Hydrocodone Rescheduling: Why It Won't Help

SEPTEMBER 18, 2014
We saw this one coming. Lately there has been a lot of attention (and rightly so) on our drug addiction and overdose problem here in the United States. In particular, the role of hydrocodone as one of the most frequently prescribed narcotics and frequently implicated drugs of abuse has led the Drug Enforcement Administration (DEA) to move hydrocodone combination products to the more restrictive category of Schedule II.

This means no more phoning in prescriptions. This means no more refills. This means no more estimating of inventory counts, but rather a tablet-by-tablet perpetual record of each and every unit we sell.

Finally…our drug trafficking and addiction problem in the United States is solved. Right?

No. Not even close.

Clinically, some argument could be made that hydrocodone is metabolized to the more potent hydromorphone, so therefore it should be Schedule II. But when we dig deeper into the clinical and biochemical picture, we discover that this conversion is limited, and variable. Some people can’t convert it at all. And even those who do have only a small percentage of the original dose converted to the hydromorphone metabolite. It’s a stretch to say the least.

But even if that argument could be made (and I doubt it could), the really big push for making this move has been predominantly carried by those who insist it will help decrease our nation’s drug abuse and overdose problem. But the problem with that statement is that it is wrong. It won’t. It can’t. And I will tell you why.

Jason Poquette
Jason Poquette
Jason Poquette, RPh, is a 1993 graduate of the University of Connecticut School of Pharmacy. For most of his career, he has held retail pharmacy management positions. He also spent 7 years working in health plan formulary analysis and research. He currently works for Pharmacy Healthcare Solutions (PHS) as manager of an outpatient hospital pharmacy, developing programs to improve utilization of the pharmacy and transitional care for patients.