To Fight Addiction, FDA Advisers Endorse Limits On Vicodin
ROBERT SIEGEL, HOST:
From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.
MELISSA BLOCK, HOST:
And I'm Melissa Block. A Food and Drug Administration panel has endorsed new restrictions on Vicodin and similar prescription painkillers. This is a recommendation, not yet policy. Supporters say the new restrictions are needed to fight rising abuse of these drugs. Addiction to painkillers is widespread, and there are thousands of overdose deaths every year.
But there are those who oppose limiting access to these drugs; among them, some doctors and their patients who suffer from debilitating pain. NPR's Rob Stein joins us now to explain the debate and today's vote. And Rob, the DEA and others call prescription painkiller abuse an epidemic in this country. How big a problem is it and who, exactly, is abusing these drugs?
ROB STEIN, BYLINE: It's really two different kinds of patients. One of them are patients who get prescribed these drugs for legitimate medical reasons. They have an operation, or they have back pain, and they end up getting addicted; these drugs can be highly addictive. And the second group are people who are just kind of looking to get high - you know, teenagers who are rummaging through their parents' medicine cabinets - and they start taking these drugs, and they get addicted.
And everybody agrees that it's a really big problem that's getting a lot worse. There are millions of people who are estimated to abuse these drugs, and millions who are addicted. And the Centers for Disease Control and Prevention estimates there are at least 15,000 deaths from overdoses occurring every year, and that's more than cocaine and heroin combined.
BLOCK: Now, we mentioned Vicodin as one of these drugs, but that's not the only drug that they're talking about here, right?
STEIN: Right. They're talking about any drug that includes hydrocodone - that's an opioid, with another product that - they're called combination hydrocodone products. And there are lots of products like this that - on the market. They have names like Lortab. And their - estimate is that there are about 136 million prescriptions written for these every year, and that's the most widely prescribed prescription drug of any kind.
BLOCK: Now, what does the Drug Enforcement Agency want to happen with these drugs?
STEIN: Right. What they want to happen is, they want these drugs put in the same legal category as other prescription painkillers, like Oxycontin and Percocet. And that would have fairly wide-scale implications. It would have all sorts of new restrictions; including, for example, doctors would be limited in how much of the pills they could prescribe at any one prescription. And certain medical professionals, like physician assistants and nurse practitioners, would no longer be able to prescribe these drugs.
BLOCK: We mentioned, Rob, that some doctors and their patients are quite concerned about this. What is their concern, exactly?
STEIN: The concern is that there are an estimated 100 million Americans out there who suffer from chronic pain. And this can be quite debilitating. These are people who have terrible pain all day long - never goes away - and they are really dependent on these drugs to exist, to function on a daily basis. And they're worried that these restrictions really could make it difficult - if not impossible - for them to get drugs they need. It could mean that they could not afford the extra visits to the doctor that they would need; that some doctors may just stop prescribing them because they're afraid of getting into trouble with the DEA; or insurance companies might stop paying for them.
BLOCK: And what do the people who are pushing for the restrictions say to that?
STEIN: What they say is that, you know, if a doctor has a patient who really needs these drugs, they still could get them the drugs. They'd still be able to prescribe them. They could do things like give them several prescriptions at one time, that are dated in the future. So they couldn't fill it all at once, but they could - when they run out, they could fill the next one and then the next one.
BLOCK: OK. Well, the FDA was hearing this today. What happened at that hearing?
STEIN: You know, I've covered a lot of these hearings; and this was one of the most intense, one of the most emotional hearings that I've actually encountered. You know, there were the usual experts - the pain specialists, the addiction specialists, the government officials. But then there were - lots of testimony from individual patients; you know, parents who lost their children through overdoses and, you know, recounted the stories, and they were crying, and very angry and upset; and also, lots of pain patients who were describing what it's like to live with this terrible pain, and the fears that they had, that what they would do if they just couldn't get the drugs they needed?
But in the end, the committee voted fairly lopsided - 19 to 10 - to endorse the new restrictions; and they decided that the benefits of that would outweigh the risks.
BLOCK: OK. NPR's Rob Stein. Rob, thanks so much.
STEIN: Oh, sure. Thanks for having me. Transcript provided by NPR, Copyright NPR.