it's far more complicated than that. you constantly have a lot of different stakeholders who have competing interests trying to get legislation passed or their own agendas through. That's not a bad thing necessarily. That's how we get patient advocates and consumer groups.

I work in the pharma industry and very closely with pain medicine companies. What doesn't make the news and what conspiracy theorists don't pay attention to are the different politics that go into making these laws and products.

For instance, you have about 100 million people in this country who suffer from chronic pain (according to the Institute of Medicine). Those people need to go to work and live their lives. Pain medicine is an easy way for us to treat their pain. Have there been unintended consequences in making pain medicine more available, absolutely. But the alternative is no treatment.

Pain medicine isn't the end all be all either. Patients need to have emotional and societal support. It's been shown that pain patients have an easier time getting off of pain meds when they have family support or behavioral therapy. Unfortunately, that's also very expensive and not always easy to provide.

We've seen that pain medicine has led to an epidemic of addiction. The country and the government hasn't just been standing still here either. There are efforts across this country to find ways to stop excessive medicine from getting out there while at the same time maintaining access for patients who really need it. That's a very difficult thing to balance. Pain is still completely subjective and we don't have a really good test to determine how much in pain folks are.

There have been lots of changes recently, including re-scheduling combination painkillers from Schedule III to Schedule II, making them harder to prescribe especially for long durations. Nearly all states now have prescription monitoring programs that require doctors to register every prescription. It's become so much harder for addicts to game their way to more pills.

Oxy was made abuse-deterrent a few years ago and FDA now refuses to approve any non-AD product. The problem is that AD products are really hard to create since there needs to be a balance of being able to release drug in the body while resisting any other attempts out of the body to release the drug. Due to politics though, FDA and medical groups have been forced to limit prescribing and approvals of pain medicine without a good alternative.

Unfortunately limitations in prescribing and abuse-deterrent formulations also led to an increase in heroin. There were plenty of people who warned against sudden changes in legislation because they foresaw that happening, but politics dictated immediate action, regardless of unintended consequences. We have in this country a system in which politicians make proclamations and laws based on the news and not on science. They make rules and don't worry about the unintended consequences. That's what happened with Oxy/heroin. There's no conspiracy.

tl;dr: there's no massive FDA conspiracy. it's mostly politics driving hasty legislation and actions without regard for unintended consequences