By Pat Anson, Editor
It’s going to get even harder for chronic pain patients in the United States to get prescriptions refilled for hydrocodone, oxycodone, morphine and other opioids classified as Schedule II controlled substances.
The Drug Enforcement Administration has announced plans to reduce the amount of almost every Schedule II opioid pain medication manufactured in the U.S. by 25 percent or more. The 2017 quota for hydrocodone, which is sold under brand names like Vicodin, Lortab and Lorcet, is being reduced by a third.
The DEA’s order, which is being published in the Federal Register, comes just seven months after the Centers for Disease Control and Prevention released guidelines that discourage primary care physicians from prescribing opioids from chronic pain. The guidelines have had a chilling effect on many patients and their doctors, who have reduced opioid doses or stopped prescribing them altogether.
Opioid prescribing was falling years before the CDC and DEA acted. According to IMS Health, hydrocodone prescriptions in the U.S. plunged by 22 percent from nearly 120 million in 2014 to 93.5 million in 2015.
The “established quota” for hydrocodone in 2017 is being reduced to 58.4 million prescriptions under the DEA order.
“The purpose of quotas are to provide for the adequate and uninterrupted supply for legitimate medical need of the types of schedule I and II controlled substances that have a potential for abuse, while limiting the amounts available to prevent diversion,” the DEA said in a press release.
“Once the aggregate quota is set, DEA allocates individual manufacturing and procurement quotas to those companies that apply for it. DEA may revise a company’s quota at any time during the year if change is warranted due to increased sales or exports; new manufacturers entering the market; new product development; or product recalls.”
The DEA has been under growing political pressure to reduce the supply of opioids. A group of U.S. senators sent a letter to the agency this summer demanding that opioid quotas be reduced.
“We urge DEA to utilize its existing quota setting authority, to the fullest extent possible, to combat this epidemic,” said the letter from Senators Dick Durbin (D-IL) Sherrod Brown (D-OH), Edward Markey (D-MA), Amy Klobuchar (D-MN), Angus King (I-ME), and Joe Manchin (D-WV).
“Fourteen billion opioid pills are now dispensed annually in the United States – enough for every adult American to have a bottle of pills. Certainly, the pharmaceutical industry is at fault for decades of misleading information about their products and the medical community bears responsibility for its role in over-prescribing these dangerous and addictive drugs, but we remain deeply troubled by the sheer volume of opioids available – volumes that are approved by DEA.”
Although opioid pain medication is routinely blamed by politicians, federal agencies and the media for the nation’s so-called opioid epidemic, recent studies in several states have found that most drug overdoses are actually caused by illegal opioids such as heroin and bootleg fentanyl. There are also increasing signs that pain patients unable to get opioids legally are turning to pain medication sold on the streets, some of it counterfeit and laced with fentanyl.
Efforts to restrict the supply of opioids may only be making things worse.
Law enforcement agencies in West Virginia recently said a federal crackdown on opioids – dubbed the Bluefield Pill Initiative -- may have contributed to a recent spike in heroin cases, according to the Bluefield Daily Telegraph.
“We are seeing an increase in heroin because pills are in fewer quantity,” said Sgt. J.S. McCarty, who heads a local crime task force. “Without pills an opioid addict’s only choice is heroin.”