The Trump administration proposed a new strategy for combating the opioid epidemic on Thursday: cutting drugs off at the source. Under a new rule, the Department of Justice and Drug Enforcement Administration would enforce a 10 percent decrease in the manufacturing quotas of six common opioid drugs in 2019, the Hill reports.
Experts say the overproduction of these drugs, which include oxycodone, hydrocodone, and fentanyl, has "contributed significantly" to the epidemic, according to the Hill. Opioids caused more than 66 percent of overdose deaths in 2016, and that number is only increasing, a recent Centers for Disease Control and Prevention report found.
"Cutting opioid production quotas by an average of 10 percent next year will help us continue that progress and make it harder to divert these drugs for abuse," Attorney General Jeff Sessions said in a statement.
The last time the DEA changed its policy on opioids, making it more difficult for doctors to prescribe them, it did not have the desired effect. A new study found that prescriptions went down after the 2014 DEA change, but illegal sales only increased.
This latest proposal, made possible by a recent rule change allowing the agency to consider a drug's potential for abuse, follows several other proposed strategies for combating the ongoing epidemic—some more effective than others—on both the state and federal levels. Here are a few that Pacific Standard has been following.
1. The White House has launched a new anti-opioid campaign with ads showing the consequences of addiction, to lukewarm reception from experts. The White House's Office of National Drug Control Policy unveiled the ads in June, featuring true stories of opioid-addicted young people, which experts say will work well to capture viewer's attention. Pacific Standard's Francie Diep reports:
In focus groups, teens and young adults—the stated targets of these spots—will often say they like dramatic, scary ads, says Craig Lefebvre, who studies public-health marketing at RTI International. Unfortunately, such ads have been documented to have unintended consequences. By themselves, they haven't been shown to create long-lasting behavioral change. They elicit revulsion and fear, feelings that people often don't deal with productively if they're not immediately shown what steps they can take to avoid a bad fate. They may simply avoid the ad, or the feelings, instead of dealing with the issue.
2. A White House proposal unveiled in March offers a mix of strategies that include sentencing drug dealers to death. Alongside prevention and treatment measures, the plan calls for "strengthen[ing] criminal penalties for dealing and trafficking in fentanyl and other opioids," including seeking the death penalty and reducing the threshold for mandatory minimum sentences. Meanwhile, opponents have questioned the effectiveness of another "war on drugs," Pacific Standard reports.
3. New bipartisan legislation in the House of Representatives pushes for increased access to treatment and development of safer painkillers—strategies similar to those in the National Institutes of Health's $1.1 billion opioid research initiative, which focuses on research and improving opioid overdose-reversing drugs.
4. Twenty-seven states have filed lawsuits against drug companies that manufacture and market opioids for their contribution to the crisis. New York state became the latest to sue on Tuesday, claiming that Purdue Pharma LP used deceptive tactics to sell its painkiller Oxycontin. Pacific Standard explains:
Many researchers, experts, and activists think that the overprescribing of opioids has resulted in some patients getting addicted, then turning to the black market for more pills or for heroin, which is chemically similar. The companies have denied the allegations.
5. Oregon is considering ending Medicaid coverage for opioid painkillers for people with chronic pain in an attempt to curb overdoses caused by overprescription. Pacific Standard reports:
If the plan passes, Oregon would be the first state to take this step. The proposal is a sign of how quickly medical and political opinion have turned against opioids. Just two years ago, a Centers for Disease Control and Prevention guideline suggesting that doctors consider capping the opioid dosage they prescribe for people with chronic pain was considered controversial.