Beginning October 6, 2014, hydrocodone combination products will be reclassified as Schedule II substances and subject to tighter restrictions to help reduce diversion, misuse, and abuse of prescription painkillers. HCPs affected by the new DEA rules include Vicodin, Lorcet, Lortab and Norco.
To learn how these changes may impact your endodontic practice, listen to this interview with AAE President Robert S. Roda and endodontist and pharmacist Dr. B. Ellen Byrne and read the information below.
Why is the DEA rescheduling HCPs?
HCPs are the most prescribed opioid in the U.S. They are associated with more abuse and diversion than other opioids. HCPs are being moved from Schedule III to Schedule II. Drugs with the highest addiction potential with an accepted medical use fall under Schedule II and those with progressively less potential for harm and abuse fall into Schedules III through V.
When does this take effect?
October 6, 2014. However, refills are valid if the original prescription was written before October 6 and the medications are dispensed before April 8, 2015. Some state laws will not allow for refills of any HCP prescriptions, regardless of when the prescription was written, so it’s important to know the regulations in your state.
Can I phone in or fax a prescription for HCPs?
No. The new rule prohibits pharmacies from filling prescriptions delivered over the phone or via fax, so you’ll need to issue written scripts. The only exception to this rule is emergency treatment, which would allow you to call in a limited quantity of the medication to cover a 72-hour emergency period only. You or the patient must provide the pharmacy with a written prescription within seven days of calling in the emergency prescription.
Are there other restrictions associated with writing prescriptions for Schedule II drugs?
Restrictions on Schedule II drugs limit patients to a single supply of medication and require the patient to visit a health care professional to get a written prescription for all refills. New prescription forms are not required, unless mandated by your state. E-prescribing is allowed if the software meets DEA requirements.
I am registered with the DEA to prescribe Schedule III-V drugs. How do I change my registration status?
Dentists who are not registered for Schedule II will have to reregister with the DEA for authority to continue prescribing HCPs for their patients. Visit the DEA’s website, call the DEA Registration Service Center at 800-882-9539 or emailDEA.Registration.Help@usdoj.gov.
What should I tell my patients?
As a profession, endodontists have done a very good about stressing the use NSAIDs whenever possible. We have a duty to the patient to be judicious about prescribing and narcotics, including the hydrocodone combinations. Patients need to understand the dangers of using the drugs for non-medical purposes and how to properly secure, monitor and dispose of their medications. There are alternatives to HCPs that endodontists should consider including Codeine combination products and tramadol.