woman with lower back pain, back sore

On October 6, 2014, a Drug Enforcement Administration (DEA) decision to restrict access to hydrocodone combination pain relievers (HCPs) went into effect. Medications like Lortab, Norco, Vicodin and generic formulations have been moved from Schedule III to Schedule II.

This may sound like a technicality, but the difference between these two categories is huge. A Schedule II drug is considered to have a strong potential for abuse. Such drugs require a written prescription. Doctors can’t call in, fax or send electronic prescriptions to a pharmacy. Each prescription lasts for only one month and no refills are permitted.

A Schedule III drug has less potential for abuse or addiction. A physician can call in a prescription and allow five refills over six months. Schedule III drugs include anabolic steroids (male hormones or testosterone), barbiturates and the anesthetic ketamine.

Why Did the DEA Change the Rules?

The reason for this sea change in the prescribing rules for HCPs is to reduce abuse. More prescriptions are written for such pain relievers each year than any other medications. At last count the total was over 130 million HCP prescriptions annually.

No doubt many hydrocodone-containing drugs are diverted to the black market and abused. The hope is that tougher restrictions will make it harder for doctors to prescribe such medications and harder for patients to become addicted to them.

What Is the Problem?

The problem with the new rules, however, is that patients in severe pain will have much more difficulty accessing needed medicine. One reader shared her story:

“What is going on with the new, and in my opinion, asinine DEA ruling regarding Schedule II pain relievers? I have been treated for some time now for chronic pain relating to neck and back issues.

“I deal with pain on a daily basis and I am prescribed hydrocodone (10 mg four times daily). Often I do not need the four daily doses. I elected this form of treatment rather than chase after various forms of surgeries for both neck and back problems when four doctors gave me conflicting recommendations.

“Yesterday I picked up my prescription which has one refill left and was advised that I will not only NOT be able to receive the final refill, but I will now be required to provide an original written prescription on a monthly basis because of the new DEA ruling. Up till now I would see my doctor four times a year for follow up and receive a three-month prescription. Each visit cost me $35 and my insurance company $78, for a total of $113 per visit or $452 per year.

“Under this new rule, 12 visits will cost $1,355.28, or for me in particular, $420.00. That’s a yearly increase of $280.00. I am retired on a fixed income.

“What about the inconvenience? I will have to make 12 visits to the doctor, plus extra visits to the pharmacy if the prescription cannot be filled immediately. I am still independent and able to make all these trips. What about those who cannot and need assistance because of severe, chronic pain?

“This added cost and inconvenience is unconscionable. Just because the DEA cannot figure out how to control the illegal use of these drugs should not be a reason to penalize millions of responsible individuals in serious pain.”

Balancing the needs of patients in pain against the abuse of such drugs is a difficult dilemma. The new rules may bring additional suffering for those with legitimate need for narcotic pain medicine.

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  1. Dawn
    Wisconsin
    Reply

    I am pushing 60. I had a non fda botched 3 level fusion in 1992. I live in agony. I refractured after motor vehicle rear end by a stolen uhaul truck 1995. I was so scared i tried everything except surgery until critical mass when i lost bowel feeling. I decided to try surgery in 1997. Better surgery. It failed. Ive been bent over in pain.

    Now 20 years later new accident popped disc above surgery Pain like no ones business plus my old sciatic and Lower back pain. Oh well

    My primary retired. He was well educated, more than any I’ve met with alot of accolades. The new ones nurses decided i was too much paper work and portrait me as a pill seeking junky. They’ve cut my extended release in half within the last three months. Ohhhh i negated to add in that three past months i fell and snapped the top of my humerus and reinjured my back. Dropped my regular meds after 25 yrs by wirld renowned drs . Trying to find new primary but this new has trashed my name and made me look like a junky by giving me weekly and rapid detox . What the heck. I could barely walk before now i try to grocery shop and everyone stops me and prays for me or i sit and cry…

    Im also taking care of orphaned grandson. Trying to have any quality of life….
    what kind of democratic society welcomes torture….
    To us. Opiate dependant pain patients that are legit…

  2. Tim
    California
    Reply

    I fully agree with the above posts. People with chronic pain that have been responsible should have the right under our constitution to pursue happiness. Not be grouped in with criminal abusers. we must find a way through legal recourse! If anyone out there has sought legal advice I would love to hear from you. I am going to begin looking for options that will protect my rights as an American with chronic pain, trying to save what little quality is left of my life. If I fail so be it. But I will not continue with this level of pain and cause unnecessary hardship on my family. It’s sad to hear of so many people taking their lives after their coward Dr’s. refused to refill necessary medication. I am willing to go down fighting for the greater good. If there are others respond to this post. My name is Tim in California. Lets fight together!

  3. Royce
    Niagara Falls, New York
    Reply

    It’s now 2019; five years removed from when my pain medication was taken away. It doesn’t look like things will ever change. There are two new trends I am seeing:
    1) now benzodiazepines are being taken away for anxiety just like opiates were five years ago. The speech I got from my doctor regarding my klonopin was very similar to the one I had when pain medication was taken away (‘this wasn’t meant to be forever’, ‘the way we’re approaching this isn’t working anymore’, ‘these drugs carry serious long-term risks’). So look out; our anti-anxiety medications are about to be taken away. I went to my last appointment and noticed I didn’t get any refills.

