The reason that your doctor can’t call your refills into the pharmacy anymore is because the US FDA reclassified hydrocodone combination products (e.g. mixed with Acetominophen) from Schedule III to Schedule II, effective October 6, 2014. This schedule change resulted from rising concerns of increased use and misuse.
There is no question that pain management is a necessary part of good patient care after a traumatic injury or surgery, but long-term use has implications for the individual and society. The individual can develop tolerance and have worse treatment outcomes.
Society can suffer when opioids are used inappropriately for nontherapeutic reasons – translated “recreational use”. Recreational use is associated with addiction and unintentional overdose deaths. This is no small problem! Increases in prescription drug overdoses are largely responsible for the alarming rise in unintentional overdose deaths in the United States, which increased 124% between 1999-2007. Opioids now account for more deaths each year than from cocaine and heroin deaths combined.Even more shocking, is the fact that opioid-related deaths are more frequent than deaths from suicide or motor vehicle crashes.
The economic burden of nontherapeutic use is staggering, > $50 billion annually attributed to loss of productivity and criminal justice costs.There is an uneven global distribution as well. Consider this, the annual estimated use of hydrocodone in the US is 27,400,000 grams. The annual estimated use in Great Britain, France, Germany and Italy combined is 3,237 grams !
Is there more pain in the past 10 years than the 10 years prior to that?
I doubt it, but the way pain is being managed is certainly different, especially when one compares hydrocodone use in other countries. One of the big problems I often see with long-term use of hydrocodone is an increased sensitivity to pain as well as decreased function. These alone are two great reasons to avoid narcotics for long term pain issues, when possible.
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