Good news for chronic pain patients––for now at least. Last month the Senate passed a bill reauthorizing user fees for the FDA, which also included new, tougher restrictions for opioid pain medications containing hydrocodone like Vicodin and Lortab. However, when the bill went to the House on Monday, the proposed restrictions were dropped from the bill.
The reason the restrictions were removed was reportedly due to a massive lobbying effort by drug stores and pharmacists. The drug stores and pharmacists had two major objections to the legislation:
Pain patients would have a more difficult time getting the treatments they need.
Pharmacies would be burdened with higher administration and security costs.
The proposed controls would have required patients to visit their doctors and get a new written prescription whenever they needed a refill for a medication containing hydrocodone. Doctors would no longer be allowed to call in prescriptions for these medications. Other new requirements proposed included tighter security for storage and transportation of the drugs and higher penalties for misuse.
Proponents of legislating tighter controls for painkillers always cite statistics that show a rising death toll from prescription drug abuse. A New York Times article quoted Senator Joe Manchin III of West Virginia, who led the effort for additional restrictions, saying, “These are legal drugs needed by some people. But they can also be addictive. They are so readily accessible, so easy to obtain, that they are ravaging society and ending many young lives.”
The article also reported, “Chuck Canterbury, National President of the Fraternal Order of Police, urged Congress to adopt the restrictions, saying they would help reduce illicit trafficking in prescription drugs.”
I am glad these proposed new restrictions were not approved––not because I'm not concerned about drug abuse but because I don't believe they would be effective in reducing drug abuse. I do believe, however, that they would hurt chronic pain patients in at least a couple of ways:
Every time new restrictions are added, more doctors decide to stop prescribing opioids all together, leaving patients without any hope for pain relief.
Patients and their insurance companies would have to pay for additional office visits, which are not necessary for any other reason than to refill a prescription.
Whenever I hear quotes like those of Senator Manchin and Mr. Canterbury, I realize that they don't have a clue about how difficult it already is for chronic pain patients to get the medications they need. I want to ask them, “If these drugs are 'so readily accessible, so easy to obtain,' why do I hear from so many people who are in pain and can't find a doctor who is willing to prescribe any kind of opioid pain medication?”
I also want to tell them that the kind of controls they're proposing will not “reduce illicit trafficking in prescription drugs.” People who are willing to break the law and sell drugs are not going to be deterred by these restrictions. Their “business” is not limited to the type of single monthly prescriptions these controls address.