Coronavirus patients on ventilators are feeling the pinch of federal drug quotas.
Amid the COVID-19 pandemic, the Drug Enforcement Administration (DEA) upped 2020’s drug manufacturing quota by 15 percent to allow drug makers to respond to pandemic‐induced shortages. Intravenous opioids such as fentanyl are being used by coronavirus patients on ventilators and the DEA recognized the pandemic would likely increase demand. However, the agency pairs prescription opioid pills used in the non‐hospital setting with intravenous opioids like fentanyl and morphine used in hospital. Thus, the pandemic has limited, overall, the DEA’s efforts to reduce the nationwide drug overdose rate through the use of quotas. Congress ordered the DEA to address abuse by tightening the regulation of the U.S. opioid supply in 2018.
“The pharmaceutical industry flooded every corner of the country with 76 billion oxycodone and hydrocodone pills between 2006 and 2012 – out-sized and unjustifiable numbers of painkillers shipped with DEA approval and awareness,” Sen. Richard J. Durbin (D-Illinois) said. “The statute is clear that DEA must exercise its quota authority to serve as a gatekeeper and weigh the public health impact of how many opioids it allows to be sold each year in the United States.”
However, the quotas have led to a shortage of intravenous opioids, causing many hospitals to cancel or delay necessary procedures and limiting access to pain relief for ventilator users. And, while hospitals bare the shortage burden, fentanyl and other IV opioids are still in abundance, being sold illicitly on the streets. A preliminary report by the Centers for Disease Control and Prevention (CDC) found “drug overdose deaths increased from 67,367 in 2018 to 70,980 in 2019, while fentanyl overdoses increased by 15 percent, from 31,529 in 2018 to 36,509 in 2019.”
If the DEA had simply cut the supply altogether, critics have argued, opioid-related deaths would have dropped substantially. However, the agency said this simply wouldn’t work because of precisely what is happening in the market now – there are still patients in hospitals who need them. And insiders have shifted the shortage blame to Congress.
“What Congress wants to do will be virtually impossible,” said John W. Partridge, a retired 28-year DEA veteran who supervised the Diversion Control Division. “It just infuriates me that you want to blame us for this. It’s an easy out.”
“Prescriptions drive the quota,” explained Ruth Carter, a 30-year veteran who retired from the Diversion Control Division. “It’s totally wrong that we could have controlled the epidemic by the quota.”
Unfortunately, policymakers continue to believe reducing opioids in the market will lead to a reduction in overuse, addiction, and deaths. This false hope persists despite the fact that data from the CDC and the National Survey on Drug Use and Health. In reality, the drug overdose crisis has been largely caused by non‐medical users getting their supply in the black market, and because there is still plenty out there on the streets, it’s the patients who actually need relief that suffer because of government quotas.