Bob! via Flickr

Bob! via Flickr

Unfortunately, America has the dubious distinction of being number one in something we should not be proud of. We are #1 market share for Vicodin (type of hydrocodone pain prescription).

Wow- why is that? Are we that much in pain compared to the rest of the world? Are we just wimps and simply can’t stand pain?

Of course, as with most complicated issues, this issue has multiple causative factors, but the overuse of prescription pain killers and the destruction it can cause is a real and present fact.

So much so that now, the most prescribed pain killer (Vicodin, norco, etc) and it’s derivatives  will be on higher prescription security. It will be the same process now to get this prescription as it is for the traditionally “stronger” narcotics like Morphine, Dilaudid and Fentanyl.

The patient will have to come in for a hand written secure prescription that has been recorded in 2 different logs, data sent to the DEA (Drug Enforcement Agency) and must see the doctor every 6 months at the very least and submit to random drug testing to make sure the medication is actually in your system.

Remember that these painkillers are highly addictive, highly lucrative and previously relatively cheap and easy to obtain. It was traditionally harder to get antibiotics than prescription pain medications from most doctors as we were riding the wave of better “pain control and treatment” the last 30 years.

Now, we are dealing with the overuse, over dependence and the inappropriate dispersion of prescription pain medications.

Honestly, I don’t know if these new regulations of requiring doctors to be certified in pain treatment, get special pain conference credits and the  new mandate of higher levels of prescription protocol will help offset this problem.

But I know that it will make it more inconvenient and perhaps make both health provider and patient think twice about using them.

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Dr. Carol

Dr. Carol- doctor, wife, mom and maker PB&J!
One of my passions is to help people Embrace change, Try new things and be BOLD for a healthier and balanced life!


  • Dr. Carol, the downside to the new regulations are how it is impacting chronic pain sufferers who live in rural areas and going to the prescribing provider every 30 days is difficult at fifteen minutes in the car but a half day’s driving can be miserable. I have several members (I work for an insurance company) who are struggling with pain control issues because they can not get to their providers. It’s a catch-22.

    On the other hand, I think this is forcing may of the more unscrupulous providers who are simply dispensing medications without following through on a multi-disciplinary approach, to re think they way they run their medical practices.

    People abuse narcotics, even those who are in chronic pain for legitimate and heartbreaking reasons abuse their pain medications. Perhaps this country needs to focus more on approving and embracing complimentary practices and cannabis which is finally getting the recognition it deserves as a legitimate form of palliative medicine.

    • Unfortunately, though we try, pain management is a time intensive process -so more and more good providers opt out of practicing this.

      I do feel for my elder or disabled patients who now have to go through these additional hoops – I bear with the added time it takes to hand write these rxs and absorb the cost of logging the Pain Lecture credits for now …hopefully we as a society can look to the other 1st world countries who do not have this problem and start learning new methods/perspectives culturally in preventing and treating pain.

      The traditional US way of litigating and policy making for drug rx- ie: blanket fishnet regulations without enforcement of codes -are likely ineffective and inefficient in deterring the misusers and mis- prescribers alike- I have seen the ingenious work arounds already-

  • As usual, someone abuses the system and then regulations have to be made or toughened. Some of those with legitimate needs will get caught and denied, and the abuse will go on because abusers always find a way. It’s so frustrating. I get that we need/want to keep destructive drugs out of the hands of abusers. But I can’t help but believe that criminalizing illegal drug use and forcing people to jump through ever smaller hoops to get drugs is all that effective at keeping drugs away from those who abuse them. I could be wrong and I’d love to see some evidence that I am.

    • I think the regulators have found out that it would be easier to enforce the restriction at the prescriber’s(doctor) and dispenser’s (pharmacy) rather than the patient’s end.

      Vicodin was prescribed heavily because while it was a controlled medication it was not restricted (previously). Placing the same restriction on Vicodin as we have for morphine would reduce the number of new Vicodin prescriptions.

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