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.”

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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.”

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  • Lol. The Illegal USA Drug Trade/Use “epidemic” -by thrill seekers/drug users- is NOT prescription-opiate (analgesic) related. Period.

    Stop torturing, killing, the millions of patients suffering intractable pain so agonizing many turn to suicide for relief.

    Good job USA/Canadian Policy makers. You should be ashamed of yourselves. And you WILL face criminal prosecution. Hopefully under the appropriate charge of: ‘Crimes Against Humanity’. And, all involved in this unimaginable tragedy (denying adequate pain relief for intractable pain patients), jailed. Indefinitely.

    peter jasz

  • Rosanne, that is a issue that has been decades in the making. When a Congress person wants to retire, they just shift over to becoming Lobbyist for Pharma, or go into the Media. Chris Christie How Christie’s influence on opioid panel landed him an $800K consulting contract https://www.politico.com/states/new-jersey/story/2019/09/26/how-christies-influence-on-opioid-panel-landed-him-an-800k-consulting-contract-1209421

    Christie was the person who recommended both the CDC Director Redfield, and Andrew Kolodny to the PROP committee, who were vetted by Senior RNC officials, not elected congress people. Redfield then went on to declare War on Opioids, as Street dealers are hard targets he went after the soft targets, Patients who use doctors, Ins, Pharmacies. The Forced Tapers hit our Veterans first. All so he could have revenge of a sort. https://www.cbsnews.com/news/cdc-director-reveals-fentanyl-almost-killed-his-son/

  • completely agree with Dr. Lawhern’s assessment. It’s becoming increasingly difficult to have any trust in regulatory agencies when lobbyists have more power over legislators than voters, and when pretty much everyone has a financial conflict of interest.

  • From the logic of this article, it might be possible to construct a criminal case against DEA and DoJ administrators as un-indicted co-conspirators in illegal drug diversion. I suspect that frustrated DEA diversion investigators who supported last year’s series by CBS 60 Minutes and the Washington Post concerning McKesson might agree.

    One question for Lev, however: Given that DEA pulled licenses of 900 licenses from distributors, pharmacists, and prescribers or each of the last eight years, how many pain management providers have been driven out of practice? For that matter, how many providers did we start with eight years ago?

    • Not covered are the Illicit Drugs that flow through our borders, via USPS, shipping, tunnels, catapults, drones, mules. Trade treaties open the door to more Illicit drugs. Most OD’s are a combo of drugs both Illicit and Legal along with large consumption of Alcohol. Why was the story of 20 ton haul of Cocaine out of Philly squashed? We do not have the man or dog power to search every ship that pulls into various ports. https://www.cnn.com/2019/06/26/us/philadelphia-cocaine-bust-weight-tally/index.html

      Cocaine, Meth are now coming in from Canada who has more lax laws than the US does. Plus illegal guns that out power Law Enforcement armament.

      Today’s Drug Abusers Did Not Derive From Yesterday’s Patients
      https://www.cato.org/blog/todays-iv-drug-abusers-were-not-yesterdays-patients?fbclid=IwAR2CBv5ukpHSK7L6FbEAg3aOeDTGlGCTEu1B1MXljUfAHVWQr-jpyF12YUM

      Many doctors refusing care of people prescribed opioids
      https://medicalxpress.com/news/2019-08-doctors-people-opioids.html?fbclid=IwAR3Yarqp-6FKO_xsPYrsv5rQtLd0PAfEL_x5RZwfgPvAyRIx4YBX3Yc5scE

      Also not covered is the dangers of OTC pain meds. They are responsible for damage to liver, kidneys, GI tracts. Many result in death. Tylenol has a 10 warning not to exceed the recommended dosage. For a Stage 3 Kidney patient Tylenol is dangerous. For a Gastro patient all the others are dangerous. Increased GERD leads to a Pre-Cancerous condition called Barrett’s Esophagus. Guess what that Generic Zantac has the same cancer causing agent as the BP meds that were Recalled, and more have been added to that list. Can we really TRUST Generics? Do they really save you that much money? I take 80 mg of Nexium and still have GERD breakthrough, Osteoarthritis drugs Destroyed my Gastro Tract. Not only Barrett’s but Gastropresis, Slow Digestion, which eliminates fiber foods. Last Lab work showed I hit the Type 2 Diabetic mark. And the 2 diets are Polar Opposites. Difference in cost between the Name Brand and Generic $4-5.00 depending where you buy it.

      Medicare, Medicaid, VA, Tricare Fraud has reached a all time high. Put them all together it comes out about $1 Trillion a year. Now certain people want to add Illegal Aliens to Medicare and Medicaid. What did they do to earn it as most are on Welfare? Which exceeds my piddly Social Security check by 3 times.

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