Policymakers still operate under the assumption that too many opioids are being prescribed.

See ‘Entire Body Is Shaking’: Why Americans With Chronic Pain Are Dying by Maia Szalavitz of The NY Times. Excerpts:

"Anne Fuqua keeps a list of suicide deaths. She’s chronicled hundreds of cases of chronic pain sufferers who have killed themselves after losing access to opioid medication since 2014. Recently, she almost became an entry.

Ms. Fuqua, a former nurse, has an incurable genetic disorder that causes ‌agonizing spasms and shaking. She can function only when she takes opioids. She’s one of the estimated five million to eight million Americans with chronic pain who regularly rely on them. But in November, her doctor’s license to prescribe controlled substances was suspended by the Drug Enforcement Administration — the second time she’s been left to fend for herself to avoid pain and withdrawal because of law enforcement action against a pain clinic.

From the mid-1990s to the early 2010s, the number of opioid prescriptions written for Americans roughly doubled, driven by dishonest pharmaceutical marketing campaigns and unscrupulous entrepreneurs who opened so-called pill mills to sell drugs. Medical guidelines, legislation, law enforcement efforts and other measures have since returned painkiller prescribing to precrisis levels. But because people who lose access to medical opioids are rarely provided with immediate treatment (whether they are experiencing pain or addiction or both), the result has been more overdose and suicide deaths, not fewer.

Despite these dismal facts, American medicine and law enforcement continue to fight the last war. Policymakers still operate under the assumption that too many opioids are being prescribed. Overdose deaths — including those among adolescents — are now overwhelmingly caused by street fentanyl, not prescription medications. And fatalities have nearly doubled since 2012, despite the decline of the medical supply.

o make matters worse, the D.E.A. has just reduced the permitted quota that opioid manufacturers can produce for next year by 5‌‌ percent — even though Kaiser Permanente, a major health insurer, recently told its patients that it may slash their doses because there is already a shortage. This scarcity, too, is linked to the last war: Distributors and pharmacies promised to minimize availability as part of opioid litigation settlements. But this course correction can create difficulties for people who need opioids to function amid chronic pain."

"the D.E.A. continues to target physicians who have large numbers of patients on high opioid doses or on combinations of opioids and other drugs that it considers red flags."

"Patient advocates say the answer is simple: Doctors who agree to take significant numbers of ‌chronic pain patients who need opioids rightly fear law enforcement scrutiny."

"Patients who are abandoned to withdrawal and untreated pain have an increased overdose death risk, nearly 300 percent, and their risk of suicide is also significantly elevated."