Proposed Aggregate Production Quotas for Schedule I and II Controlled Substances and Assessment of Annual Needs for the List I Chemicals Ephedrine, Pseudoephedrine, and Phenylpropanolamine for 2024, 75312-75323 [2023-24282]

Download as PDF khammond on DSKJM1Z7X2PROD with NOTICES 75312 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices demonstrate that he has undertaken corrective measures. Holiday CVS, L.L.C., dba CVS Pharmacy Nos 219 and 5195, 77 FR 62316, 62339 (2012) (internal quotations omitted). Trust is necessarily a fact-dependent determination based on individual circumstances; therefore, the Agency looks at factors such as the acceptance of responsibility, the credibility of that acceptance as it relates to the probability of repeat violations or behavior, the nature of the misconduct that forms the basis for sanction, and the Agency’s interest in deterring similar acts. See, e.g., Robert Wayne Locklear, M.D., 86 FR 33738, 33746 (2021). When a respondent declines to testify and ‘‘neither [takes] responsibility for his misconduct nor provid[es] any assurances that he has implemented remedial measures to ensure such conduct is not repeated,’’ the respondent’s silence weighs against registration. Zvi H. Perper, M.D., 77 FR 64131, 64142 (2012) (citing Medicine Shoppe-Jonesborough, 73 FR 364, 387 (2008)); see also Jeanne E. Germeil, M.D., 85 FR 73786, 73803 (2020). Such silence also warrants an adverse inference against the respondent. MacKay v. Drug Enf’t Admin, 664 F.3d 808, 820 (10th Cir. 2011) (upholding the Agency’s finding that a respondent’s failure to testify warranted an adverse inference because there was ‘‘no evidence that [respondent] recognized the extent of his misconduct and was prepared to remedy his prescribing practices’’); T.J. McNichol, M.D., 77 FR 57133, 57153–54 (2012) (stating that ‘‘it is appropriate to draw an adverse inference from Respondent’s failure to testify’’). Here, Respondent has failed to accept responsibility or offer any basis for the Agency to trust him, despite his past misconduct, with the responsibility of a registration. RD, at 21. In light of Respondent’s silence, he has not sufficiently demonstrated that he can be entrusted with a DEA registration. See id.; MacKay, 664 F.3d at 820; Jeanne E. Germeil, M.D., 85 FR at 73803; Zvi H. Perper, M.D., 77 FR at 64142. In addition to acceptance of responsibility, the Agency looks to the egregiousness and extent of the misconduct, Garrett Howard Smith, M.D., 83 FR at 18910 (collecting cases), and considers both specific and general deterrence when determining an appropriate sanction. Daniel A. Glick, D.D.S., 80 FR 74800, 74810 (2015). Here, Respondent’s blatant and repeated disregard for the laws relating to controlled substances warrants a sanction. Respondent’s inappropriate and unlawful prescribing of controlled VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 substances placed multiple patients, and the public, at risk of harm. In this case, the Agency believes that denial of Respondent’s application would deter Respondent and the general registrant community from disregarding controlled substance laws and engaging in the pattern of misconduct that permeated Respondent’s actions as a registrant. See RD, at 22. As the Chief ALJ noted, ‘‘[t]he misconduct established was sufficiently egregious that a denial is strongly supported.’’ RD, at 22. Further, there is no evidence that Respondent’s behavior is unlikely to recur in the future such that the Agency can entrust him with a registration. In sum, the public interest factors weigh in favor of denial as a sanction; accordingly, the Agency shall order the sanctions the Government requested, as contained in the Order below. Order Pursuant to 28 CFR 0.100(b) and the authority vested in me by 21 U.S.C. 823(g)(1), I hereby deny the DEA registration application of Osmin A. Morales, M.D. (Control No. W20125906C) and any other pending application of Osmin A. Morales, M.D., for a DEA registration in Florida. This Order is effective December 4, 2023. Signing Authority This document of the Drug Enforcement Administration was signed on October 25, 2023, by Administrator Anne Milgram. That document with the original signature and date is maintained by DEA. For administrative purposes only, and in compliance with requirements of the Office of the Federal Register, the undersigned DEA Federal Register Liaison Officer has been authorized to sign and submit the document in electronic format for publication, as an official document of DEA. This administrative process in no way alters the legal effect of this document upon publication in the Federal Register. Heather Achbach, Federal Register Liaison Officer, Drug Enforcement Administration. [FR Doc. 2023–24151 Filed 11–1–23; 8:45 am] BILLING CODE 4410–09–P PO 00000 Frm 00050 Fmt 4703 Sfmt 4703 DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. DEA–1228P] Proposed Aggregate Production Quotas for Schedule I and II Controlled Substances and Assessment of Annual Needs for the List I Chemicals Ephedrine, Pseudoephedrine, and Phenylpropanolamine for 2024 Drug Enforcement Administration, Department of Justice. ACTION: Notice with request for comments. AGENCY: The Drug Enforcement Administration (DEA) proposes to establish the 2024 aggregate production quotas (APQ) for controlled substances in schedules I and II of the Controlled Substances Act (CSA) and the assessment of annual needs (AAN) for the list I chemicals ephedrine, pseudoephedrine, and phenylpropanolamine. For the 2024 quota year, DEA intends to allocate procurement quotas to DEA-registered manufacturers of schedule II controlled substances on a quarterly basis. In order to address domestic drug shortages of controlled substances, procurement quota allocations will be divided between quantities authorized for domestic sales and quantities authorized for export sales. DATES: Electronic comments must be submitted, and written comments must be postmarked, on or before December 4, 2023. Interested persons may file written comments on this notice in accordance with 21 CFR 1303.11(c) and 1315.11(d). Commenters should be aware that the electronic Federal Docket Management System will not accept comments after 11:59 p.m. Eastern Time on the last day of the comment period. Based on comments received in response to this notice, the Administrator may hold a public hearing on one or more issues raised. In the event