Members of the Alabama Pharmacy Association are fighting a decision to impose additional regulations on alprazolam -commonly known as Xanax – which will place the drug into the most tightly-controlled group of medications.

Alabama would become the first state in the nation to move alprazolam into the same category as the powerful opioids methadone, oxycodone and fentanyl.

“The State Committee of Public Health received a request from the Alabama Board of Medical Examiners to reschedule alprazolam from Schedule IV to Schedule II due to concerns about patient safety in the midst of the substance abuse epidemic that Alabama and the nation are facing,” according to a statement released by the Alabama Department of Public Health. “This epidemic is marked by overdose deaths including those from opioids and benzodiazepines. After consideration of the criteria outlined in SS 20-2-20 of the Alabama Code, it was determined that alprazolam has a high potential for abuse, which may lead to severe psychological or physical dependence, thereby warranting the rescheduling.”

If legislators approve the reclassification at a committee meeting later this week, patients receiving the drug could no longer receive refills without a doctor’s visit. Under current regulations, doctors can provide up to six refills in six months for patients taking alprazolam.

Alprazolam is used to treat anxiety and panic disorders. It works more quickly than similar drugs and has a higher potential for abuse.

According to a 2014 federal report, emergency room visits for non-medical use of alprazolam more than doubled from 2005 to 2010. Drug abusers often combine alprazolam with other sedating drugs including opioids and muscle relaxants, increasing the potential for overdose and death, according to the U.S. Centers for Disease Control and Prevention..

Michael Hogue, pharmacy professor and assistant dean for the Center for Faith and Health at Samford University, said the reclassification of alprazolam won’t solve the serious problem of overdoses, but could cause many problems for patients taking the drug to treat anxiety.

Alabama has a shortage of psychiatric providers, Hogue said, which will make it difficult for patients who need to schedule a visit to refill a prescription.

“By changing alprazolam to schedule two, we are going to put incredible pressure on the psychiatric system in this state,” Hogue said.

The U.S. Drug Enforcement Agency classifies some prescription drugs with the potential for abuse, imposing more restrictions on the most dangerous and addictive substances. The DEA currently groups alprazolam with other anxiety drugs such as Valium and Klonopin. For the most part, Alabama follows federal classification, but state law allows public health officials to move drugs into more highly-regulated categories if there is evidence of widespread injury.

Hogue said he hasn’t seen any evidence to support the state’s effort to impose tighter restrictions on alprazolam.

Alabama ranks near the top in prescriptions per capita of anxiety medications and opioid painkillers, according to the CDC. Overdose deaths linked to those drugs rose after 2001, but have leveled off in recent years. The DEA put the painkiller hydrocodone in the most highly-restricted category in 2014, but Alabama physicians still prescribe it frequently, Hogue said.

“The only thing that changed was that the rate of heroin addiction skyrocketed after they changed the classification,” Hogue said.

And then there is this:

Alabama is the most stressed US state — where does yours rank?