WASHINGTON — The Drug Enforcement Administration fell dramatically short in regulating the prescription opioid supply over the past two decades — even as the country’s addiction and overdose crisis escalated, according to a new report from the Justice Department’s inspector general.
As prescription levels and demand for pain drugs rose, the agency continued to raise manufacturing quotas for opioids with little regard to potential oversupply or misuse, according to the report. Prescription opioid oversupply is seen as a major factor in the broader drug crisis, which left 70,000 Americans dead in 2017 — roughly 48,000 from opioid-involved overdoses.
The DEA’s shortcomings, the report stated, left the agency “ill-equipped to effectively monitor ordering patterns for all pharmaceutical opioids, which could enable the diversion of these prescription drugs and compromise public safety.”
Though health officials were aware of the escalating crisis in the 1990s, the DEA allowed manufacturing levels for oxycodone — often sold by the now-infamous manufacturer Purdue Pharma as OxyContin — to nearly quadruple between 2000 and 2013.
Even now, the DEA remains ill-equipped to track opioid sales by volume or whether drugs eventually are diverted for misuse, the report said. The agency doesn’t require sufficiently frequent reports from companies registered to manufacture controlled substances, often leaving the agency with a yearlong information lag that has hampered critical analysis.
One database, known as ARCOS, “does not track” diversion of many opioid compounds.
Another, known as the Suspicious Order Reporting System, included a fundamental flaw: Reports of suspicious orders were sent to DEA field divisions but never uploaded into the database, leaving the DEA largely blind as to which orders had been flagged as suspicious. The DEA had little access to the vast majority of reports, the report said — just eight out of 1,4000 manufacturers and distributors required to report suspicious orders sent the information directly to the agency’s Virginia headquarters.
“When we asked DEA for records of suspicious orders reports sent to field divisions rather than headquarters, DEA was unable to locate them,” the report said.
Opioid oversupply has been frequently cited by policy experts as a major driver of the country’s drug crisis, which has claimed hundreds of thousands of lives. In some areas, the crisis continues to escalate, particularly in terms of methamphetamine and cocaine overdose rates.
Some towns have become famous for their staggering levels of opioid oversupply, seen as driven by manufacturers, drug distributors, and lax law enforcement. The 2,900-person town of Williamson, W.Va., received 20.8 million pills over the course of a decade — nearly 7,000 per resident.
A handful of Democratic lawmakers have written repeatedly to the DEA asking that the agency use its quota-setting authority to reduce the nation’s supply of prescription opioids.
Numerous health experts see that move as controversial and likely to harm pain patients using the drugs as prescribed — but few disagree that DEA helped to facilitate a generational oversupply that furthered a historic crisis.
Though he continually cites the opioid crisis as a top policy priority, President Trump has not nominated a DEA administrator during his first three years in office. The current acting administrator, Utam Dhillon, has served in the role for over a year — after helping to ensure other candidates were not nominated, the Wall Street Journal reported.
In a statement, the Justice Department pointed to the $194 million in civil fiscal penalties DEA secured in 2017, and said the agency had removed approximately 900 licenses from distributors, pharmacists, and prescribers from its books each year for the past eight years, “preventing further diversion of controlled substances.”