Fewer Prescriptions, Fewer Pills; Can Fewer Deaths be Next?

Fundamental changes in the prescription process designed to reduce fraud and abuse.

Deborah Hersman is president and CEO of the National Safety Council.

​There has been a lot of bad news about opioid painkillers lately, so it was refreshing to hear some good news, news that could mean thousands of lives saved.

The good news is, due to a change in the rules for prescribing painkillers in 2014, certain opioids prescriptions were reduced by more than one-fifth.

What the DEA did was straightforward: Hydrocodone combination products (HCPs), which had been listed as Schedule III medications, were shifted to the more restrictive Schedule II. By moving these opioid painkillers to Schedule II, there were two fundamental changes in the prescription process.

First, prescriptions need to be signed by a health care practitioner – the prescription cannot be phoned in or faxed in.  Second, refills of the medication are prohibited. The first change will reduce fraud, and the second change will reduce abuse, and in a nation where more than 18,000 people die every year from opioid overdoses, these changes can make a difference.

The reclassifying of HCPs as Schedule II medications will almost certainly have an impact. The reclassification resulted in a 22% decline in the number of HCP prescriptions issued and a 16% drop in the number of HCP tablets dispensed, according to research conducted by the U.S. Food and Drug Administration. With fewer people getting prescriptions for these opioids, and with refills no longer an option, the exposure to these painkillers – and the opportunity for abuse – is reduced.

We know there are a lot of factors that contribute to the problem of overdose deaths, and those factors have been the subject of studies and articles in recent months. So we can't be certain the reductions in prescriptions and tablets dispensed will translate into a measurable drop in overdose deaths. But we can be optimistic.

There are alternatives to HCPs; over-the-counter medicines such as ibuprofen, naproxen and acetaminophen are effective pain relief options that don't have the risks that opioids have. The National Safety Council has been one of many voices calling for reduced availability of opioid painkillers because of the risk of abuse, addiction and overdose.

FDA researchers recommended that future research be conducted to determine if the DEA's changes continue to allow access for patients in need while bringing about reductions in abuse and overdose. I look forward to seeing that research, and I hope it will show that people in pain are getting relief while opioid-related fatalities decline. Every drop in the number of deaths by overdose is a life saved and a reminder that potentially transformative improvements are out there if we are willing to find them.

The DEA made a change that might save thousands of lives, and you can make small changes too. By opting for non-opioid painkillers, declining refills and not keeping unused opioids around your home, you can reduce the availability of opioids and make abuse less likely in your home and your community.

Follow @DebbieHersman on Twitter.

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