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ADD I C T I O N M E D IC IN E New Guidelines Aim to Curb Overuse of Narcotic A UCLA Health family physician and addiction-medicine expert believes stricter federal prescribing rules that took effect in October 2014 for products containing hydrocodone — the ingredient in some of the most widely used painkillers — represents an important step toward curbing the overuse and abuse of the narcotic. The new rules enacted by the U.S. Drug Enforcement Administration move hydrocodone-combination products, including commonly prescribed drugs such as Vicodin, Norco, Lortab and Reprexain, from schedule III classification to the more restrictive schedule II category, where they will be subject to the same restrictions as narcotics such as oxycodone and morphine. That means that doctors can no longer write prescriptions that can be automatically refilled, and they can’t phone or fax prescription orders to a pharmacy — patients must visit their doctors in person to obtain any prescription order. The action came after prompting from both the U.S. Food and Drug Administration and the U.S. Department of Health and Human Services in an effort to reduce the problem of opioid dependence, which affects nearly 5 million people in the United States and results in approximately 17,000 deaths each year. In 2011, the U.S. Centers for Disease UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) Control and Prevention declared painkiller abuse an epidemic. “This is a major societal problem,” says Joy Hao, MD, PhD, a UCLA family medicine doctor and a research physician with the UCLA Center for Behavioral and Addiction Medicine. “There are certainly legitimate reasons for the use of these drugs, but they can be highly addictive, to the point that people physically need to have them to feel normal, and they are also abused by people who don’t have pain but are simply seeking the euphoria.” Because of the new restrictions, Dr. Hao notes, individuals with chronic-pain syndromes who require products containing hydrocodone should plan ahead and make sure to schedule an appointment with their doctor when their prescription begins running low, rather than waiting until they run out of the medication and relying on their doctor to call in a refill when they need more. “This doesn’t mean patients with a legitimate need for these medications won’t have access — just that their needs will be more closely monitored,” Dr. Hao explains. “Requiring physicians to weigh each prescribing decision more carefully can help to protect patients from unintended harm. Ultimately, that improves their care.”