Monday, February 18, 2013

New restrictions on painkiller prescriptions take effect Saturday |

Syracuse, N.Y. – Central New Yorkers with prescriptions for Vicodin and other painkillers containing hydrocodone will not be able to get them refilled starting Saturday unless they go to their doctor for a new prescription.
The change is required by the state's new I STOP law, designed to address the epidemic of prescription painkiller abuse and addiction sweeping Central New York and the rest of the nation.
Hydrocodone will become classified as a schedule 2 drug Saturday. That means refills will no longer be allowed for hydrocodone prescriptions. Even people holding hydrocodone prescriptions authorized for more refills won't be able to refill them starting Saturday.
"What we've been doing is warning our patients that they will need a new prescription the next time," said Selig Corman of the Pharmacists Society of the State of New York.
Hydrocodone is a type of drug known as an "opioid." Opiods can create intense feelings of euphoria or well-being. They are synthetic versions of opiate drugs such as morphine and heroin, derived from the opium poppy. Hydrocodone is usually combined with other drugs such as acetaminophen. Some of the popular brand-name prescription drugs containing hydrocodone include Vicodin, Lortab and Tussionex.
Dr. Brian Johnson, director of addiction medicine at Upstate, said patients are often prescribed enough hydrocodone after surgery to last them several months, when they should only get enough for a few days.
The number of prescriptions written in Central New York for the two most popular prescription painkillers — hydrocodone and oxycodone — soared between 2007 and 2011, according to the state Health Department. 
Hydrocodone prescriptions increased more than 50 percent, from 181,993 in 2007 to 274,293 in 2011, while oxycodone prescriptions jumped by nearly 90 percent, from 64,755 in 2007 to 122,415 in 2011.
Also starting Saturday, Tramadol, a prescription muscle relaxant drug, will become classified as a schedule 4 drug as part of the I STOP law. Brand name versions of the drug include Ultram, Ultacet and Ryzolt. There are no limits on how much Tramadol can be prescribed now. Under the new classification, doctors will only be allowed to prescribe a 30-day supply of Tramadol with five refills. People with prescriptions for Tramadol issued before Saturday can get them refilled as long as the prescription is not more than 6 months old and the number of authorized refills does not exceed five.

Johnson of Upstate is happy about the changes. "It has to do with raising consciousness of how addictive these drugs are," he said.
Patients are often incorrectly told Tramadol is not addictive, then they end up in detox programs, Johnson said.
The new restrictions may create problems for some chronic pain patients and their doctors, said Dr. Joseph Catania of the New York Spine and Wellness Center, a pain management practice with offices in North Syracuse and DeWitt.
Catania said he agrees with the law's intent to curb diversion and abuse of painkillers. "But this prevents a medical office from using some judgment to determine the required follow up visit," he said.
Patients who are stable and only need to see their doctor every several months now will have to schedule office visits monthly, he said.
"This is going to create a flood of patients into the medical community who may not have that type of routine access to care," he said. "It will impact all of us in how we take care of patients."
Under the new regulation, doctors can prescribe 90-day supplies of hydrocodone for chronic pain patients.
The prescribing changes are just the first of several provisions in the I STOP law designed to overhaul the way prescription drugs are distributed and tracked in New York. The law will require doctors beginning Aug. 27 to consult an electronic prescription database when they are prescribing controlled substances. The database, being developed by the state, will include information about controlled substances – drugs regulated by federal law -- dispensed by pharmacies on a real time basis. The intent of the database is to prevent "doctor shoppers" from obtaining prescriptions from multiple physicians.
The law also will eventually mandate that all controlled substances be prescribed electronically.