It's the nation's second most abused medicine, linked to murders, celebrity overdoses and a rising tide of violent pharmacy robberies. But since 1999 federal regulators have put off deciding whether to tighten controls over hydrocodone, the addictive narcotic that is the key ingredient in Vicodin and other medicines.
The Drug Enforcement Administration and the Food and Drug Administration insist they are still actively studying whether to move hydrocodone-containing medicines from the Schedule III category of medicines to the more restrictive Schedule II.
"They're not doing a darn thing," said Robert DuPont, a former White House drug czar and head of the Institute for Behavior and Health, a Rockville, Md.-based think tank. "There's no study that takes 12 years. When you think how many people have died of hydrocodone overdoses, it's inexcusable."
Nationally, emergency room visits related to nonmedical hydrocodone use have quadrupled since 2000 -- to 86,258 in 2009 from 19,221. Actors Heath Ledger, Brittany Murphy and Corey Haim all died from drug cocktails containing it.
A DEA review of police drug labs shows seizures of hydrocodone-containing pills number second only to those of oxycodone, the narcotic used in drugs such as OxyContin and Percocet. Hydrocodone seizures have soared to 44,815 in 2010 from 13,659 in 2001.
The boom was underscored in June, when a man walked into a Medford pharmacy and gunned down four people before leaving with 11,000 hydrocodone pills. An accused prescription-drug abuser named David Laffer, 33, has been charged in the slayings. His wife, Melinda Brady, 30, also a suspected drug abuser, is accused of driving the getaway car.
As of last month, there had been 16 holdups of Long Island pharmacies since October 2008. In the vast majority of the thefts, thieves stole oxycodone-based painkillers or those containing hydrocodone. There's also been a sharp increase in the number of prescription-pill abusers admitted to drug treatment programs, statistics show.
Legitimate pain patients are worried that new restrictions could jack up their medical expenses by forcing them to repeatedly return to their doctors for refills. They also worry that doctors will be afraid to prescribe needed medicines for fear of attracting regulator scrutiny.
Hydrocodone is a painkiller that is chemically similar and almost as strong as oxycodone. Pills that combine oxycodone with another painkiller like acetaminophen or aspirin are strictly controlled as Schedule II drugs. But their hydrocodone equivalents fall under the less-restrictive Schedule III.
Schedule II drugs must be kept under lock and key at pharmacies; doctors can only prescribe one bottle at a time; and patients must have an original prescription slip with them. Traffickers can face up to 20 years in prison for the first offense under federal law.
Prescriptions for Schedule III medications can be refilled up to six times without a doctor visit, and doctors can renew prescriptions by phone or fax. And the penalties for abusing Schedule III drugs are lighter: a maximum 10 years for first-time traffickers under federal law.
The DEA agreed in 1999 to review whether combination products containing it should be rescheduled. Twelve years later, the DEA and FDA say they are still in the preliminary stages of that review. Said an FDA spokeswoman: "It's the nature of the process; it takes time."
With Matthew Chayes