the Administrator decides in her sole discretion to hold such a hearing, the Administrator will publish a notice of any such hearing in the Federal Register. After consideration of any comments or objections, or after a hearing, if one is held, the Administrator will publish in the Federal Register a final order establishing the 2024 aggregate production quotas for schedule I and II controlled substances, and an assessment of annual needs for the list I chemicals ephedrine, pseudoephedrine, and phenylpropanolamine. SUMMARY: E:\FR\FM\02NON1.SGM 02NON1 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices To ensure proper handling of comments, please reference ‘‘Docket No. DEA–1228P’’ on all correspondence, including any attachments. DEA encourages that all comments be submitted electronically through the Federal eRulemaking Portal, which provides the ability to type short comments directly into the comment field on the web page or attach a file for lengthier comments. Please go to https:// www.regulations.gov and follow the online instructions at that site for submitting comments. Upon completion of your submission, you will receive a Comment Tracking Number for your comment. Please be aware that submitted comments are not instantaneously available for public view on Regulations.gov. If you have received a Comment Tracking Number, your comment has been successfully submitted, and there is no need to resubmit the same comment. Paper comments that duplicate electronic submissions are not necessary and are discouraged. Should you wish to mail a paper comment in lieu of an electronic comment, it should be sent via regular or express mail to: Drug Enforcement Administration, Attention: DEA Federal Register Representative/DPW, 8701 Morrissette Drive, Springfield, Virginia 22152. FOR FURTHER INFORMATION CONTACT: Scott A. Brinks, Regulatory Drafting and Policy Support Section, Diversion Control Division, Drug Enforcement Administration; Mailing Address: 8701 Morrissette Drive, Springfield, Virginia 22152, Telephone: (571) 776–3882. SUPPLEMENTARY INFORMATION: khammond on DSKJM1Z7X2PROD with NOTICES ADDRESSES: Posting of Public Comments Please note that all comments received in response to this docket are considered part of the public record. They will, unless reasonable cause is given, be made available by the Drug Enforcement Administration (DEA) for public inspection online at https:// www.regulations.gov. Such information includes personal identifying information (such as your name, address, etc.) voluntarily submitted by the commenter. The Freedom of Information Act applies to all comments received. If you want to submit personal identifying information (such as your name, address, etc.) as part of your comment, but do not want it to be made publicly available, you must include the phrase ‘‘PERSONAL IDENTIFYING INFORMATION’’ in the first paragraph of your comment. You must also place all the personal identifying information you do not want made publicly VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 available in the first paragraph of your comment and identify what information you want redacted. If you want to submit confidential business information as part of your comment, but do not want it to be made publicly available, you must include the phrase ‘‘CONFIDENTIAL BUSINESS INFORMATION’’ in the first paragraph of your comment. You must also prominently identify confidential business information to be redacted within the comment. Comments containing personal identifying information or confidential business information identified and located as directed above will generally be made available in redacted form. If a comment contains so much confidential business information or personal identifying information that it cannot be effectively redacted, all or part of that comment may not be made publicly available. Comments posted to https:// www.regulations.gov may include any personal identifying information (such as name, address, and phone number) included in the text of your electronic submission that is not identified as directed above as confidential. An electronic copy of this document is available at https:// www.regulations.gov for easy reference. Legal Authority Section 306 of the Controlled Substances Act (21 U.S.C. 826) requires the Attorney General to establish production quotas for each basic class of controlled substances listed in schedules I and II, and for the list I chemicals ephedrine, pseudoephedrine, and phenylpropanolamine. The Attorney General has delegated this function to the Administrator of DEA pursuant to 28 CFR 0.100. Analysis for Proposed 2024 Aggregate Production Quotas and Assessment of Annual Needs The proposed 2024 aggregate production quotas (APQ) and assessment of annual needs (AAN) represent those quantities of schedule I and II controlled substances, and the list I chemicals ephedrine, pseudoephedrine, and phenylpropanolamine, to be manufactured in the United States (U.S.) in 2024 to provide for the estimated medical, scientific, research, and industrial needs of the United States, lawful export requirements, and the establishment and maintenance of reserve stocks. These quotas include imports of ephedrine, pseudoephedrine, and phenylpropanolamine, but do not include imports of controlled PO 00000 Frm 00051 Fmt 4703 Sfmt 4703 75313 substances for use in industrial processes. Aggregate Production Quotas In determining the proposed 2024 APQ, the Administrator has taken into account the criteria of 21 U.S.C. 826(a) and 21 CFR 1303.11, including the following seven factors: (1) Total net disposal of the class by all manufacturers during the current and two preceding years; (2) Trends in the national rate of net disposal of the class; (3) Total actual (or estimated) inventories of the class and of all substances manufactured from the class, and trends in inventory accumulation; (4) Projected demand for such class as indicated by procurement quotas requested pursuant to [21 CFR] 1303.12; (5) The extent of any diversion of the controlled substance in the class; (6) Relevant information obtained from the Department of Health and Human Services (HHS), including from the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the Centers for Medicare and Medicaid Services (CMS), and relevant information obtained from the states; and (7) Other factors affecting medical, scientific, research, and industrial needs in the United States and lawful export requirements, as the Administrator finds relevant, including changes in the currently accepted medical use in treatment with the class or the substances manufactured from it, the economic and physical availability of raw materials for use in manufacturing and for inventory purposes, yield and stability problems, potential disruptions to production (including possible labor strikes), and recent unforeseen emergencies such as floods and fires. 