The Drug Enforcement Administration has made a number of moves to help in the federal response to coronavirus. It’s raising production quotas for controlled substances. It’s focusing enforcement on certain hot areas. And it’s taken steps to make sure people have consistent access to prescription medicines. Joining Federal Drive with Tom Temin with the highlights, the acting DEA administrator, Uttam Dhillon.
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Tom Temin: Mr. Dhillon, good to have you on.
Uttam Dhillon: Well, thanks for having me.
Tom Temin: Let’s talk about the quotas for controlled substances. How does that whole system work? And what leavers can you pull for what substances to make sure that there is adequate supply?
Uttam Dhillon: Well, every year the FDA determines the amount of controlled substances that can be manufactured by drug manufacturers, and that’s done by a variety of ways. Talking to the drug manufacturers themselves, talking to various state officials. So there’s a survey done every year of the drugs that are needed and then those quotas are set. This year because of the coronavirus issue, one of the things we recently did was we increased the quotas for certain drugs that are needed to fight the coronavirus.
Tom Temin: I guess most people probably didn’t realize there are drugs that can fight the coronavirus. We’ve heard about a couple of them that the President has mentioned and certain people have mentioned publicly. Which particular ones have you allowed the quotas to rise on?
Uttam Dhillon: Well, some of these are drugs that are being used for patients who are being treated who need them when they’re being treated by the doctors in the hospital. So, Fentanyl, for example, is one of the drugs that is needed when individuals are being treated. Fentanyl is also an opioid and it’s an addictive opioid, you probably heard that we have an opioid crisis and fentanyl is one of the drivers of that. So Fentanyl was a highly controlled substance, a highly controlled medication. But unfortunately, because we’re in this difficult situation, higher levels of Fentanyl are needed for people ventilators so DEA is acted and we’ve increased the amount of fentanyl and other drugs that are needed for people who are on ventilators to be manufactured to a higher level.
Tom Temin: And do you require certain reporting regimes on the companies that make it to make sure that when they are doing it, if they’re getting paid for it, and that also the DEA is aware of what the supply is?
Uttam Dhillon: Absolutely, we’re in regular communications with these companies. And so each individual company also has a quota. So one of the things that we’ve been doing is the companies have been coming to us asking to increase their quotas, and we’ve been doing that. So we’ve been increasing individual quotas for companies, we’ve also increased the overall quota to make sure that there’s no shortage of these critical drugs.
Tom Temin: All right, and looking to the other side of the DEA, the enforcement of illegal substances, you’ve made some pretty detailed investigations and some stoppages, tell us about some of those.
Uttam Dhillon: Yes, DEA keeps working even during these very difficult times. Just a couple of examples. Within the last month working with our other federal law enforcement partners, we discovered a tunnel coming from Mexico. Across the southwest border in the San Diego region. It was over 2000 feet long and it was loaded with a variety of different drugs. Over 4400 combined pounds of cocaine, methamphetamine, heroin, marijuana and Fentanyl with an estimated street value of nearly $30 million. And earlier this month, DEA agents seized $1.7 million in narcotics proceeds from drug traffickers in Southern California. On March 26, the Attorney General announced narco terrorism and drug trafficking weapons charges against former Venezuelan President Maduro and other high ranking members of government officials there. And DEA played a major role in supporting those indictments. And on March 11, I was honored to be able to announce the results of Project Python, which was a combined federal, state and local DEA led operation attacking and targeting the cartel de Jalisco Nueva Generación, commonly known as CJNG, and that operation resulted in over 700 arrests. 15,000 kilograms of methamphetamine seized and a variety of other drugs and more than $22 million in money and assets seized, so we have been busy.
Tom Temin: And do you sense that there is an increased at least attempted levels of illegal activity because the smugglers and the producers feel maybe US law enforcement is diverted at the moment because of coronavirus?
Uttam Dhillon: Well, actually, that’s really not what we’re seeing at the moment. We’re seeing throughout the country, some actual decreases in the amount, I think the best way to describe it is we’re seeing disruptions of nearly all illicit drugs both on the wholesale and retail level. So just to give you a couple of examples, methamphetamine is a drug that we see unfortunately, throughout the country, the wholesale and retail prices for methamphetamine have been going up, which indicates that the amount of methamphetamine available is going down. We’re seeing that in a number of locations throughout the country. That’s also the case with cocaine and heroin. We’re not seeing that in as many places. But once again, we’re seeing price increases for those two drugs. With fentanyl, we’re seeing that in just a couple of places, but we are seeing price increases in a few places for fentanyl.
