Addressing the opioid crisis on the front end with the Opioid Quota Reform Act
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Our nation is in the midst of an unparalleled opioid abuse crisis that is devastating communities of all sizes in every state.  In 2016, more than 42,000 Americans died from an opioid overdose—more than 115 people each day.  From Illinois to Louisiana and all of the states in between, we have met too many families who are coping with the devastation wrought by opioid abuse. From Congress to doctors, pharmacists to manufacturers, we must use every tool at our disposal to confront this epidemic.

While there are many factors that have caused this crisis, one factor that cannot be ignored is the enormous volume of legal opioids being manufactured each year. Fourteen billion opioid doses are now put on the market annually—enough for every adult American to have nearly a one month prescription of pills.  The sheer volume of available opioids exceeds what is called for under current guidelines for medical use. And as powerful painkillers are aggressively marketed and prescribed at high rates, it heightens the risk for illicit diversion and abuse. For example, we know that four in five new heroin users first began their addiction with prescription painkillers.

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While it is well-known for its critical role in disrupting illegal drug trafficking, it may come as a surprise to many that the Drug Enforcement Administration (DEA) also plays an important gatekeeper role when it comes to the production of opioids. DEA is responsible for setting annual quotas to determine the amount of schedule I and II controlled substances – such as oxycodone and hydrocodone – that can be manufactured each year. For years, DEA had approved significant increases in opioid quotas; for example, from 1993 to 2015, the aggregate production quota for oxycodone increased 39-fold. Such increases occurred largely because current law forces DEA to only consider limited factors when setting quotas. Those factors include things like past sales and estimated demand, but do not include such factors as diversion, abuse rates, or overdose deaths. Why should DEA not consider the downstream effects of the drugs it approves for production?

By making targeted changes to DEA’s quota-setting authority, we can help address the opioid crisis on the front end instead of simply reacting to the consequences of the flood of opioids on the back end in our communities. That’s why we have introduced the “Opioid Quota Reform Act,” a bipartisan bill to enhance DEA’s existing quota-setting authority to focus on preventing opioid diversion and abuse. Our legislation would direct DEA to consider additional factors, like diversion, abuse, overdose deaths, and public health impacts, when setting annual opioid quotas.  It would also improve transparency in the quota-setting process and require DEA, if it approves any annual increase in opioid quotas, to explain publicly why the health benefits of the increase outweigh the potentially harmful consequences. 

Successfully stemming the tide of the opioid abuse epidemic will require an all-hands-on-deck response.  A common-sense place to start is at the beginning, by reforming DEA’s opioid quota process in a way that preserves access for legitimate medical use while strengthening the agency’s ability to sensibly and proactively adjust quotas in light of the epidemic we face.  The “Opioid Quota Reform Act” can make a real difference that will save lives. 

Durbin and Kennedy are members of the Judiciary Committee.