I can imagine a hundred scenarios in which Dsuvia somehow leaves the battlefield and finds it way into the world of drug abuse.

The Guardian recently published this article about the approval of a yet another potent new opioid, Dsuvia, by the FDA– over the objections of key members of its own Advisory body. The drug is a form of sufentanil, a relative of fentanyl and carfentanil. Those are two opioids that helped launch a dangerous Phase 3 of the opioid epidemic. Seems odd that our government would be approving a new opioid at this point in the worst epidemic ever. But this isn’t the first time that’s happened.

Aren’t they paying attention?

I’m sure they are, but the FDA keeps examining the evidence and arriving at what some see as the wrong conclusion. Big Pharma and its vast network of lobbyists are thought to play a major role in this outcome. The new painkillers are invariably approved for restricted use under close medical supervision, and in that context, they’re okay. Yet somehow, as time passes, the controls and restrictions prove to be inadequate. Then fentanyl, a valuable medication for cancer pain, winds up as a  popular– and extremely deadly– drug of abuse.

How does a prescription medication transition to the streets? It’s amazing how consistently this happens.

Now Dsuvia is being introduced in the midst of a major epidemic. No need to create a demand for an opioid, it’s already there. Dsuvia is specifically aimed at battlefield medicine, which I imagine means it will be distributed via the military medical apparatus for use in combat situations. Now, how much confidence can we have in the military’s ability to protect this new opioid from the risk of diversion to illicit use?

There’ll be money to be made on the illegal side, and that’s usually all the incentive that’s required. I can imagine a hundred ways in which a drug escapes the medical bag and turns up on the streets. We could be creating a whole new set of difficulties, the way fentanyl has. Now outlaw chemists simply make their own.

So I see the objection: why exactly do we need another opioid in circulation at this point in history? Is it just to fatten a pharma firm’s bottom line?

If so, maybe they could try something else for once


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