Tom Temin: For those drugs that you have raised the quotas on, the legal substances, have you noticed this increase in activity or some attempts to smuggle or otherwise illegally transport those because of the value they have right now?
Uttam Dhillon: I don’t know that we’ve seen a specifically the drugs that are needed by patients who are fighting the coronavirus that we’ve necessarily seen increases of those drugs illegally. Obviously we’re seeing increases in the legal manufacturer of those drugs, which we’ve adjusted the quotas to allow to ensure that those manufacturers can manufacture as much as is needed to aggressively attack this virus. But I don’t know that we’ve seen anything with respect to the illegal importation of those drugs increasing.
Tom Temin: Well, that’s some good news then. And you’ve also taken some steps, the DEA, to ensure the flow of supplies to where they are needed. Tell us about some of those.
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Uttam Dhillon: Yes, well, so there were a number of individuals who are being treated for opioid addiction and the treatment regimen requires that they obtain a particular drug such as metadone on a daily basis. And the usual way they do that is they go to a clinic or a facility where they can get the methadone. Well, today because of all the issues we’re facing with the coronavirus, it’s difficult for people to get out, the clinics may not be open so the availability of those drugs was becoming an issue. We’ve temporarily relaxed our requirements so that a medical practitioner can now give a patient, a stable patient who’s recovering from opioid addiction, 28 days worth of methadone for example. We also changed our telemedicine requirements so that individuals who need to communicate with doctors can do it over the telephone in some cases, so they don’t have to go in to see the doctor. They don’t even have to do a two way audio visual kind of setup. They can do it through the telephone, and then the doctor can call in a prescription. And we’ve also relaxed the requirements for doctors to call in prescriptions, make it easier for them to do call in prescriptions, patients to receive their medications, and that sort of thing. And also with the methadone, one of the things we’ve done is we’ve allowed individuals like law enforcement or the National Guard to actually deliver methadone to patients who need it. So we’ve temporarily changed a lot of our rules and regulations to allow people to continue to receive their medications during this difficult time.
Tom Temin: And does some of that activity require coordination say with I don’t know FDA or other federal agencies?
Uttam Dhillon: We work every day with SAMHSA with HHS with FDA with all of them. There are a lot of entities and agencies that are involved in this. And we’re talking to them every single day to make sure we’re fully coordinated and to make sure that patients who are facing whatever issues they’re facing, never have a problem accessing the medications they need.
Tom Temin: And also, unfortunately, DEA had to cancel the annual day when everyone gets together and tosses out their unused and expired prescriptions. What should people do instead?
Uttam Dhillon: Well, first of all, it was postponed, so we’re hopeful that we’ll be able to schedule at some point in the future. It was originally scheduled for April 25. But we’re taking this opportunity to talk about something else, something we call secure your meds. The secure your meds awareness campaign addresses a vital public safety and public health issue. Where DEA’s national prescription drug take back day would focus on in person event, the secure your meds awareness campaign emphasizes that while many of us are remaining at home, this is a great opportunity to prepare for the next take back day by cleaning medicine cabinets of unwanted unneeded and expired prescription medications and putting those medications at a safe location out of the reach of children and others until we can all gather for the next national prescription take back day.
Tom Temin: All right, so I won’t flush down that Paregoric that’s 57 years old.
Uttam Dhillon: No, we would ask that you not do that. Part of the reason that take back day started about 10 years ago was because people were either throwing those prescription medications away or they were flushing them down the toilet. And if our Environmental Protection Agency pointed out that that was actually polluting our water supply, or if you throw them in a trash can, somebody could find them and still use them. So that was one of the reasons we started this because after we collect all those drugs for national prescription drug take back day, they’re all destroyed in an EPA approved generator that is good for the environment.
Tom Temin: Uttan Dhillon is Acting Administrator of the Drug Enforcement Administration. Thanks so much for joining me.
Uttam Dhillon: Well, thank you so much for having me. I very much appreciate it.