hydrocodone combination pills now to be Schedule II medications.

[Hmac]

Isn't oxycodone stronger than hydrocodone?

Yup.

Oxycodone has been Schedule II from the beginning, IIRC.

This is the kind of stupid shit that happens when the government tries to practice medicine. Politics and bureaucratic incompetence make for bad medicine.

[markm]

This is the kind of stupid shit that happens when the government tries to practice medicine. Politics and bureaucratic incompetence make for bad medicine.

Why is this so hard for Voters to see.

[fixit69]

Anyone with a problem like degenerative disc (me, due to repetitive injury) or a plethora of other disorders or diseases has been prescribed these drugs. It sucks. Pain is relative to the person who is afflicted by it.
If they choose to abuse it, than you should recieve the consequences. Life is hard enough without the douche bags messing everything up and selling, overdosing, and otherwise not taking the meds like your supposed to. Then the .gov is going to take care of it for you. And that always ends well, doesn't it?

[Hmac]

Most physicans I know who arent pain docs or oncologist don't routinely Rx schedule II medications.

I don't agree. Surgeons often prescribe Schedule II narcotics for post-op pain control...usually oxycodone or oxycodone/acetominiphen (Percocet). Different surgeons usually have different post-op pain regimens and medication preferences and while many do use hydrocodone, many do not. Personally, I find that hydrocodone is less often effective than oxycodone. The trend these days is to limit the daily dose of acetominophen because of concerns about the potential for liver damage, so there is often less prescribing of Percocet or Vicodin, for example.

A few years ago I underwent a bilateral knee replacement. The surgeon sent me home with a prescription for 60 oxycodone tablets. I probably took about 5. I'm sure I still have 55 oxycodone tabs sitting around home somewhere. I found them effective at controlling pain and they didn't make me particularly goofy. That experience has modified my prescribing tendencies.

[skydivr]

A friend of mine is a Hospice Care (those who are gonna die) nurse, and they use pain meds prodigiously (because the patient is dying). She says that hydro is hugely popular on the street about $2/pill. She's a big fan of marijuana (I'm not) as she believes it does a better job of relieving pain, stimulates the appetite, and for those dying it provides a modicum of comfort, with less side-effects.

As a back surgery and kidney stone 'survivor', hydro didn't do squat for me, but oxyx did. And yes, I kept what I didn't use, because when a stone is moving and the Dr is closed, it's that or the ER...

[ALCOAR]

Marijuana is THE kryptonite for big Pharma. It's only a matter of time now til we see huge advancements in medical marijuana.

I've known a number of people that have had their lives completely ruined by Doctors, and opiate pain prescription medications.

Long term pain management on these types of drugs is an absolute joke. I'm all for huge restrictions on these types of medications.

[wildcard600]

Marijuana is THE kryptonite for big Pharma. It's only a matter of time now til we see huge advancements in medical marijuana.

I've known a number of people that have had their lives completely ruined by Doctors, and opiate pain prescription medications.

Long term pain management on these types of drugs is an absolute joke. I'm all for huge restrictions on these types of medications.

marijuana should be legal period. it it were never illegal in the first place alot of the problems this country currently experiances porbably wouldnt exist.

[ALCOAR]

Completely agree. It would be amazing to see how many fewer alcohol, and prescription drug related deaths would occur each year if marijuana was either completely legalized or at least available for medical purposes in all 50 states.

Just today a major study was released regarding this very topic....

"America has a major problem with prescription pain medications like Vicodin and OxyContin. Overdose deaths from these pharmaceutical opioids have approximately tripled since 1991, and every day 46 people die of such overdoses in the United States.

However, in the 13 states that passed laws allowing for the use of medical marijuana between 1999 and 2010, 25 percent fewer people die from opioid overdoses annually."

http://www.newsweek.com/states-medic...drop-25-266577
http://www.m.webmd.com/a-to-z-guides...arijuana-study

[Sensei]

Yup.

Oxycodone has been Schedule II from the beginning, IIRC.

This is the kind of stupid shit that happens when the government tries to practice medicine. Politics and bureaucratic incompetence make for bad medicine.

I'm not so sure that this is a bad idea. Like you, I agree that hydrocodone is a rather crappy analgesic when you consider the rather high rate of GI side effects compared to oxycodone. However, the purpose of this move is to begin to breakdown the practice of primary care providers prescribing hydrocodone preparations over long periods of time with minimal oversight. I'm sure that you too see your fair share of patients whose PCP provides them with 120 tablets of hydrocodone every month (usually combined with 90 tablets of Xanax). This is piss poor medicine, a major source of public morbidity/mortality, and an example of the medical community failing to police itself.

Bottom line, this ruling will have no impact on our practice of providing appropriate short term analgesia to our patients with acute pain. It is however a good first step in reigning-in PCP's who think that they know how to manage chronic pain with the long-term use of short acting opiates. It will also help control diversion techniques such as calling in false prescriptions.

[Hmac]

I'm not so sure that this is a bad idea. Like you, I agree that hydrocodone is a rather crappy analgesic when you consider the rather high rate of GI side effects compared to oxycodone. However, the purpose of this move is to begin to breakdown the practice of primary care providers prescribing hydrocodone preparations over long periods of time with minimal oversight. I'm sure that you too see your fair share of patients whose PCP provides them with 120 tablets of hydrocodone every month (usually combined with 90 tablets of Xanax). This is piss poor medicine, a major source of public morbidity/mortality, and an example of the medical community failing to police itself.

Bottom line, this ruling will have no impact on our practice of providing appropriate short term analgesia to our patients with acute pain. It is however a good first step in reigning-in PCP's who think that they know how to manage chronic pain with the long-term use of short acting opiates. It will also help control diversion techniques such as calling in false prescriptions.

I don't disagree with your points above, although this state has a very robust narcotics "oversight" program and has for years. At least a few of my primary care colleagues have been called down to appear before the Board of Medical Practice over the last several years to explain just such prescribing practices and then be sentenced to some form of rather onerous remedial action. Of course, the pendulum has since swung the other way, and I find that adequate pain control is more likely to be underprescribed these days, even for acute pain...but chronic bulk Vicodin giveaways are quite rare. So we have that going for us, which is nice.

Anyway, my quarrel is with the government, state or Federal, involving itself in the practice of medicine. One only needs to look at the Veterans Administration to see how well that works. From a practical standpoint moving hydrocodone to Schedule II will have virtually zero impact on my practice and very probably the practice of my colleagues.