While opioid prescriptions have declined, opioid overdoses continue to increase. According to preliminary data from the CDC nearly 49,000 Americans died in 2017 from opioid overdoses, more than half of them due to illegal fentanyl and heroin, not prescription opioids.
"This is not necessarily the case when suddenly more people switch from prescription opioids to these illegal drugs, and the idea that people are switching to illegal drugs is not new, as addiction expands and some people have a harder time, doctors with prescription drugs, "said Gottlieb. "What is new is that more people are turning to highly potent drugs that are far more deadly, mainly due to the growing availability of illegal fentanyls."
Illegal fentanyl and its chemical cousins are synthetic opioids, 50 to 100 times more potent than morphine. They are mostly made in secret drug laboratories in China and then smuggled into the US, where they are often mixed with heroin, cocaine and counterfeit drugs. A record of 1,640 pounds of fentanyl and nearly 5,500 pounds of heroin has so far been confiscated by law enforcement this year; probably a small fraction of what is available on the black market.
While the Trump government is stepping up its efforts to stop the sale and sale of illegal opioids, it continues to focus on reducing the supply of prescription opioids. The FDA plans to develop new prescriptive guidelines for the treatment of acute short-term pain that complement the CDC guideline for the treatment of chronic pain.
" No 30-day prescriptions more a tooth extraction or an appendectomy," said Gottlieb.
The Department of Justice recently announced plans to lower production quotas by 10% next year for six widely prescribed opioid medications. The aim of the administration is to reduce opioid regulations by one third over the next three years.
"The number of opioid prescriptions is just one of many factors and may not be the most important factor contributing to the opioid crisis, although opioid use has been low in the US for 15 years, but it has there is still an overdose of overdoses, "said Dr. Lynn Webster, Pain Management Expert and former President of the American Academy of Pain Medicine.
"Much of the effort to curb the amount of prescription opioids has contributed to more suffering in people with chronic pain and possibly an increase in suicides, and it has done nothing to reduce the number of overdose deaths Rather than focusing on the number of pills or the amount of opioid prescribed, we need to focus on what is the best and most appropriate treatment for individual patients, and if done correctly will prescribe the right amount of opioids . "