Position Statement

AANS/CNS Position Statement on Hydrocodone Prescribing Policy

Position Statement on HYDROCODONE PRESCRIBING POLICY

Background
The FDA’s Drug Safety and Risk Management Advisory Committee has been evaluating the status of hydrocodone combination drugs, such as Vicodin®, Lortab®, Norco®, and Vicoprofen®. In January 2013, this committee voted 19 to 10 in favor of reclassifying combination medications containing hydrocodone from Schedule III drugs under the Controlled Substances Act to Schedule II. This would impose significantly stricter prescribing rules on drugs containing hydrocodone. This change would also affect anti-tussive medications containing hydrocodone. Understandably, this action was prompted by the increasing implication of hydrocodone in deaths related to narcotic overdoses. The
death rate from hydrocodone combination drug overdoses has tripled in the last 20 years. Over 130 million prescriptions for hydrocodone were written in the United States in 2011, making it the most prescribed narcotic analgesic. The United States is responsible for 99 percent of the world’s use of hydrocodone, per the International Narcotics Control Board. Additionally, the change is being driven not only by the increase in hydrocodone-related mortality, but also by the increasing number of DEA interventions due to skyrocketing narcotic distribution by select retail pharmacies.

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