Hydrocodone in Houston: Stepping away from the streets

Prescription drug abuse is by no means a regional problem, but Houston has been recognized nationally as a mecca of controlled substances, particularly hydrocodone. Federal changes taking effect today will make this drug much harder to come by.

A synthetic cousin of codeine, hydrocodone is an opioid pain medication often combined with other analgesics such as acetaminophen or ibuprofen. These medications — more commonly known by their trade names Lorcet, Norco, Vicodin and Vicoprofen, to name a few — have become far too easy to get.

Over the years, pain management clinics have popped up everywhere across Houston, putting drugs in the hands of anyone with the money for an office visit. Housed in buildings as strange as former Pizza Hut locations, these facilities — known colloquially as a “doc-in-a-boxes” or “pill mills” — are notorious for writing massive quantities of hydrocodone, as well as a host of other controlled substances, with little evaluation of their cash-only customers.

Health promotion senior Tien Pham, a pharmacy technician, said that it’s not uncommon for pain clinics to write hydrocodone in amounts of 120 units or more.

In comparison, most emergency rooms will send a patient with semi-serious injuries home with about a sixth of that number.

In 2012, the Drug Enforcement Administration recognized Houston as the source of a major problem, raiding some fifty clinics in the Houston area during operation “King of the Pill.”

Despite the pun, what they found was anything but a laughing matter. 3,500 boxes of medical and financial records revealed that one supervising physician was making $7,000 a week in an office where hydrocodone was prescribed to 95 percent of the patients seen.

Hydrocodone is a powerful drug with deadly repercussions for improper administration. The risks associated with this drug are compounded when excessive amounts are placed in the hands of someone who, by all accounts, shouldn’t have been prescribed it to begin with.

Hydrocodone is responsible for 70 percent of drug overdoses in the US, and Houston has one of the nation’s highest rates of emergency room visits linked to abuse of this drug.

Ease of accessibility has been one factor in the increased abuse of hydrocodone, but societal perspectives on prescription drugs have certainly been another.

There’s an assumption that if a drug is a prescription substance, it is somehow safer than drugs cooked up in unregulated conditions. Just because the drug is prescribed by a doctor doesn’t mean that it can’t be lethal.

“The government fights to keep marijuana illegal, yet allows prescription drugs to be abused by just about anyone. What makes one worse than the other?” said Hispanic studies graduate student Trevor Boffone.

While it is illegal to possess hydrocodone without a prescription, the federal government has realized that a prescription for the drug is too easily acquired. Given the substance’s high potential for both misuse and addiction, the DEA has reclassified hydrocodone as a schedule II, a change that enacted last Tuesday.

Controlled substances are classified into groups, or schedules, based upon their likelihood for abuse and dependency. Hydrocodone has been moved from schedule III to II, which has the highest level of regulatory requirements and restrictions of all prescription medications.

This reclassification will impose far greater limitations on prescribing and dispensing: A new script must be written for each fill — no refills, the prescription must be in the form of a hard copy on an official Department of Public Safety prescription blank — no electronic, e-scribed or telephone orders allowed and it must be written by a medical doctor — no NPs or PAs.

With its reclassification now implemented, hydrocodone will almost certainly be prescribed less than it currently is, because schedule II drugs are neither written nor dispensed indiscriminately.

Only time will determine the efficacy of the reclassification of hydrocodone by the DEA. While users will always find drugs to abuse, the government has a responsibility to control the supply of medications that have been identified as a health threat to citizens.

Hopefully this change will result in a decrease not only in the supply of this drug on our streets, but also in the number of deaths from accidental overdose.

Opinion columnist Jonathon Bolan is an English graduate student and may be reached at [email protected].