21 CFR 1303.11(b) DEA formally solicited input from FDA and CDC in February of 2023 and from the states in April 2023, as required by 21 U.S.C. 826 and 21 CFR part 1303. DEA did not solicit input from CMS for reasons discussed in previous notices.1 DEA requested information on trends in the legitimate use of select schedule I and II controlled substances from FDA and rates of 1 Proposed Adjustments to the Aggregate Production Quotas for Schedule I and II Controlled Substances and Assessment of Annual Needs for List I Chemicals Ephedrine, Pseudoephedrine, and Phenylpropanolamine for 2021, 85 FR 54414 (Sept. 1, 2020) and Proposed Aggregate Production Quotas for Schedule I and II Controlled Substances and Assessment of Annual Needs for List I Chemicals Ephedrine, Pseudoephedrine, and Phenylpropanolamine for 2021, 85 FR 54407 (Sept. 1, 2020). E:\FR\FM\02NON1.SGM 02NON1 75314 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices overdose deaths for covered controlled substances from CDC. DEA’s request for information from the states was made directly to the Prescription Drug Monitoring Program (PDMP) Administrators in each state as well as through the National Association of State Controlled Substances Authorities (NASCSA). Assessment of Annual Needs khammond on DSKJM1Z7X2PROD with NOTICES In similar fashion, in determining the proposed 2024 AAN for the list I chemicals ephedrine, pseudoephedrine, and phenylpropanolamine, the Administrator has taken into account the criteria of 21 U.S.C. 826(a) and 21 CFR 1315.11, including the five following factors: (1) Total net disposal of the chemical by all manufacturers and importers during the current and two preceding years; (2) Trends in the national rate of net disposal of each chemical; (3) Total actual (or estimated) inventories of the chemical and of all substances manufactured from the chemical, and trends in inventory accumulation; (4) Projected demand for each chemical as indicated by procurement and import quotas requested pursuant to [21 CFR] 1315.32; and (5) Other factors affecting medical, scientific, research, and industrial needs in the United States, lawful export requirements, and the establishment and maintenance of reserve stocks, as the Administrator finds relevant, including changes in the currently accepted medical use in treatment with the chemicals or the substances manufactured from them, the economic and physical availability of raw materials for use in manufacturing and for inventory purposes, yield and stability problems, potential disruptions to production (including possible labor strikes), and recent unforeseen emergencies such as floods and fires. 21 CFR 1315.11(b) In determining the proposed 2024 AAN, DEA used the calculation methodology previously described in the 2010 and 2011 assessments of annual needs (74 FR 60294, Nov. 20, 2009, and 75 FR 79407, Dec. 20, 2010, respectively). Estimates of Medical Need for Schedule II Opioids and Stimulants In accordance with 21 CFR part 1303, 21 U.S.C. 826, and 42 U.S.C. 242, HHS continues to provide DEA with estimates of the quantities of select schedule I and II controlled substances and three list I chemicals that will be VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 required to meet the legitimate medical needs of the United States for a given calendar year. The responsibility to provide these estimates of legitimate domestic medical needs resides with FDA. FDA provides DEA with predicted estimates of domestic medical usage for selected controlled substances based on information available to them at a specific point in time in order to meet statutory requirements. FDA predicts that levels of medical need for schedule II opioids in the United States in calendar year 2024 will decline on average 7.9 percent from calendar year 2023 levels. These declines are expected to occur across a variety of schedule II opioids including fentanyl, hydrocodone, hydromorphone, oxycodone, and oxymorphone. DEA considered the potential for diversion of schedule II opioids, as required by 21 CFR 1303.11(b)(5), as well as a potential increase in demand for certain opioids identified as being necessary to support the previously postponed elective surgeries now that the COVID–19 public health emergency has ended, pursuant to 21 CFR 1303.11(b)(7), in developing the proposed 2024 APQ. FDA predicted an average of a 3.1 percent increase in domestic medical use of the schedule II stimulants amphetamine, methylphenidate (including dexmethylphenidate), and lisdexamfetamine, which are prescribed to treat patients with attention deficit hyperactivity disorder (ADHD) and more recently prescribed off-label to treat patients diagnosed with longCOVID symptoms commonly known as brain fog where fatigue and cognitive impairment persist 4 to 12 weeks after a COVID infection.2 FDA also raised concerns over drug shortage notifications it received from patients for specific ADHD medications containing methylphenidate and amphetamine. FDA’s stated reasons for these specific shortages include increased prescribing potentially related to the growth in telemedicine, supply chain issues, manufacturing and quality issues, and business decisions of manufacturers. DEA considered FDA’s concerns when determining the APQ for these substances. DEA believes that manufacturers will be able to meet the increase in domestic medical need with the APQs proposed in this notice. 