Michigan doctors increased, not decreased, the amount of hydrocodone they prescribed after the Drug Enforcement Agency tightened controls on the powerful prescription opioid, a new study says.
The DEA's 2014 relabeling of the powerful opioid as a schedule II drug was intended to curb opioid abuse and rising overdose deaths, the Washington Times reported. But, researchers at University of Michigan in Ann Arbor found, the opposite was true.
The number of prescriptions issued by doctors in the year following the rescheduling fell, according to the researchers' findings. But the total volume of hydrocodone and other powerful medical opioids actually increased, meaning more pills were being handed out overall.
"Our main thought was that since surgeons were more limited in their ability to prescribe extra pain medications after the patient left the hospital, they prescribed more up-front to avoid the risk of patients running out," Dr. Joe Habbouche, one of the study's co-authors, told the Times.
Hydrocodone, which is often sold under the brand name Vicodin, is the most popular post-operative opioid for pain control, according to the Times. More than 72 percent of post-operative prescriptions are for hydrocodone.
But drug overdose deaths from prescription opioids have been rising steadily since 1999, and in 2014 they were the leading cause of drug overdose deaths nationwide. Responding to public health officials' growing alarm, the DEA shifted hydrocodone from schedule III to schedule II, thereby increasing the amount of oversight required to prescribe and renew a prescription.
But, looking at a group of more than 22,000 patients in Michigan between 2012 and 2015, the study's authors found that while refill rates fell substantially after 2014, prescriptions increased by seven pills on average. The number of pills notably increased for patients who had previously never been prescribed opioids, a group that are especially at risk of abuse and addiction.
"It is possible that, in the absence of clear prescribing guidelines for postoperative care, restricting opioid prescribing may inadvertently motivate surgeons to prescribe greater amounts to ensure adequate pain treatment," the study says.
This latest study adds further data to the mixed evidence on the efficacy of reducing the supply of prescription opioids. A study from the University of Massachusetts found that Medicaid claims for hydrocodone fell after rescheduling. But analysis of actual deaths from prescription opioids indicates that years of declining prescriptions has done little to curb rising overdose deaths. Given the costs of tightened access to often-needed prescription opioids, it is unclear if the benefits of enhanced controls outweigh the cost.