocodone is not likely to change that. Dr. Webster also stated that the rescheduling of hydrocodone could easily effect the costs of the medication, increase insurance cost and make patient...
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