2 New Long-Haul COVID Clinics Treat Mysterious and Ongoing Symptoms, Scientific American, June 30, 2021; Successful Treatment of Post-COVID–19 ADHD-like Syndrome-A case Report, J Atten Disord., 2023 Aug; 27(10): 1092–1098. PO 00000 Frm 00052 Fmt 4703 Sfmt 4703 DEA Projected Trends for Certain Schedule I Controlled Substances There has been a significant increase in the use of schedule I hallucinogenic controlled substances for research and clinical trial purposes. DEA has received and subsequently approved new registration applications for schedule I researchers and new applications for registration from manufacturers to grow, synthesize, extract, and prepare dosage forms containing specific schedule I hallucinogenic substances for research and clinical trial purposes. DEA supports regulated research with schedule I controlled substances, as evidenced by the higher APQ proposed for 2024 as compared with APQ for these substances in 2023. Further, DEA published the final rule, ‘‘Controls to Enhance the Cultivation of Marihuana for Research in the United States’’ in December 2020, and the Medical Marijuana and Cannabidiol Research Expansion Act (Pub. L. 117–215) was enacted in December 2022. The agency continues to review and approve applications for schedule I manufacturers of marihuana that conform to the federal requirements contained in the CSA. See 21 CFR part 1318. Thus, DEA is proposing APQ for ibogaine, psilocyn, psilocybin, delta-9tetrahydrocannabinol (d-9-THC), and all other tetrahydrocannabinols to support manufacturing activities related to the increased level of research and clinical trials with these schedule I controlled substances. Additionally, DEA proposes APQs for d-9-THC and all other tetrahydrocannabinols for 2024 to reflect the relocation of manufacturing of these controlled substances from abroad to the United States. Information Received for Consideration of the Remaining Factors For the factors listed in 21 CFR 1303.11(b)(3) and (4), DEA registered manufacturers of controlled substances in schedules I and II provide information such as inventory, distribution, manufacturing, sales forecasts and quota requests to the DEA database systems. See 21 CFR 1303.12, 1303.22, and part 1304. The regulation at 21 CFR 1303.11(b)(5) requires DEA to consider the extent of diversion of controlled substances.3 Diversion is defined as all distribution, dispensing, or other use of controlled substances for other than legitimate medical purposes. In order to 3 The estimates of diversion for five ‘‘covered controlled substances’’ as required by 21 U.S.C. 826(i) are discussed later in the document. E:\FR\FM\02NON1.SGM 02NON1 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices khammond on DSKJM1Z7X2PROD with NOTICES consider the extent of diversion, DEA analyzed reports of diversion of controlled substances from 2022 submitted to its Theft Loss Report database. This database is comprised of DEA registrant reports documenting diversion from the legitimate distribution chain, including employee thefts, break-ins, armed robberies, and material lost in transit. The data was categorized by basic drug class, and the amount of active pharmaceutical ingredient (API) in the dosage form was delineated with an appropriate metric for use in proposing aggregate production quota values (i.e., weight). In this proposed 2024 APQ, DEA also considered the lingering effects of the COVID–19 pandemic on the global supply chain, pursuant to 21 CFR 1303.11(b)(7), and specifically the continued impacts on the availability of raw materials for use in the domestic manufacturing process. Additionally, DEA considered the impact of the demand for surgical care for elective surgeries that were deferred during the COVID–19 public health emergency. Estimates of Diversion of Covered Controlled Substances In establishing any quota . . . , or any procurement quota established by [DEA] by regulation, for fentanyl, oxycodone, hydrocodone, oxymorphone, or hydromorphone (in this subsection referred to as a ‘‘covered controlled substance’’), [DEA] shall estimate the amount of diversion of the covered controlled substance that occurs in the United States. 21 U.S.C. 826(i)(1)(A) In estimating diversion under that provision, DEA: (i) shall consider information . . . , in consultation with the Secretary of Health and Human Services, [it] determines reliable on rates of overdose deaths and abuse and overall public health impact related to the covered controlled substance in the United States; and (ii) may take into consideration whatever other sources of information [it] determines reliable. 21 U.S.C. 826(i)(1)(B) The statute further mandates that DEA ‘‘make appropriate quota reductions, as determined by [DEA], from the quota [it] would have otherwise established had such diversion not been considered.’’ 4 In estimating the amount of diversion of each covered controlled substance that occurs in the United States, DEA considered information from state PDMP Administrators and from 4 21 U.S.C. 826(i)(1)(C). VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 legitimate distribution chain participants. Consideration of Information From Certain State PDMPs and From National Sales Data Pursuant to 21 CFR 1303.11(b)(6), DEA requested state PDMP data for the purpose of establishing its APQ. DEA believes state PDMPs to be an essential, reliable source of information for use in effectively estimating diversion of the five covered controlled substances. In April 2023, DEA sent a letter to NASCSA requesting its assistance in obtaining aggregated PDMP data for the five covered controlled substances from each state covering the years 2020–2022. The letter indicated that DEA was specifically interested in an analysis of prescription data from each state’s PDMP that would assist DEA in estimating diversion and setting appropriate quotas in compliance with 21 U.S.C. 826(i). In its request, DEA provided specific questions, discussed in detail below, based on common indicia of potential diversion known as ‘‘red flags’’ by physicians, pharmacists, manufacturers, distributors, and federal and state regulatory and law enforcement agencies.5 DEA investigators and administrative prosecutors also rely on Agency case law in which these red flags of diversion have been upheld as indicia of potential diversion.6 Certain state regulations now include red flag circumstances as potential indicators of illegitimate prescriptions, and thus of potential abuse and diversion of controlled substances.7 See The Pharmacy Place Order, 86 FR 21008, 21012 (Apr. 21, 2021) (citing 22 Tex. Admin. Code 291.29(c)(4), specifying the geographical distance between the practitioner and the patient or between the pharmacy and the patient as a red flag). DEA requested responses from state PDMP Administrators by June 15, 2023. NASCSA disseminated DEA’s request to its PDMP Administrators and provided them with a report tool to ensure that responses to DEA’s questions were extracted consistently across all responsive states. Thirty states and two 5 National Association of Boards of Pharmacy (NABP) coalition consensus document ‘‘Stakeholders’ Challenges and Red Flag Warning Signs Related to Prescribing and Dispensing Controlled Substances’’ (2015). www.nabp.pharmacy/resources/reports. 