Hydrocodone and Schedule II

For the introduction, please read the always excellent DB’s Med Rants about the DEA’s bright idea to put a clamp on prescription drug abuse by moving hydrocodone (Vicodin, Lortab) to Schedule II.

After you’ve read the above, then read below.

This rescheduling could also have the unintended consequence of increasing Schedule II medication prescription. In Texas, any med above Schedule III needs a government issued prescription, with a state monopoly on printing and distribution, and some reasonably restrictive rules about keeping copies, etc. (They used to be triplicate copy forms, with “Name of patient or animal” on one line, showing their utility for physicians and vets alike).

So, my main choice for my patient with a broken arm will be Tylenol #3 (acetaminophen with 30mg of codeine, a study-proven dog of a pain killer), or filling out a special order form for my patient with acute pain.

Here’s where this backfires: if I’m going to the trouble of getting and filling out the state prescription, why not give percocet, which is a better pain med, and is still Schedule II? I’m giving even better pain meds that I’ve been avoiding due mainly to the paperwork and oversight hassels, but this could compell me to get the state prescriptions and start using them.

The Law of Unintended Consequences awaits another government regulation.