FDA Opioid Giveback Program: Who Knew They Had a Sense of Humor??

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Two thousand people a week are dying from (almost entirely) illegal street drugs. While at the same time prescriptions for legal pain medications have been cut by half in the past decade. The FDA’s solution? Postage-paid envelopes for people to return the extra pills they don't have. It's almost funny. Just don't laugh until it hurts.

Let's try an experiment.

You get paid every two weeks. If, by some miracle, you have a little money left over on day #13 of a pay period (perhaps the $12 Wheat Thin you were planning on having for dinner was on sale for $11). What will you do?

  1. Hang onto the money in case you might need it someday
  2. Give it back to your employer
  3. Donate it to North Korea's nuclear weapons program

OK, I admit it. That is really stupid.

But not as stupid as this:

“The FDA is committed to addressing the opioid crisis on all fronts, including exploring new approaches that have the potential to decrease unnecessary exposure to opioids and prevent new cases of addiction. Prescribing opioids for durations and doses that do not properly match the clinical needs of the patient not only increases the chances for misuse, abuse and overdose, but it also increases the likelihood of unnecessary exposure to unused medications."

 FDA Commissioner Robert M. Califf, M.D., April 20, 2022

Earth to Carliff: Seriously? Do you really think there are barrels of unused opioid pills sitting around? Because if you do, kindly explain where they came from. Feel free to use the following figures to craft your response.

Opioid prescriptions (in MME) have dropped by more than half since 2011 and are now at levels not seen since 2000. So, where'd all those damn pills come from? Source: Pain News Network, Iqvia Institute for Data for Human Data Science

So, would someone who would not blow up a lie detector please explain how further decreasing the non-existent hoards of pills "sitting around" in imaginary medicine cabinets will do anything to mitigate this:

Drug overdose deaths by year. It doesn't look like that reduction in prescriptions isn't working too well, right? Of course, anyone with a working neuron knows that illicit fentanyl, heroin, cocaine, and methamphetamine are responsible for almost all drug OD deaths; even when prescription drugs are detected, there are almost always multiple other drugs involved. The red hatched lines indicate when opioid prescriptions began to be slashed (insert). Source: CDC.  

Send your comments!

The FDA wants to know your thoughts on their initiative to provide postage-paid envelopes to send back the extra pills (that you don't have) in the mail. 

Good news: You have until June 21st to send in your comments

Bad news: No one is going to read them.

Should you return the unused opioid pills you don't have?

Let's go back to the exercise I started with. 

You get prescribed four Vicodin following knee replacement surgery. But your leg falls off, so you only use two of them. What will you do with the other two pills?

1. Hang onto them in case you might need them someday

2. Send them to the FDA

3. Sell them on the street so you might be able to afford another Wheat Thin

4. Send the FDA to North Korea

Should those envelopes go to waste?

This is, of course, a personal decision. I cannot advise you to defy the FDA. Some of you may be out of your mind and want to return the pills. If you're really concerned that your kids might get their hands on pills, fine, send them in. But if you need to go to the ER with a kidney stone or ruptured Achilles and get offered IV Tylenol, you may be kicking yourself. I think I'll hang onto mine.

Our government at work

It is beyond pathetic that when 2,000 people per week are dying of drug overdoses, almost all of which were caused by illegal drugs, while at the same time, pain patients continue to suffer mightily because their physicians have been bullied into undertreating their pain that the FDA is still feeding us BS about prescription drugs being responsible for the "opioid epidemic" (1) 

I suggest another awards show –  "The Government Oscars," where stupid policies can earn the adulation they deserve.

The envelope, please.


(1) There is no longer a single opioid crisis; there are two: pain patients being denied medications they need to survive and people dying from illegally manufactured fentanyl.