6 The Medicine Shoppe, 79 FR 59504, 59507, 59512–13 (2014); Holiday CVS, L.L.C., d/b/a CVS Pharmacy Nos. 219 and 5195, 77 FR 62316 (Oct. 12, 2012). 7 The mere indicia of red flags alone is not proof of violation of 21 U.S.C. 824 or any other provision of the CSA. This rule discusses only their use by DEA as an analytical tool to estimate diversion. PO 00000 Frm 00053 Fmt 4703 Sfmt 4703 75315 territories provided DEA with summarized PDMP data between May 3, and June 15, 2023, utilizing the standardized report developed by NASCSA.8 See Table 1a below. TABLE 1a—STATES/TERRITORIES THAT RESPONDED TO DEA’S DATA REQUEST State/territory 1. Alabama 2. Alaska 3. Arizona 4. Arkansas 5. Connecticut 6. Delaware 7. District of Columbia 8. Hawaii 9. Idaho 10. Indiana 11. Iowa 12. Kansas 13. Kentucky 14. Louisiana 15. Maine 16. Maryland 17. Michigan 18. Minnesota 19. Mississippi 20. Montana 21. Nevada 22. New Jersey 23. North Carolina 24. North Dakota 25. Ohio 26. Oklahoma 27. Puerto Rico 28. Rhode Island 29. South Carolina 30. South Dakota 31. Texas 32. Utah Pharmacies are required by state law to enter controlled substance dispensing data into the state’s PDMP database, including the prescriber’s name, registered address and DEA number; prescription information (such as drug name); dispensing date; dosage dispensed; pharmacy registered address; and patient name and address. DEA considers PDMP data to be an accurate representation of dispensing activities in states. DEA received data for the following red-flag metrics: • The total number of patients who saw three or more prescribers in a 90day period and were dispensed an opioid following each visit. For this metric, DEA requested and was provided the number of prescriptions for the five covered controlled substances dispensed to these patients, as a percentage of the total prescriptions dispensed for that particular covered controlled substance, as well as the corresponding quantity of the covered 8 NASCSA formatted DEA’s request into an analytics model developed by one of its associates, Appriss Inc. E:\FR\FM\02NON1.SGM 02NON1 75316 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices khammond on DSKJM1Z7X2PROD with NOTICES controlled substance dispensed. This metric (patients being prescribed covered controlled substances from three or more prescribers in a 90-day period) is used to identify potential doctor shopping, a common technique to obtain a high number of controlled substances, which may lead to abuse or diversion of controlled substances. DEA has long considered doctor shopping to be an indicator of potential diversion.9 • The number of patients that were dispensed prescriptions for each of the five covered controlled substances that exceeded 240 morphine milligram equivalents (MME) daily. States provided the raw number of such prescriptions dispensed, the number of prescriptions as a percentage of the total covered controlled substance prescriptions dispensed, and the corresponding quantity of the covered controlled substance dispensed. DEA believes that accounting for quantities in excess of 240 MME daily allows for consideration of oncology patients with legitimate medical needs for covered controlled substance prescriptions with high MME. Higher dosages place individuals at higher risk of overdose and death. Prescriptions involving dosages exceeding 240 MME daily may indicate diversion, such as illegal distribution of controlled substances or prescribing outside the usual course of professional practice. • The number of patients that paid cash for covered controlled substance prescriptions, without submitting for insurance reimbursement.10 States also provided the number of prescriptions paid entirely with cash as a percentage of the total prescriptions for the five covered controlled substances dispensed, as well as the corresponding quantity of the covered controlled substances dispensed. When investigating potential diversion, cash payments are one element considered in identifying prescriptions filled for nonmedical purposes. Unusually high percentages of cash payments made to a prescriber or pharmacy for controlled substances may indicate diversion.11 9 Frank’s Corner Pharmacy, 60 FR 17574 (1995); Holiday CVS, L.L.C., d/b/a CVS Pharmacy Nos. 219 and 5195, 77 FR 62316 (Oct. 12, 2012). 10 This total does not include insurance copayments made with cash. 11 Suntree Pharmacy and Suntree Medical Equipment, LLC, 85 FR 73753 (2018) (finding that the pharmacy filled prescriptions despite the presence of multiple unresolved red flags, including cash payments); Pharmacy Doctors Enterprises d/b/ a Zion Clinic Pharmacy, 83 FR 10876 (Mar. 13, 2018) (revoking pharmacy’s registration for filling prescriptions that raised the red flag of customers paying cash for their prescriptions, among other red flags). VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 DEA received PDMP data from the states in a standardized format that allowed DEA to aggregate the data. The PDMP data sample represents a population of approximately 150.7 million people, which is approximately 45 percent of the U.S. population. DEA believes this sample is sufficient to derive a reasonable nationwide estimate. While PDMP data is useful in estimating diversion, it is not conclusive. Further investigation would be required before concluding that any of the subject prescriptions were actually diverted. DEA continues to evaluate its methodologies in estimating diversion in an effort to adjust quotas more efficiently. State participation is crucial to accurate data analysis, and DEA anticipates working closely with states, as well as other federal and state entities, in future quota determinations. To calculate a national diversion estimate for each of the covered controlled substances from the responses received from state PDMP Administrators, DEA relied upon the number of individuals who received a prescription for a covered controlled substance that met any of the three redflag metrics for each of calendar years 2020–2022. Using the population of the states responding to DEA’s request, DEA then calculated the percentage