Reclassified Hydrocodone Means More Headaches for Community Pharmacists

September 10, 2014
Jay Sochoka, RPh, BSPharm, CIP

The community pharmacist's life is about to get a lot more difficult.

The community pharmacist’s life is about to get a lot more difficult.

On October 6, 2014, the admittedly powerful narcotic hydrocodone will be moved from Schedule III to Schedule II of the Controlled Substances Act. In layman’s terms, this means the drug will be reclassified from having a medical benefit, but being really addictive, to having a medical benefit, but being super addictive.

This move will add a few more minutes of processing per script, which is extra time that a high-volume pharmacist doesn’t exactly have. I already run from 9 a.m. to 9 p.m. with very few minutes to take anything resembling a break.

Reclassifying hydrocodone means that every time we fill a prescription, it is required to be on a hand-signed, hardcopy prescription without any refills.

Refills usually take about 1 minute to do from start to finish. You scan the stock drug bottle, get a label, count it, label it, and check it. A narcotic prescription, however, takes 3 times as long. It needs to be entered into the computer, procured from a safe by only the pharmacist, counted twice by a tech and once by me, and labeled. Then, I have to enter the quantity dispensed into a logbook and check the prescription ever so meticulously.

Now, we will have to complete this process every time a hydrocodone script shows up. We’re good for at least 12 of these a day. Sometimes, it’s double that.

The safe in which we are going to keep thousands of tablets is what perplexes me. We have a double-door safe where real estate is already at a premium. Are we going to get a walk-in model next? If so, where are we going to put it?

We could also use a full-time pharmacist whose main job is to process the narcotic ordering, receiving, logging, and dispensing. I might as well catheterize myself before work, because I am not going to be able to get away from the counter.

In addition, hydrocodone’s reclassification is going to vastly increase the number of patients staying and waiting for their prescriptions. Rarely does a patient with a narcotic prescription not wait for it or come back in 15 minutes. All I can envision is an angry mob with pitchforks and torches in withdrawal because they, once again, used up their medication 2 days too early. No problem there, though.

In my opinion, hydrocodone should have been classified in Schedule II from its release. I have seen it become a silverback gorilla for patients that just absolutely ruins them. I don’t think that will change, though, because our society is far too drug happy.

The streetiest of street drugs are available by prescription. Yet, somehow, medical cannabis is not federally legal.

Jay Sochoka, RPh, is going for a pack of Reds.