Drug Enforcement Administration to Cut Opioid Production by 20 Percent in 2018

The Drug Enforcement Administration (DEA) announced last month that they would be decreasing the number of opioids produced in 2018 by 20 percent.

The new quota was first proposed in August, and a public comment period followed. The final quota order, published on November 8 and signed by Robert W. Patterson, acting administrator of the DEA, says that the DEA received over a hundred comments that expressed concern that the proposed 20 percent reduction would adversely affect the availability of pain-relieving prescription drugs for people with chronic pain. These comments, however, did not impact the final quota.

“These comments were general in nature, and raised issues of specific medical illnesses and medical treatment, and therefore are outside of the scope of this Final Order for 2018,” the order said. “As a result, these 106 comments did not provide new discrete data for consideration, and do not impact the original analysis involved in establishing the 2018 aggregate production quotas.”

DEA spokesperson Barbara Carreno told The Mighty that the DEA’s quota is reactive and follows demand, looking at a variety of factors from the previous year to determine how many opioids will be produced the following year. The number of prescriptions written, sales by manufacturers and distributors, the amount of leftover inventory and the number of disposed materials are entered into a formula created by Congress under the Controlled Substances Act, which determines what the quota should be.

Next year’s 20 percent reduction follows a period of five years, from 2013 to 2016, when the DEA raised the quota by 25 percent to make sure it was not responsible for any shortages. But Carreno said nobody used the increased inventory and the Food and Drug Administration did not find evidence of a shortage, so the quota was reduced by 25 percent in 2017. She said the 2018 quota should not affect people using opioids legitimately for chronic pain.

For chronic pain patients who have experienced shortages of their opioid medication, Carreno said that’s the result of decisions made by manufacturers and distributors, such as distributors who set their own quotas of what they’re going to sell to pharmacies.

“It’s not like we [at the DEA] just decide, ‘Wow, there’s a problem with that, we’re going to cut it by 50 percent,’” Carreno said, adding:

I think lot of people don’t recognize that our mission is to guarantee the availability of controlled substances for legitimate purposes. And all the efforts we do to reduce diversion is towards that end — to make sure these medications are available to the people who legitimately need them and are not being diverted to the street.

Sandro Galea, dean of the Boston University School of Public Health, told The Mighty it’s hard to tell what effect the new quota will have on chronic pain patients or the opioid crisis. Much of opioid addiction has moved to synthetic opioids such as fentanyl.

“One hopes that these rules simply help sharpen our focus on a real problem without creating new ones,” Galea said.

The fight against the opioid crisis has led to an increased stigma against opioids, state laws that limit opioid prescriptions and pressure on doctors to prescribe fewer opioids, which can leave chronic pain patients feeling like collateral damage and concerned that the 2018 quota doesn’t take their experiences into account.

Mikki Ingram, a Mighty contributor who lives with fibromyalgia, told The Mighty she can’t get behind the new quota 100 percent, and is concerned that the DEA isn’t considering the chronic pain community.  She feels the DEA’s anti-opioid objective contributes to the idea that anyone who takes opioids is “just looking to get high.”

“It looks almost as though they are ‘kicking the can down the road’ some more,” Ingram said. “I hope that, at some point soon, they begin to openly discuss all aspects of this issue. The chronic pain community needs to be included in this discussion and, thus far, we haven’t been outside of ourselves.”

Getty photo by txking