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SUNDAY TWEETORIAL: This week I'm highlighting a top priority for me and #FDA: How we're combatting the #opioidcrisis and its changing contour; and specifically, how we're working to get ahead of its dangerous turn into illicit drugs through our enforcement efforts #FDATWEETORIAL
Addressing the different facets of the opioid crisis, and its evolution from an epidemic mostly involving prescription drugs to one that’s increasingly fueled by illicit substances being purchased online or off the street, will take a concerted and multi-pronged approach
To tackle this crisis, we must learn from the lessons of the past. For instance, how quickly actions taken to curtail opioid abuse and misuse in one part of the market can be thwarted as demand shifts to other, even more dangerous channels
Even as lawful prescribing of opioids is declining, we’re seeing large increases in deaths from accidental drug overdoses as people turn to dangerous street drugs like heroin and synthetics opioids like fentanyl @samhsagov @DrMcCance_Katz @CDCgovpic.twitter.com/iFJgYb2JrD
Illegal online pharmacies, drug dealers and other bad actors are increasingly using the Internet to further their illicit distribution of opioids, where their risk of detection and the likelihood of repercussions are seen by criminals as significantly reducedpic.twitter.com/hlkd4xRe3H
No controlled substances, including opioids, can be lawfully sold or offered to be sold online. There is no gray area here. While other channels may still be more predominant sources of opioids, we must work now to stop illegal online sales. We can’t continue to be a step behind
Research by the @nabp found that when searching online for prescription opioids across the three major search engines, about 90% of the first search results led users to an illegal online drug seller offering prescription opioids https://bit.ly/2tCeagB
.@legitscript research on the Internet pharmacy market found about 96% of websites marketing pharmaceuticals on the open internet (30k to 35k web sites) failed to adhere to legal requirements. Of those, about 95% were selling prescription drugs without requiring a prescription
A January 2018 Senate report provided compelling evidence that average Americans can now readily purchase illicit opioids online – with credit cards, Bitcoin, or PayPal – and have them sent virtually anywhere in the U.S. https://bit.ly/2FtADjk @senrobportman @SenatorCarper
Senate investigators found hundreds of transactions in more than 40 states, adding up to more than $750 million worth of fentanyl by its street value, from just six online sellers, resulting in several deaths. https://bit.ly/2FtADjk
People are increasingly going online to illegally buy drugs like Vicodin or Percocet, but we believe they are often unknowingly getting pressed fentanyl – sometimes at lethal doses – given the lower cost and greater profitability of fentanyl for drug trafficking organizations
.@DEAHQ estimates that the gross profits for drug traffickers would be roughly 20x more if they imported a kg of fentanyl from China for use in counterfeit prescription pills versus a kg of heroin from Colombia https://bit.ly/2zNx2dR pic.twitter.com/m8qRYjBXpp
We must focus on this new threat. So FDA is increasing enforcement activities to crack down on illegal sales of opioids, particularly drugs sold online and typically shipped through the mail. We have greatly increased our presence in int’l mail facilities https://bit.ly/2KhMqIo pic.twitter.com/Y3ocXdWm7L
Last year, our Office of Criminal Investigations opened 339 port of entry investigations and opened 167 so far in 2018. A growing # of investigations relate to opioids, including fentanyl, demonstrating the increasing scope of the problem and the attention we're directing to itpic.twitter.com/qf6FlOMAbm
Our investigations are holding criminals accountable. In 2017, POE investigations resulted in 115 arrests/prosecutions, 63 guilty pleas and 83 convictions. So far this year, 92 arrests/prosecutions, 67 guilty pleas and 80 convictions have resulted from #FDA's POE investigationspic.twitter.com/Y4LBIPKunE
OCI’s investigations include the counterfeiting and illicit manufacturing of opioid products and other illicit pharmaceuticals being distributed on the surface web and dark web, as well as other investigations surrounding the facilitation and sale of these illicit drugs online
#FDA is cracking down on illegally operated, on-line sites that sell opioids. We recently sent warning letters to Internet networks operating more than 50 web sites that we believe were engaging in unlawful activityhttps://bit.ly/2JsQi81
This week #FDA convened Internet stakeholders to work on new ways to address the widespread availability of opioids online. I'm grateful for the engagement by these stakeholders and the private and public actions they've already taken to address issuehttps://bit.ly/2MsXT4u
Approaches we discussed included promoting legitimate/educational content in results and social posts, making it harder for individuals to find illegal sellers online, and using big data and machine learning/AI to identify illegal activityhttps://bit.ly/2MwbGY2
Part of our efforts must also include working to connect individuals and families searching for information about opioids online with trusted resources for dealing with substance abuse or addictionhttps://www.samhsa.gov/find-help
The magnitude of this public health crisis requires adoption of a forward-looking, socially responsible, collective approach to eliminating illegal opioid distribution via the Internet. This collaboration and engagement with Internet stakeholders is a key part of #FDA's strategy
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