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The US Drug Enforcement Administration (DEA) has reclassified hydrocodone combination
drugs from Schedule III to Schedule II in the Schedule of Controlled Substances, effective
October 6, 2014. This reclassification change impacts all physicians and pharmacies, including
drugs prescribed and dispensed in the Texas workers’ compensation system. Hydrocodone
combinations are the most frequently prescribed drugs in the Texas workers’ compensation
This change has no direct impact on the application of DWC’s pharmacy closed formulary.
However, prescriptions for Schedule II drugs have specific requirements, and the
reclassification will result in changes to the physician prescription process for hydrocodone
combinations. For example, physicians may not delegate to advance practice nurses and
physician assistant’s authority to prescribe these drugs outside of a hospital or hospice setting,
nor may they “call in” prescriptions for these medications to pharmacies (except in
emergencies, in which case oral transmission must be followed up with written prescription
within seven days). In addition, physicians must use official prescription pads from the Texas
Department of Public Safety (DPS) for written prescriptions; or if e‐prescribing, must use a
certified Electronic Prescribing of Controlled Substances (EPCS) vendor. Most significantly in
our context, physicians may not refill prescriptions of these drugs without a patient visit or
consultation, and prescriptions may be issued for a maximum 90‐day period (three 30‐day
prescriptions to be written at one time). Refills are to be filled on a “not before date” written
on the prescription note by the prescriber. Claimants and pharmacies are encouraged to work
with the physician to resolve any issues regarding these changes when prescribing or
attempting to fill prescriptions for hydrocodone combinations.
Takeaway: Hydrocodone medications will become triple‐script medications, and an injured
worker will have to have a doctor’s office visit to get the script.