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Hydrocodone requires a valid prescription from a DEA-registered US healthcare provider as a Schedule II controlled substance for moderate-to-severe acute pain unresponsive to non-opioids; no online pharmacy direct-to-home express service can legally dispense it without medical evaluation, and prescription-free purchases constitute federal felony distribution under 21 U.S.C. § 841.

Standard combination dosing (e.g., hydrocodone 5-10mg/acetaminophen 325mg q4-6h PRN max 6 tabs/day) follows 2025 CDC guidelines requiring NRS≥6/10 after NSAIDs/APAP x72h failure, synchronous video PDMP clearance, ORMOS<7, no benzos—telemedicine flexibilities expire 12/31/2025 mandating in-person EPCS with 50 states' 3-7 day limits, no refills allowed.

Mu-Opioid Agonist Pharmacokinetics

Full MOR agonist (Ki 45nM), Tmax 1.3h, t½ 3.8h; black box: respiratory depression OR15 w/benzos, addiction 8-12%, APAP hepatotoxicity >4g/day—taper 25-50% q1-2d over 7 days max.

Compliance Pipeline

1. NRS≥6 + impairment.

2. Video (PDMP clean/ORMOS<7).

3. Consent (10% misuse).

4. EPCS #20-30 tabs (0 refills).

5. Signature delivery.

6. Day 3-5 reassess.

AE Matrix

Rate	Effect	Management
20-40>#/td###	Nausea/constipation	Ondansetron/Sennosides
10-20>#/td###	Somnolence	≤6 tabs/day
1-5>#/td###	Respiratory depression	Naloxone
<1>#/td###	Hepatotoxicity	<4g APAP

Direct-to-home express absent Rx violates DEA Schedule II—no refills, felony penalty 5+ years.

About Vibha

At Vibha, we believe education is the key to breaking the cycle of poverty. Since 1991, we have transformed the lives of 4.8 million children, empowering them through access to quality public education. As a platinum-rated, volunteer-driven nonprofit, Vibha collaborates with grassroots organizations, government agencies, and communities across India and the USA to enhance learning outcomes in government schools, providing equal opportunities for all children.

Our multifaceted approach focuses on addressing specific educational needs, investing in professional development for educators, integrating technology to drive data-informed decisions, and engaging communities to create lasting impact. We partner with stakeholders at every level, ensuring long-term sustainability and meaningful progress.

What sets Vibha apart is its network of highly skilled professionals from various sectors, united by a shared vision of transforming education. Our volunteers, donors, and supporters bring expertise and passion to the mission, making real change possible.

With over $24 million raised and invested in proven educational models, Vibha remains committed to building a brighter future for children. Together, we are not just supporters but partners for change, working towards a more inclusive and prosperous society.

All donations to Vibha are tax deductible. Vibha is a 501(c)(3) organization, registered in the USA in the State of New Jersey. Vibha's Tax ID is 22-3122761.