DEA Raises Controlled Substance Quota for COVID Response

The global coronavirus pandemic is now coinciding with the nation’s opioid epidemic in a manner contrary to how America has responded to the tens of thousands of deaths per year from prescription drug abuse. While the Administration has lowered annual quotas for controlled substances and the total quantity of opioids and other products for medical use, it now appears that many of these are now at risk of shortage given the pharmaceutical supply chain strains felt from COVID-19.

In response low supply, the Drug Enforcement Administration announced this week that it was increasing the 2020 Aggregate Production Quotas for select controlled substances by 15% to accommodate COVID-related needs. Products in the APQ revision include: fentanyl, morphine, hydromorphone, codeine, ephedrine, pseudoephedrine, and methadone. Many of these products are critical for patients that must be on ventilators for comprehensive respiratory care.

Upon a change in the status of the public health emergency, the DEA will consider any further revisions to the APQ commensurate with post-pandemic need.

Articles & Resources

DEA Newsroom – DEA Takes Additional Steps to Allow Increased Production of Controlled Substances Used in COVID-19 Care

LINK – DEA Notice of Final Order on Adjustments to Aggregate Production Quotas

POLITICO – America’s New Opioid Crisis

Research Identifies Alarming Overdose Death Rate Within One Year Following Emergency Department Interventions

In Massachusetts, researchers have identified over 11,500 patients in a retrospective observation study looking at healthcare outcomes following non-fatal overdoses treated in emergency departments. Results of the study are alarming with approximately 5.5% of patients having died in the following twelve months, and about 1% within the first 30 days following discharge. Of all overdose deaths (635 total), 4.6% passed away within two days. Given the mortality rates of opioid-related overdose deaths for patients following discharge, the authors suggest risk-stratification of patients in order to triage for appropriate interventions such as MAT, counseling or referral to more robust treatment programs.

Upon publication of the findings, lead author Dr. Scott G. Weiner noted, Knowing the high mortality rate of these patients makes the case for [emergency departments] to provide buprenorphine to appropriate patients and for health systems to create rapid-access ‘bridge clinics’ for patients who are in desperate need of help…Our emergency physicians now know that their buprenorphine prescription is an important link in the survival chain to then get the patient to the bridge clinic.”

Articles & Resources

National Institute on Drug Abuse – Many People Treated for Opioid Overdose in Emergency Departments Die Within 1 Year

Annals of Emergency Medicine – One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose

What We Read Last Week

Several articles were published last week pertaining to the opioid epidemic, covering a variety of different components of the issue. Links to relevant articles are provided below.

Articles & Resources

Health Affairs – The COVID-19 Pandemic: Practice And Policy Considerations For Patients With Opioid Use Disorder

STAT News – Methadone Clinic Lines and Packed Waiting Rooms Leave Clients Vulnerable to Coronavirus

Bloomberg Law – Virus Pandemic, Opioid Epidemic Collide Around Social Distancing

Wall Street Journal – Coronavirus Pandemic Complicates Opioid Treatment

STAT News – Opioid-Overdose Prescriptions May Go Unfilled Due to the Cost

The Atlantic – America’s Other Epidemic. A New Approach to Fighting the Opioid Crisis as it Quietly Rages On

POLITICO – Trump Officials, Health Experts Worry Coronavirus Will Set Back Opioid Fight

Atavist – Revive. A fatal overdose, a stunning coincidence, and a mother’s long quest to heal.

National Institute on Drug Abuse – COVID-19: Potential Implications for Individuals with Substance Use Disorders

Journal of the American Medical Association – Assessment of Excess Mortality Associated With Drug Overdose in Ohio From 2009 to 2018

Journal of the American Medical Association – Alcohol or Benzodiazepine Co-involvement With Opioid Overdose Deaths in the United States, 1999-2017

U.S. Attorney for the Eastern District of Wisconsin – Wisconsin Physician Agrees to Pay Financial Penalties to Resolve Allegations That He Prescribed Opioids Illegally and Violated False Claims Act

This Week’s Calendar

We hope that everyone is remaining safe and healthy during the ongoing coronavirus pandemic.

Given the ongoing circumstances, there are no hearings or relevant events noticed at this time. At this point in time, members of the House and Senate are back in-district In the instance that there are any changes to the schedule for this week, we will make additional information available.

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