The Department of Justice and U.S. Drug Enforcement
Administration (DEA) have proposed a reduction for controlled substances that
may be manufactured in the U.S. next year. Consistent with President Trump’s
“Safe Prescribing Plan” that seeks to “cut nationwide opioid prescription fills
by one-third within three years,” the proposal decreases manufacturing quotas
for the most six frequently misused opioids for 2019 by an average ten percent
as compared to the 2018 amount. The Notice of Proposed Rulemaking (NPRM) marks
the third straight year of proposed reductions, which help reduce the amount of
drugs potentially diverted for trafficking and used to facilitate addiction.
On July 11, 2018, the Justice Department announced that DEA
was issuing a final rule amending its regulations to improve the agency’s
ability consider the likelihood of whether a drug can be diverted for abuse
when it sets annual opioid production limits. The final rule also promotes
greater involvement from state attorneys general, and today’s proposed
reduction will be sent to those offices.
In setting the aggregate production quote (APQ), DEA
considers data from many sources, including estimates of the legitimate medical
need from the Food and Drug Administration; estimates of retail consumption
based on prescriptions dispensed; manufacturers’ disposition history and
forecasts; data from DEA’s own internal system for tracking controlled
substance transactions; and past quota histories.
The DEA has proposed to reduce more commonly prescribed
schedule II opioids, including oxycodone, hydrocodone, oxymorphone,
hydromorphone, morphine, and fentanyl: (see chart attached below)
Ultimately, revised limits will encourage vigilance on the
part of opioid manufacturers, help DEA respond to the changing drug threat
environment, and protect the American people from potential addictive drugs
while ensuring that the country has enough opioids for legitimate medical,
scientific, research, and industrial needs.
"The opioid epidemic that we are facing today is the
worst drug crisis in American history," Attorney General Jeff Sessions
said. "President Trump has set the ambitious goal of reducing opioid
prescription rates by one-third in three years. We embrace that goal and are
resolutely committed to reaching it. According to the National Prescription
Audit, we have already made significant progress in reducing prescription rates
over the past year. Cutting opioid production quotas by an average of ten
percent next year will help us continue that progress and make it harder to
divert these drugs for abuse. The American people can be confident that federal
law enforcement and the Trump administration are taking action to protect them
from dangerous drugs. These smarter limits
bring us one big step closer to President Trump's goal of finally ending this
unprecedented crisis. I congratulate Acting Administrator Uttam Dhillon and his
team for taking action.”
“We’ve lost too many lives to the opioid epidemic and
families and communities suffer tragic consequences every day,” said DEA Acting
Administrator Uttam Dhillon. “This significant drop in prescriptions by doctors
and DEA’s production quota adjustment will continue to reduce the amount of
drugs available for illicit diversion and abuse while ensuring that patients
will continue to have access to proper medicine.”
Once the aggregate quota is set, DEA allocates individual
manufacturing and procurement quotas to those manufacturers that apply for
them. DEA may revise a company’s quota at any time during the year if change is
warranted due to increased or decreased sales or exports, new manufacturers
entering the market, new product development, or product recalls.
When Congress passed the Controlled Substances Act, the
quota system was intended to reduce or eliminate diversion from “legitimate
channels of trade” by controlling the quantities of the basic ingredients
needed for the manufacture of controlled substances.
The Proposed Aggregate Production Quotas for schedule I and
II controlled substances published in the Federal Register reflects the total
amount of controlled substances necessary to meet the country’s medical,
scientific, research, industrial, and export needs for the year and for the
establishment and maintenance of reserve stocks. DEA establishes an APQ for
more than 250 schedule I and II controlled substances annually.
In 2016, the Centers for Disease Control and Prevention
issued guidelines to practitioners recommending a reduction in the prescribing
of opioid medications for chronic pain. DEA and its federal partners have
increased efforts in the last several years to educate practitioners,
pharmacists, manufacturers, distributors, and the public about the dangers
associated with the misuse of opioid medications and the importance of proper prescribing.
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