PHARMACIST STEVE

I asked Perplexia.ai:

One of the media today declared the “fentanyl crisis” was over because OD’s from illegal fentanyl was going on.. Is there really any rational reason for the DEA to reduce the pharmaceutical company’s opioid production.. since Rx opioid – if anything – may be a very minor part of OD opioids

DEA’s own quota framework is built to balance diversion control with an “adequate and uninterrupted supply” of controlled substances, not to declare a crisis “over,” and current evidence still shows illicitly manufactured fentanyl (and other illicit synthetics), not prescription opioids, as the overwhelming driver of opioid overdose deaths. There is little epidemiologic justification, from an overdose-prevention standpoint, for further restricting medically used opioid supply in a way that worsens legitimate patient access while illicit markets continue to dominate mortality.fdli+3​

What DEA quotas are supposed to do

• Under the CSA (21 USC 826) and its regulations (21 CFR 1303), the Attorney General (via DEA) must set aggregate production quotas (APQs) for each Schedule II “basic class” so as to ensure an adequate national supply for medical, scientific, research, industrial needs, lawful export, and reasonable reserve stocks.ecfr+1​

• DEA and its Diversion Control Division explicitly state a dual mission: prevent diversion/abuse while ensuring an adequate and uninterrupted supply of pharmaceutical controlled substances for legitimate use.dea+2​

How diversion now actually looks

• National overdose data for 2023–2024 show that deaths involving synthetic opioids other than methadone (primarily illicitly manufactured fentanyl and analogs) account for the vast majority of opioid deaths, while deaths attributed to prescription opioids have remained relatively flat or declined compared with the 2010 peak.usafacts+2​

• State and regional profiles (for example, Oregon in 2022) show illicitly manufactured fentanyl contributing to well over half of all overdose deaths, again underscoring that the dominant supply is non‑pharmaceutical.oregon+1​

How quotas are now being tied to diversion

• Congress amended 21 USC 826 to require DEA, when setting quotas for several major opioids (fentanyl, oxycodone, hydrocodone, oxymorphone, hydromorphone), to estimate and factor in diversion of those substances.uscode.house​

• DEA’s quota rules and related commentary emphasize that quotas are now an overt diversion‑control tool in addition to a supply‑assurance tool, and DEA has broad discretion to decrease APQs if it believes diversion is substantial.federalregister+3​

Why “just cut pharma supply” is a weak overdose strategy

• Pharmacy and hospital groups (e.g., ASHP and others) have formally urged DEA to adjust APQs upward for certain opioids because over‑tight quotas have contributed to shortages that interfere with pain management, anesthesia, and palliative care, even as illicit fentanyl deaths climb.dea+1​

• Expert commentary on the quota system notes that APQs are largely driven by actual prescribing/dispensing data; restricting quotas beyond real clinical demand mainly creates access problems and does not meaningfully impact illicit fentanyl markets, which operate outside the regulated manufacturing chain.pharmacytimes+1​

Direct answer to your question

• From a pharmacovigilance and epidemiologic perspective, there is not a strong rational basis to continue ratcheting down legitimate pharmaceutical opioid production as a primary response to an overdose crisis now dominated by illicit synthetic opioids, especially when prescription‑opioid–involved deaths are comparatively stable and quotas are already keyed to actual medical need.kff+2​

• The legal rationale DEA cites is its statutory mandate to consider diversion when setting quotas, but that mandate does not distinguish well between diversion of FDA‑approved products and the overwhelmingly larger problem of illicitly manufactured fentanyl, so the policy lever is blunt and misaligned with the main source of mortality.congress+2​

In short, if Rx opioids now represent a relatively minor slice of overdose deaths, using DEA production quotas as a central overdose‑prevention tool lacks a solid evidence base and predictably harms legitimate patients and clinicians more than it constrains the illicit fentanyl supply.