of the population issued a prescription with a red flag. Using this estimated percentage for 2020–2022, DEA analyzed trends in the data to predict the estimated percentage of patients who would be expected to be included in these red-flag metrics for 2024. DEA also reviewed aggregate sales data for each of the covered controlled substances, which it extracted from IQVIA’s National Sales Perspective.12 IQVIA sales data was selected to help quantify diversion at the national level because it reflects the best national estimate for all prescriptions written and filled, including the total quantity available for diversion or misuse. DEA analyzed trends in IQVIA sales data from January 2020—April 2023, in order to predict the estimated national sales for 2024. To estimate diversion for each of the covered controlled substances, DEA multiplied the forecasted percentage of patients likely to receive a prescription for a covered controlled substance that meet any of the three red-flag metrics in 2024 by the forecasted sales data from IQVIA for 2024. The resulting estimate 12 DEA has purchased this data from IQVIA for decades and routinely uses this information to administer several regulatory functions, including the administration of DEA’s quota program. PO 00000 Frm 00054 Fmt 4703 Sfmt 4703 of diversion from data submitted by state PDMP Administrators is summarized below in Table 1b. This data contributed to the final diversion estimate set forth in Table 3. TABLE 1B—DIVERSION ESTIMATES FOR 2024 BASED ON STATE PDMP DATA FOR COVERED CONTROLLED SUBSTANCES FROM 2020–2022 Controlled substance Fentanyl ................................ Hydrocodone ........................ Hydromorphone .................... Oxycodone ............................ Oxymorphone ....................... (g) 18 83,823 356 150,684 0 Consideration of Registrant Reported Diversion in the Legitimate Distribution Chain DEA extracted data from its Theft Loss Report database and categorized it by each basic drug class. DEA calculated the estimated amount of diversion by multiplying the quantity of API in each finished dosage form by the total amount of units reported stolen or lost to estimate the metric weight in grams of the controlled substance being diverted. This estimate of diversion from the legitimate supply chain for each of the covered controlled substances is displayed in Table 2. This data contributed to the final diversion estimates set forth in Table 3. TABLE 2—DIVERSION ESTIMATES BASED ON SUPPLY CHAIN DIVERSION DATA FOR COVERED CONTROLLED SUBSTANCES Controlled Substance Fentanyl ................................ Hydrocodone ........................ Hydromorphone .................... Oxycodone ............................ Oxymorphone ....................... (g) 74 12,454 481 31,698 252 In accordance with 21 U.S.C. 826(i), DEA’s estimate of diversion for the five controlled substances was calculated by combining the values in Tables 1b and 2. DEA reduced the APQ for each covered controlled substance by the quantities listed in Table 3. TABLE 3—TOTAL ESTIMATES OF DIVERSION FOR COVERED CONTROLLED SUBSTANCES TO BE APPLIED TO THE 2024 APQS Controlled substance Fentanyl ................................ Hydrocodone ........................ Hydromorphone .................... E:\FR\FM\02NON1.SGM 02NON1 (g) 92 96,277 838 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices as compared to mixed-salt amphetamine products which may be indicative of product switching from amphetamine to methylphenidate and dexmethylphendiate. Neither DEA nor FDA anticipated these changes. In addition to these demographic Controlled substance (g) shifts in prescribing, DEA also evaluated Oxycodone ............................ 182,382 inventory, manufacturing, and sales Oxymorphone ....................... 252 data submitted by manufacturers through ARCOS and through reports Forthcoming Regulatory Changes and submitted to DEA’s Quota Management Administration of Individual Quotas System. That analysis revealed that for 2024 dosage manufacturers of amphetamine DEA is committed to ensuring that all did not utilize the full extent of their authorized quotas. DEA authorized Americans can access appropriately amphetamine medication dosage form prescribed medications. As part of this manufacturers across the entire market commitment, DEA undertook work to to purchase and use 38,418 kilograms of understand the supply chain dynamics amphetamine but those manufacturers for controlled substances subject to initially 15 reported the purchase of only quotas over the last year and a half, 31,539 kg. Of that quantity, dosage especially in highly genericized manufacturers only shipped 26,953 kg markets. Based on that review, DEA observed various challenges in the quota of amphetamine medications. This ongoing work has led DEA to allocation process stemming from the conclude that changes to its regulations lack of real-time inventory and sales likely will be useful in developing more data accessible to DEA, the lack of precise quotas that will provide for the information on manufacturers’ estimated medical, scientific, research, production lead times, and issues of and industrial needs of the United timeliness in ARCOS reporting. States, for lawful export requirements, Relatedly, beginning in the latter half and for the establishment and of 2022, the DEA and FDA observed an increase in the number of drug shortages maintenance of reserve stocks, while reported by manufacturers of schedule II also reducing opportunities for stimulants including mixed-salt diversion. For instance, DEA believes amphetamine products starting in April that changes to reporting requirements 2022 and lisdexamfetamine and are necessary to improve both the type methylphenidate starting in July 2023. of data collected and the timeliness of As DEA and FDA stated in their open that data, allowing DEA to be more letter,13 we remain committed to doing nimble in its administration of the quota all we can to prevent stimulant drug program. Future regulatory changes may shortages, limit their impact, and seek to address the lack of real-time resolve them as quickly as possible. inventory and sales data accessible to DEA commissioned two reports by DEA, the lack of information on IQVIA 14 in order to understand the production lead times, and issues of demographic shifts impacting the timeliness in ARCOS reporting, by prescribing of schedule II