DEA Demands Reduction in Opioid Manufacturing
In early October 2016, the Drug Enforcement Administration released a statement announcing a mandate to reduce manufacture of opioid medications like oxycodone and hydrocodone by 23 to 34 percent. It is the DEA’s job to regulate this manufacture to ensure that only the quantity of drugs needed for medical treatment, research, export and other valid needs are produced. This guide to control production is called the Aggregate Production Quota (APQ).
This mandate comes seven months after new prescriber guidelines from the Centers for Disease Control and Prevention. In those guidelines, the CDC focused on the treatment of chronic pain, recommending starting with the lowest possible dose and only providing the patient with the quantity of pills needed for the duration of the pain. The CDC also recommended using non-opioid alternatives and even drug-free methods of improving the patient’s pain instead of routinely relying on opioids.
Why These Actions to Reduce the Use of Opioids?
The following numbers reveal why these actions by the DEA and CDC were necessary. In their statement, the DEA observed: “The 2015 National Survey on Drug Use and Health released last month found 6.5 million Americans over the age of 12 used controlled prescription medicines non-medically during the past month.” Also, each year, 350,000 people begin their drug abuse with a painkiller. And in 2013, it was estimated that 1.9 million Americans were dependent on or abusing painkillers—five times as many were dependent on or abusing cocaine. Obviously, there are more drugs in circulation than are needed for medical reasons.
Will Pain Patients be Affected?
This change aims to reduce the number of pills on the market to just the quantity needed to help patients suffering from pain. But how many pills does it take to deal with that pain? America consumes 80% of the world’s opioid pain relievers and 99% of the world’s hydrocodone.
Overprescribing—sending a patient home with too many pills or prescribing opioids instead of non-opioid or drugless alternatives—is still a problem. While reducing the number of pills in circulation can help reduce abuse, serious problems arise when mandated changes are not intelligently applied.
The point is not to destroy the improved quality of life of chronic pain patients taking their proper dosage of oxycodone, hydrocodone or other opioid. Unfortunately, there are many stories from pain patients whose doctors “cut them off” or told them they were “drug seeking” when they asked for a prescription to deal with around-the-clock pain.
These stories make it obvious that re-training doctors in correct prescribing must be part of the overall solution. There are people who need these medications but there are others relying on pills to cover up emotional pain. Doctors must know how to tell the difference and must be trained in helping each type of patient correctly. That means there must be more and better education in medical schools so people with chronic pain can still get the relief they need.
There is yet one more reason the DEA has asked for this decrease. Their announcement includes this statement:
“Much of this reduction is attributed to the elimination of a 25 percent buffer that was added to the APQ annually in 2013 through 2016 to guard against shortages.”
So if there are no shortages at this time, that’s another reason that these reductions can occur without penalizing any chronic pain patient.
This change may worry some people but if it is understood by the medical community and patients, it should be clear that it doesn’t pose any threat to vital painkiller supplies.
