Hydrocodone restrictions recently implemented by the Drug Enforcement Administration (DEA) have sparked debate in the ongoing discussion about prescription drug abuse and put addiction treatment in the spotlight. The DEA’s decision to enact more rigorous restrictions on prescriptions and pharmacy supplies of the drug is an effort geared towards minimizing the levels of abuse by limiting overall access to the medication.
The New York Times reports that over 20,000 Americans per year die from prescription drug abuse, more than those killed in traffic accidents. The American Association of Poison Control records over 27,000 reports of people seeking help for abuse of the opiate. Teenagers top the list of those struggling with hydrocodone addiction, according to Rehab International. This makes the DEA’s decision to move the narcotic drug to a more restrictive category an important preventive measure to intercept the chain of abuse and addiction before it starts by limiting access to the medication.
The new restrictions limit doctors to written prescriptions, as much narcotic abuse happens through telephone orders. Patients will have to visit their health care provider before obtaining a refill and pharmacies must take extra precautionary measures to keep their supplies in a locked vault. Some pain management professionals express concerns about the rule placing an unfair burden on the elderly or those living in remote areas where a doctor visit is not easily accomplished. David Kroll, a pharmacologist at The Research Triangle Park in North Carolina writing for Forbes magazine, does not find this argument compelling. He expresses doubt about the negative impact on patients and expects more frequent doctor visits could actually result in better pain management, lessening the likelihood of opiate abuse.
The DEA reported almost 140 million prescriptions for hydrocodone products for post-surgical and chronic pain conditions in 2010 alone, making it the most frequently prescribed opiate in the U.S. However, some patients find it difficult to walk away from the high it produces or the relief that it gives. As a person increases the dosage and frequency of the drug beyond their doctor’s recommendations, their body and mind adjust and develop a tolerance that demands an ever-higher dose to experience the same relief. Dependence occurs when the brain tells the body that the user cannot achieve peace of mind or perform normal daily functions without the drug. Hydrocodone addiction not only has physical consequences on respiration and liver function, but can also cause mental health problems, which negatively affect a person’s personal and family life, work performance and ability to carry out the routines of daily life.
Being aware of the typical symptoms of narcotic abuse can help protect friends or family members who take the opiate, whether as a temporary post-surgical measure or for habitual pain, from traveling the dark road of addiction and recovery. Warning signs that should spark concern include excessive refill requests, duplicate prescriptions from multiple doctors, social isolation, a fixation on narcotics as the answer to life’s pain to the exclusion of everything else, mood swings, unexplained changes in customary social life and money shortages. Because hydrocodone is a legal drug, the abuse problem may not receive as much attention in drug abuse discussions as illegal substances. However, the addiction produces the same cravings and self-esteem damage that only a proper drug and alcohol rehabilitation treatment program can provide. Although the new restrictions are not a panacea for all the circumstances surrounding opiate addiction, Kroll contends that the fewer surplus pills gracing the shelves of friends and family members, the fewer opportunities those at risk for hydrocodone abuse will have to start down the road to dependence.
By Tamara Christine Van Hooser
New York Times
Drug Enforcement Administration: Drugs of Abuse, page 41
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