Drugs that are controlled substances are those that have the most potential for abuse and physical and mental addiction and are “scheduled” according to the degree to which they have the ability to cause these effects. Controlled drugs that are considered schedule II (CII) for example Percocet, are the most likely to cause mental and physical dependence. The scheduling ranges from CII- CV, schedule II (CII) being most addictive to CIII, CIV and CV being least probable to cause addiction and dependence
CI drugs are not available by prescription and heroine is an example. CII prescriptions may not be called into a pharmacy
A situation that has been debated over and over again finally seems to be becoming a reality for those who have wanted hydrocodone combination products put into CII status. It seems that the FDA (Federal Drug Administration) recently cleared the way for this to happen, a move that the DEA (Drug Enforcement Agency) has endorsed for some time.
Pure Hydrocodone has always been a CII product, but it is only found in compounding pharmacies. That’s about to change, too, as Zogenix Pharmaceuticals obtained approval for an extended-release hydrocodone pain reliever called Zohydro. Understandably, it was placed into the CII category since it has no acetaminophen or ibuprofen combination.
When you take a look at what makes a prescription drug a CII, the most restrictive prescription schedule, it is the propensity for addiction and abuse. By that definition, hydrocodone combinations clearly fit the bill although hydrocodone combo drugs are currently schedule CIII. Hydrocodone has long been the most abused pharmaceutical, representing half or more of the caseload for those who work in the law enforcement field combating drug diversion.
Many would argue that with hydrocodone combinations being in the CIII category, fake call-ins and refill alterations are possible, unlike with their CII cousins which need to be written prescriptions and cannot be called into a pharmacy unless under specific and rare circumstances, and cannot have refills. The combinations are bunched together with the CIV and CV drugs, unlike the CII drugs, which have the distinction of being in their own files. Criminal penalties with CIII drugs are typically less in state courts and require a tractor trailer load to generate any interest by US attorneys in federal court!
Some states require a person to possess at least 30 extra strength hydrocodone combination pills illegally to generate a low-level felony charge while it stays at CIII. Once it becomes CII, possession of just 1 of these same pills becomes a felony.
Another aspect to look at in this debate is the fact that hydrocodone is also the #1 prescribed prescription drug in the US! With these overwhelming numbers in mind, a certain percentage of controlled substances will be abused by society.
Although many want hydrocodone combination products to be CII because it takes away the ability to call them in to the pharmacy and give patient refills, this is the very reason some prescribers and patients want hydrocodone to remain a CIII. The biggest argument is that legitimate patients will have to visit their prescriber each time they want a refill adding to the inconvenience and expense of more office visits to the already rising costs of health care. But a lot of prescribers won’t even call in controlled substances and require that the patient pick up the prescription from the office. This system does not have to require an office visit, if they are just picking up the prescription thus avoiding fake call-ins by office staff and/or patients because the doctor knows when it was picked up through documentation.
One things for sure, once hydrocodone combo drugs are place into the CII category , it will most surely never return to the the CIII status it enjoys today. What do yout think? Is making thses products more restrictive in scheduling, will it affect patients negatively or positively? How about the pharmacy industry? Let me kow what you think.