There’s a lot of blame to go around for the opioid crisis that has hit West Virginia so hard—the addicts themselves, unscrupulous pill mill doctors and pharmacies, and the drug companies and wholesalers that dumped highly addictive pain pills by the millions.

And now the United States Department of Justice Office of the Inspector General (OIG) is pointing an accusatory finger at the very government agency responsible for overseeing controlled substances—the Drug Enforcement Administration (DEA).

The just-released investigation found the DEA was “slow to respond to the dramatic increase in opioid abuse.”

There were plenty of red flags.  The gradual rise in opioid overdose deaths started just before the turn of the century. By 2013, they were increasing by 71 percent a year.  However, the OIG report found that “from 2003 through 2013 DEA was authorizing manufacturers to produce substantially larger numbers of opioids.”

Specifically, the oxycodone production quota established by the DEA increased 400 percent between 2002 and 2013.  “It was not until 2017 that DEA significantly reduced the (production quota) for oxycodone by 25 percent.”

All the while more people were dying. OIG’s report says since 2000, more than 300,000 Americans have lost their lives to opioid overdose. Every day, between one and two West Virginians and more than 130 people nationally die from opioid overdose.

The DEA is responsible for enforcing federal laws governing the import, export, manufacture, distribution and dispensing of these powerful drugs.  The agency has the power to take enforcement action, issue civil penalties and pursue criminal prosecution when misuse occurs.

However, the OIG report found the DEA did not thoroughly vet new distributors and “rarely used its strongest enforcement tool, the Immediate Suspension Order,” to stop suspicious sales.  But even that tool is flawed because of breakdowns in the agency.

For example, “A doctor who had engaged in serious misconduct and had his registration (to distribute opioids) revoked, moved to another state under the authority of a different DEA field division and immediately reapplied for and was granted a new DEA registration, even though the field division that revoked the previous registration expressed concerns.”

The DEA has had successes.  The agency reported that in the last eight years it has removed opioid distribution licenses from approximately 900 manufacturers, distributors, pharmacies and prescribers.  The agency also started a new enforcement strategy, although the OIG could not determine how much better it’s working.

One of the questions that often comes up when discussing the opioid crisis is, “How did it get this bad?”  The answer is complicated, but one of the pieces to that puzzle, according to the OIG, is that the agency responsible for keeping tight control over these powerful drugs did not recognize the growing crisis and failed to use the available tools to contain it.

 

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