stimulants. considering, for example, requiring The reports provided valuable insights. manufacturers to provide anticipated Chief among those insights was the production timelines and monthly observed increase in prescriptions ARCOS reporting. DEA is not seeking dispensed for mixed-salt amphetamine comments on these concepts through products to adults between the ages of this notice, but will publish detailed 31–40 years, particularly women, and proposals for comment in the future. older patients (71–80 years old), DEA also will seek additional particularly during the COVID–19 information that will assist the agency pandemic (i.e. 2020 and 2021). In to more accurately forecast export contrast, during 2022, dispensed requirements, especially for those prescriptions for products containing substances that are not controlled methylphenidate HCl and dexmethylphenidate HCl had a higher 15 In July 2023, several manufacturers who— annual increase in 2022 (than in 2021) according to their reporting to DEA—had failed to khammond on DSKJM1Z7X2PROD with NOTICES TABLE 3—TOTAL ESTIMATES OF DIVERSION FOR COVERED CONTROLLED SUBSTANCES TO BE APPLIED TO THE 2024 APQS—Continued 13 Both DEA and FDA released this letter on Aug. 1, 2023. It is available at: https://www.dea.gov/sites/ default/files/2023-08/DEA%20and %20FDA%20Issue%20Joint%20Letter %20to%20the%20Public.pdf. 14 Both reports are available at: https:// www.deadiversion.usdoj.gov/drug_chem_info/ stimulants/. VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 use their full amphetamine procurement quotas in 2022 received correspondence from DEA and FDA asking them to confirm that they would use their full 2023 procurement quotas. Upon receiving that correspondence—approximately seven months after the close of calendar year 2022—one such manufacturer then revised its 2022 reporting to DEA to reflect that it had, in fact, used nearly all of its 2022 amphetamine procurement quota. PO 00000 Frm 00055 Fmt 4703 Sfmt 4703 75317 internationally.16 DEA understands that manufacturers have contractual obligations that dictate business decisions regarding the quantities of finished dosage forms they will produce under a single DEA-issued quota, which applies to products manufactured with an active ingredient, whether for domestic or foreign markets. DEA also is exploring the purchase of third-party data to improve its understanding of the dynamic changes in foreign markets. Building off the recently issued quota management rule,17 DEA also intends to add new subcategories to individual manufacturing quotas and procurement quotas, to distinguish between domestic requirements and export requirements. DEA also is considering methods by which it might increase transparency in its quota setting process. Future regulatory proposals may define additional steps, including such concepts as public notification and an opportunity for public input when prescribing rates for controlled substances deviate substantially from FDA’s estimate of future use. Furthermore, DEA is considering regulatory changes which will authorize it to reduce a manufacturer’s individual manufacturing or procurement quota in order to apportion it to another manufacturer. As with the regulatory changes mentioned above, DEA will welcome comment on detailed proposals in the future, and is not requesting comment on these general concepts in this notice. The abovementioned regulatory changes will take time. In the meantime, for the 2024 quota year, DEA intends to allocate procurement quotas to DEAregistered manufacturers of schedule II controlled substances on a quarterly basis. In order to address domestic drug shortages of controlled substances, procurement quota allocations for schedule II controlled substances will be divided between quantities authorized for domestic sales and quantities authorized for export sales. DEA will be sending a letter to each manufacturer with instructions on the data that will be necessary to allow DEA to process subsequent quarterly procurement quota allocations. DEA may publish or post how many companies have been allocated quota in 16 While amphetamine and methylphenidate are currently recognized as schedule II controlled substances under the Convention on Psychotropic Substances of 1971, lisdexamfetamine is not. Additional details may be found at: https:// www.incb.org/incb/en/psychotropics/1971_ convention.html. 17 Management of Quotas for Controlled Substances and List I Chemicals, 88 FR 60117 (Aug. 31, 2023) (effective Nov. 29, 2023). E:\FR\FM\02NON1.SGM 02NON1 75318 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices a given calendar year, and how many of those companies have utilized their allocated quota. Further, DEA may publish or post the names of the companies that have been allocated quota. The Administrator, therefore, proposes to establish the 2024 APQ for certain schedule I and II controlled substances and AAN for the list I chemicals ephedrine, pseudoephedrine, and phenylpropanolamine, expressed in grams of anhydrous acid or base, as follows: Proposed 2024 quotas Basic class (g) khammond on DSKJM1Z7X2PROD with NOTICES Schedule I -[1-(2-Thienyl)cyclohexyl]pyrrolidine .................................................................................................................................................... 1-(1-Phenylcyclohexyl)pyrrolidine ........................................................................................................................................................ 1-(2-Phenylethyl)-4-phenyl-4-acetoxypiperidine .................................................................................................................................. 1-(5-Fluoropentyl)-3-(1-naphthoyl)indole (AM2201) ............................................................................................................................ 1-(5-Fluoropentyl)-3-(2-iodobenzoyl)indole (AM694) ........................................................................................................................... 1-[1-(2-Thienyl)cyclohexyl]piperidine ................................................................................................................................................... 2′-fluoro 2-fluorofentanyl ...................................................................................................................................................................... 