The Creating and Restoring Equal Access to Equivalent Samples Act, known as the CREATES Act and co-sponsored by members of both parties, was rumored to be a part of budget negotiations until the final days. It would have given generic drug companies the tools to end a practice whereby brand-name manufacturers unnecessarily delay the ability of rivals to bring their products to market.
As Nora Volkow, director of the National Institute on Drug Abuse, noted in a 2016 New England Journal of Medicine article, “addiction occurs in only a small percentage of persons who are exposed to opioids—even among those with preexisting vulnerabilities.” A 2010 review found that less than 1 percent of patients taking opioids for chronic pain experienced addiction. A 2012 review likewise concluded that “opioid analgesics for chronic pain conditions are not associated with a major risk for developing dependence.” Volkow found that “rates of carefully diagnosed addiction have averaged less than 8% in published studies.”
The risk of fatal overdose is even lower. A 2015 study that had followed pain patients treated with narcotics for up to 13 years found that one in 550 died from an opioid-related overdose, which is a risk of less than 0.2 percent. A study of opioid-related deaths in North Carolina found 478 fatalities among 2.2 million residents who were prescribed opioids in 2010, making the annual rate 0.022 percent.