Internet service providers should help find and stop opioid offers, FDA chief says

Fentanyl and other opioids kill tens of thousands of Americans a year.
(Associated Press)

The head of the Food and Drug Administration is calling on internet service providers and social media companies to help rid the web of illegal offers of prescription opioids and illicit drugs that have contributed to the nation’s drug crisis.

Noting that internet providers and others have taken action when government required them to help control the spread of child pornography, FDA Commissioner Scott Gottlieb says it is time for a similar, but voluntary, response to opioids. The painkillers have created the worst drug epidemic in U.S. history — one that killed nearly 64,000 people in 2016.

In addition to internet service providers, Gottlieb called out Twitter, Facebook, Google and other online platforms.

“Internet firms simply aren’t taking practical steps to find and remove these illegal opioid listings,” Gottlieb said in prepared remarks he was scheduled to deliver at a national summit on the drug crisis late Wednesday. “There’s ample evidence of narcotics being advertised and sold online.”


“I know that internet firms are reluctant to cross a threshold where they could find themselves taking on a broader policing role,” he added. “But these are insidious threats being propagated on these web platforms.”

Gottlieb cited a recent congressional investigation that found how easy it was to find the powerful opioid fentanyl online; pay for it with cryptocurrency, PayPal or other methods; and receive it via the U.S. postal system.

The investigators identified 500 transactions worth $230,000 with 300 people in 43 states, Gottlieb said. They identified seven people who died of overdoses after receiving drugs online.

He said the FDA would soon meet with chief executives of internet companies, researchers and advocacy groups to identify solutions.


Gottlieb also suggested that the time may have come to require mandatory drug prescription and pain management training for medical personnel who provide prescription opioids.

The idea of required training for those who dispense controlled substances remains controversial because physicians have traditionally opposed government imposing it. The American Medical Assn., which represents the nation’s doctors, is against mandatory training.

There is ample evidence that the need for analgesics varies widely from patient to patient and that physicians aren’t sure how many pills to prescribe in different cases. Overprescribing of pain medication is widely considered one of the causes of the epidemic and continues to fuel it, though the number of prescriptions authorized in the United States has begun to fall in the last few years.

To assess the extent of overprescribing, the FDA looked at nearly 1 million surgical procedures and found a wide variation in the number of pills offered for the same operation. Other researchers have found the same thing.


The FDA also found that the average number of pills provided for an appendix or gallbladder removal is 30. But its analysis showed that on average, just one day of pain relief is required.