    2) rather than prescribing pain medications, those of us in chronic pain are being pressured to get injections or have unnecessary surgeries. All because these doctors are afraid of being sued for prescribing opiates. This is ridiculous. If the doctor is afraid to treat their patient, then why the HELL did these people become doctors?! I never thought I’d survive being without pain medication. If you had asked me 5 years ago I would have said I’d be gone by now. But what other choice do we have? All you can do is keep on. My quality of life is terrible. I’m depressed all the time; I can’t do much or go anywhere. But I have a family.

    I’m very, VERY angry that we wound up being collateral damage in this war on drugs. I am also extremely skeptical about the angle that this ‘crisis’ has been delivered via the media. Someone HAS to be making money off of this. We aren’t being told about opiates just for our own good. I’m convinced that the drug treatment and insurance industry is making a fortune off these treatment clinics that are licensed to bill insurance for every addict they get.

    I don’t see any of this changing. I’ve had to suck it up and just get on with life in pain. Nobody cares, and unless someone has been in pain – especially when there are ways to treat it but our doctors are sitting on those options and won’t help us, well, tough. We can’t do anything about it. I’ve stopped talking about it in public because the medical marijuana people have an agenda and want to get you fired up about moving over to that; I’ve tried it and sorry, medical marijuana didn’t do anything for my pain. Not to mention…I don’t want medical marijuana; I want my prescriptions that gave me a quality of life back!

  4. Terry
    Houston, Texas
    Reply

    I have severe lower back pain. I have deterioration of the lower spine plus arthritis and just recently another very painful malady to my lower spine. A leading Neurosurgeon in my area advised me against taking any operative measures for this recent new pain because “the pain would still exist and, indeed, could become worse”. I have been taking Hydrocodone 7.5/325 for 12 years. (I’ve had 3 injections to my lower back and have taken steroids all to no avail) I was just ready to ask my doctor for 10/325 when I was told it is too late. By law, they cannot give me anything stronger. I had only held off as long as I could because I never wanted to go to anything stronger than hydrocodone.

    After 4 months of a leading pharmacy withholding my prescription, always telling me when I called it in that there was plenty, only to be told they were out and did not know when they would have more when it was time for me to pick it up, I switched to a smaller pharmacy who is always honest with me. Then another drug hit the market in place of my regular hydrocodone. It is called M366. This is the worst thing that ever has happened to me personally. After 4 months of this drug, I am in pain continually. I had to stop my walks around my block. The pain was too much. My pain doctor had me doing stretching exercises. I can no longer exercise at all. I cannot shop for groceries, I cannot do any housework. When I must absolutely force myself to do any housework at all, I am bedridden afterward.

    I love my grandchildren. Keeping only one of them for even a couple of hours, I am bedridden the rest of the day and cannot move the next day. My husband must do all shopping without me. I rarely cook, as standing for any length of time sends my lower back into what feels like a fresh severe injury, but I know that it is the M366 just not working.

    My good pharmacist tells me that he cannot obtain anything but M366. The black market must be getting richer and richer. Marijuana is being legalized. I would never even consider taking such a drug or any other illegal drug, yet the quality of my lifestyle has taken such a nosedive. I lie on the couch or in bed every day. What kind of life is this?

    I did not have any side effects whatsoever with the regular hydrocodone, certainly not taking it this long. I never felt “high” on this drug. I never abused it. I have always taken urine tests along with regular blood tests all this time. My liver is fine. I get blood tests every six months and “drug” (urine) tests regularly.
    Why, oh why, must I pay for the addiction problem? My life is now falling apart as I am sure the black market gets bigger…and bigger..and bigger.

    Is there ever going to be help for me and others like me? Will the help take place in my lifetime?

  5. Douglas Martin
    Modesto, California
    Reply

    This is extremely ridiculous and I can’t believe it is legal without some kind of active appeal system in place, or a neutral 3rd party who can be an advocate for patient rights! The system has gone astray. Where is the correlation between the responsible pain patient and the addicts overdosing (most without prescriptions to boot)? There is not one. I have been taking pain medication for a variety of reasons since I was 23. That’s 16 years. Responsibly.

    I also used to take Soma, then came the start of this ridiculousness….they took it away and gave me pseudo medication which might as well be sugar pills.

    NOW they are after my Xanax which I take daily as I have very bad PTSD that stems from a traumatic experience in my life that changed me as a human being forever. I have relied on this medication for 16 YEARS. I, am alive.. I AM responsible. I am not a junkie.. yet today my doctor literally told me about these restrictions and said “you will have to make a choice between being in pain or having to go through anxiety”… wth kind of physician responds to the patient that way? Talk about a violation of the oath he took!!! People have a RIGHT to be pain free, and a RIGHT to not have to suffer horrible, legitimate anxiety. Why is there no option for the patient to sign a legally binding form which says the doctor is NOT RESPONSIBLE in the event of a medication related problem? A waiver?

    This needs to be redacted and changed with long term responsible patients taken into consideration and not thrown away into the garbage because doctors are afraid if lawsuits.

    This is a perfect example, Americax of the government having too much power over the people and mistreating us. They are legalizing weed for the potheads like crazy in states all over, and my kids get to breath in marijuana smoke if we choose to have our windows down while driving in our cars or at home on a nice day because our neighbors are potheads.. and they literally have free reign right not with zero consequence to do their drugs in public.. but a law abiding citizen in their own home had their rights stripped from them, to not be able to go to sleep because of panic attacks or wake up and relieve their pain so they can start their day and take care of their lives?

    This is a mockery of justice.
    Deep shame on the system!!!!
    OPIATE AND BENZO LAW REFORM NOW!

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