Attorney general's open letter informs doctors and pharmacists that hydrocodone products are now Schedule II controlled substances
Doctors may not write hydrocodone prescriptions with refills; pharmacist may not dispense automatic refills
Schedule change is part of comprehensive I-STOP program to fight prescription drug abuse
Attorney General Eric T. Schneiderman issued an open letter Wednesday to doctors, pharmacists and other medical professionals alerting them that the prescription painkiller hydrocodone is now a Schedule II controlled substance under New York state law. Going into effect this week, the change from Schedule III to Schedule II subjects all strengths, formulations and combination products of hydrocodone to a variety of stricter controls, including a prohibition on automatic refills. The schedule change was mandated as part of Schneiderman's Internet system for tracking overprescribing law, or I-STOP, which was signed in to law last year in an effort to rein in abuse of addictive prescription drugs like hydrocodone.
"Hydrocodone is highly addictive and widely abused," Schneiderman said. "By implementing new rules for hydrocodone, including ensuring follow-up visits with patients instead of providing automatic refills, medical professionals can prevent more New Yorkers from being trapped in a damaging cycle of addiction. This rule change will ensure that those who need pain medication are protected and those who abuse it are detected.
In addition to implementing stricter controls on hydrocodone prescriptions, I-STOP creates an online database that enables doctors and pharmacists to report and track controlled narcotic substances in real time. The I-STOP database, which providers will be mandated to use starting in August, will provide health care practitioners and pharmacists with centralized information to avoid over-prescribing, help shut down prescription drug trafficking, and identify and treat patients who seek to abuse prescription drugs.
Prescription drug abuse is the country's second most prevalent illegal drug problem, and recent reports and studies have documented corresponding data in the state. According to a recent Centers for Disease Control and Prevention report, hydrocodone is among a group of opioid drugs that contributes to 3 out of 4 medication overdose deaths. The report also noted that drug overdose deaths rose for the 11th straight year, and the majority of those deaths were accidents involving addictive painkillers.
Statewide, prescriptions for hydrocodone filled increased from 3.8 million to 4.5 million from 2007 to 2009, an increase of 18.4 percent, while those for oxycodone have increased an astonishing 82 percent. In many regions of the state, hydrocodone is the most commonly prescribed controlled substance:
•Albany County: From 2008-10, hydrocodone was the most commonly prescribed controlled prescription drug in Albany County, followed by zolpidem (Ambien), then alprazolam (Xanax).
•Erie County: From 2008-10, hydrocodone was the most commonly prescribed controlled prescription drug in Erie County, followed by zolpidem (Ambien), then alprazolam (Xanax).
•Jefferson County: From 2008-10, hydrocodone was the most commonly prescribed controlled prescription drug in Jefferson County, followed by oxycodone.
•Monroe County: From 2008-10, hydrocodone was the most commonly prescribed controlled prescription drug in Monroe County, followed by oxycodone, then zolpidem (Ambien).
•Nassau County: In 2008 and 2009, hydrocodone was the most commonly prescribed controlled prescription drug in Nassau County, followed by zolpidem (Ambien), then oxycodone.
•NYC:Hydrocodone and oxycodone were the most commonly prescribed opioid analgesics in New York City in 2010, with more than 787,000 hydrocodone prescriptions filled that year.
•Onondaga County: From 2008-10, hydrocodone was the most commonly prescribed controlled prescription drug in Onondaga County, followed by oxycodone, then alprazolam (Xanax).
•Suffolk County: From 2008-10, hydrocodone was the most commonly prescribed controlled prescription drug in Suffolk County, followed by oxycodone, then zolpidem (Ambien).
•Westchester County: In 2008 and 2009, hydrocodone was the most commonly prescribed controlled prescription drug in Westchester County, followed by zolpidem (Ambien), then oxycodone.
By requiring a new consultation in order to refill a hydrocodone prescription, I-STOP will enhance physician oversight of patients treated with hydrocodone, providing additional opportunities for physicians to identify and treat signs of potential abuse or addiction.
Below is a copy of Schneiderman's open letter to medical professionals:
"February 27, 2013
"This open letter is addressed to physicians, pharmacists, and other medical professionals who prescribe or dispense medications containing hydrocodone in the State of New York.
"Effective this week, Hydrocodone (dihydrocodeinone) has been added to Schedule II of Section 3306 of the New York State Public Health Law. Common brand name pharmaceutical preparations containing the hydrocodone include Vicodin®, Lortab®, Tussionex®. This action renders all products containing hydrocodone, including but not limited to hydrocodone in combination with acetaminophen or ibuprofen, Schedule II.
"For details on the additional restrictions that are now in effect for medications containing hydrocodone, including inventory requirements and restrictions on refills, please consult the New York State Department of Health, Bureau of Narcotic Enforcement website at: www.health.ny.gov/professionals/narcotic/.
"As you know, prescription drug abuse is a serious and growing problem in New York State and across the nation. Your cooperation in implementing the rescheduling of hydrocodone will reduce instances of illegal diversion and abuse, and ultimately save lives.
"Thank you for your dedication to your patients, and to the promotion of public health in our state.
"Eric T. Schneiderman
New York State Attorney General"