DEA taking measures against opioid abuse

DEA taking measures against opioid abuse

In an effort to combat prescription drug abuse and addiction, the U.S. Drug Enforcement Administration (DEA) is taking measures to increase penalties associated with illegal use of certain prescription medications and to make it easier for people to dispose of their unused medications after discontinuing use.

According to a press release from the Texas Department of Public Safety (DPS), the DEA is reclassifying hydrocodone combination products (HCPs) from a Schedule III controlled substance to a more restrictive Schedule II controlled substance effective Oct. 6. The rescheduling would increase restrictions on prescribing and dispensing practices for HCPs, presumably making it more difficult for abusers to get their hands on the drugs.

HCPs contain both hydrocodone and other substances, like aspirin or acetaminophen. Hydrocodone by itself is already a Schedule II drug. According to information from the Mayo Clinic, hydrocodone belongs to the group of medicines called narcotic analgesics (pain medicines). It acts on the central nervous system (CNS) to relieve pain, and stops or prevents cough. As a narcotic, hydrocodone relieves pain by binding to opioid receptors in the CNS. Hydrocodone is most commonly combined with a second analgesic, creating an HCP. Common brands of HCPs include Vicodin, Lortab, Lorcet-HD, Hycodan and Vicoprofen among others. According to the DEA, since 2009, hydrocodone has been the second-most frequently encountered opioid pharmaceutical in drug evidence submitted to federal, state and local forensic laboratories as reported by the DEA’s National Forensic Laboratory Information System (NFLIS) and System to Retrieve Information from Drug Evidence (STRIDE).

The federal Controlled Substances Act places substances with accepted medical use into one of four schedules, with the substances with the highest potential for harm and abuse being placed in Schedule II. Substances with less potential for harm and abuse are scheduled progressively from Schedule III to Schedule V, V being the least threatening. Schedule I controlled substances currently have no accepted medical use and are considered not safe for use.

The DEA’s final rule rescheduling HCPs as Schedule II was published Aug. 22. The action “imposes the regulatory controls and administrative, civil, and criminal sanctions applicable to Schedule II controlled substances on persons who handle (manufacture, distribute, dispense, import, export, engage in research, conduct instructional activities with, conduct chemical analysis with, or possess) or propose to handle hydrocodone combination products,” according to the published rule.

Another medication the DEA believes is being abused, the prescription medication tramadol – a centrally acting opioid analgesic – was deemed a Schedule IV controlled substance effective Aug. 18.

Reclassifying hydrocodone and tramadol into stricter scheduling categories not only increases the restrictions on doctors prescribing and pharmacists distributing the drugs but also increases penalties associated with abuse of the medications. See the website www.statutes.legis.state.tx.us for more information regarding penalty groups associated with illegal prescription drug possession and distribution.

Orange County Sheriff’s Office Chief Deputy Clint Hodgkinson says he is pleased to see the rescheduling of hydrocodone and tramadol due to numerous arrests involving abuse and illegal possession of the drugs. According to Hodgkinson, prescription drug abusers in Orange County are still seeking out old favorites but other medications have become more common recently.

“It used to be Xanax, Somas, hydrocodone, and those kinds of drugs,” reports Hodgkinson. “We still see that stuff, but now Adderall and tramadol are a lot more common than before.”

In addition to rescheduling certain prescription medications, a news release issued by the U.S. Department of Justice (DOJ) reports that on Sept. 8 Attorney General Eric Holder, calling prescription drug addiction an “urgent and growing threat” to the nation’s public health, announced new DEA regulations that would allow pharmacies, hospitals, clinics and other authorized collectors to serve as authorized drop-off sites for unused prescription drugs. According to the news release, under the new policy, long-term care facilities would also be able to collect controlled substances turned in by residents of those facilities, and prescription drug users everywhere would have permission to directly mail in their unused medications to authorized collectors. The rule takes effect Oct. 9.

Attorney General Holder said the new changes will help save lives and protect American families from the increased dangers of prescriptions drug misuse. In 2011 alone, more than half of the 41,300 unintentional drug overdose deaths in the United States involved prescription drugs, and hazardous opioid pain relievers led to about 17,000 of those deaths. Young people are especially susceptible to these dangers, says the DOJ. The Attorney General noted that nearly four in 10 teens who have misused or abused a prescription drug have obtained it from their parents’ medicine cabinet.

“These shocking statistics illustrate that prescription drug addiction and abuse represent nothing less than a public health crisis,” the Attorney General said in a video message posted on the Justice Department’s website.  “Every day, this crisis touches – and devastates – the lives of Americans from every state, in every region, and from every background and walk of life.”

DEA Administrator Michele Leonhart says the new rule would assist in battling prescription drug abuse by facilitating the disposal process.

“These new regulations will expand the public’s options to safely and responsibly dispose of unused or unwanted medications,” said Leonhart. “The new rules will allow for around-the-clock, simple solutions to this ongoing problem. Now everyone can easily play a part in reducing the availability of these potentially dangerous drugs.”

Unused medications in homes create a public health and safety concern because they are highly susceptible to accidental ingestion, theft, misuse, and abuse, reports the DEA. Almost twice as many Americans (6.8 million) currently abuse pharmaceutical controlled substances than the number of those using cocaine, hallucinogens, heroin, and inhalants combined, according to the 2012 National Survey on Drug Use and Health. Nearly 110 Americans die every day from drug-related overdoses, and about half of those overdoses are related to opioids, a class of drug that includes prescription painkillers and heroin.  More than two-thirds (70 percent) of people who misuse prescription painkillers for the first time report obtaining the drugs from friends or relatives, including from the home medicine cabinet.

The DEA began hosting National Prescription Drug Take-Back events in September 2010. Since then, the agency has sponsored eight take-back days. Enormous public participation in those events resulted in the collection of more than 4.1 million pounds (over 2,100 tons) of medication at over 6,000 sites manned by law enforcement partners throughout all 50 states, the District of Columbia, and several U.S. territories.

“Every day, I hear from another parent who has tragically lost a son or daughter to an opioid overdose. No words can lessen their pain,” said Michael Botticelli, Acting Director of National Drug Control Policy. “But we can take decisive action, like the one we’re announcing today (Sept. 8), to prevent more lives from being cut short far too soon. We know that if we remove unused painkillers from the home, we can prevent misuse and dependence from ever taking hold. These regulations will create critical new avenues for addictive prescription drugs to leave the home and be disposed of in a safe, environmentally friendly way.”

On September 27, the DEA holds its next, and likely last,  Take-Back Day. The public may visit www.dea.gov or call 1-800-882-9539 in September to find a nearby collection site.  At this time, DEA has no plans to sponsor more nationwide Take-Back Days in order to give authorized collectors the opportunity to provide this valuable service to their communities.

According to the Attorney General, the most important consideration of the new regulations regarding prescription drug disposal is that patients or family members can mail their prescription controlled substances to authorized collectors using “pre-paid mail-back packages that can be obtained from their pharmacy, or from other locations like libraries and community centers.”

The DEA’s release also reminds the public that law enforcement continues to have autonomy with respect to how they collect pharmaceutical controlled substances from ultimate users, including holding take-back events. Any person or entity – DEA registrant or non-registrant – may partner with law enforcement to conduct take-back events.

Patients also may continue to utilize the guidelines for the disposal of pharmaceutical controlled substances listed by the Food and Drug Administration on their website at http://www.fda.gov/downloads/Drugs/ResourcesForYou/Consumers/BuyingUsing...

Any method of disposal that was valid prior to these new regulations being implemented continues to be valid, according to the DEA.

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