1-Benzylpiperazine .............................................................................................................................................................................. 1-Methyl-4-phenyl-4-propionoxypiperidine ........................................................................................................................................... 2-(2,5-Dimethoxy-4-ethylphenyl)ethanamine (2C–E) .......................................................................................................................... 2-(2,5-Dimethoxy-4-methylphenyl)ethanamine (2C–D) ....................................................................................................................... 2-(2,5-Dimethoxy-4-nitro-phenyl)ethanamine (2C–N) ......................................................................................................................... 2-(2,5-Dimethoxy-4-n-propylphenyl)ethanamine (2C–P) ..................................................................................................................... 2-(2,5-Dimethoxyphenyl)ethanamine (2C–H) ...................................................................................................................................... 2-(4-Bromo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25B–NBOMe; 2C–B–NBOMe; 25B; Cimbi-36) ...................... 2-(4-Chloro-2,5-dimethoxyphenyl)ethanamine (2C–C) ........................................................................................................................ 2-(4-Chloro-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25C–NBOMe; 2C–C–NBOMe; 25C; Cimbi-82) ..................... 2-(4-Iodo-2,5-dimethoxyphenyl)ethanamine (2C–I) ............................................................................................................................. 2-(4-Iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25I–NBOMe; 2C–I–NBOMe; 25I; Cimbi-5) ................................ 2,5-Dimethoxy-4-ethylamphetamine (DOET) ...................................................................................................................................... 2,5-Dimethoxy-4-n-propylthiophenethylamine ..................................................................................................................................... 2,5-Dimethoxyamphetamine ................................................................................................................................................................ 2-[4-(Ethylthio)-2,5-dimethoxyphenyl]ethanamine (2C–T–2) ............................................................................................................... 2-[4-(Isopropylthio)-2,5-dimethoxyphenyl]ethanamine (2C–T–4) ........................................................................................................ 3,4,5-Trimethoxyamphetamine ............................................................................................................................................................ 3,4-Methylenedioxyamphetamine (MDA) ............................................................................................................................................ 3,4-Methylenedioxymethamphetamine (MDMA) ................................................................................................................................. 3,4-Methylenedioxy-N-ethylamphetamine (MDEA) ............................................................................................................................. 3,4-Methylenedioxy-N-methylcathinone (methylone) .......................................................................................................................... 3,4-Methylenedioxypyrovalerone (MDPV) ........................................................................................................................................... 3–FMC; 3-Fluoro-N-methylcathinone .................................................................................................................................................. 3-Methylfentanyl ................................................................................................................................................................................... 3-Methylthiofentanyl ............................................................................................................................................................................. 4,4′-Dimethylaminorex ......................................................................................................................................................................... 4-Bromo-2,5-dimethoxyamphetamine (DOB) ...................................................................................................................................... 4-Bromo-2,5-dimethoxyphenethylamine (2–CB) ................................................................................................................................. 4-Chloro-alpha-pyrrolidinovalerophenone (4-chloro-alpha-PVP) ......................................................................................................... 4–CN-Cumyl-Butinaca ......................................................................................................................................................................... 4-Fluoroisobutyryl fentanyl ................................................................................................................................................................... 4F–MDMB–BINACA ............................................................................................................................................................................ 4–FMC; Flephedrone ........................................................................................................................................................................... 4–MEC; 4-Methyl-N-ethylcathinone ..................................................................................................................................................... 4-Methoxyamphetamine ...................................................................................................................................................................... 4-Methyl-2,5-dimethoxyamphetamine (DOM) ...................................................................................................................................... 4-Methylaminorex ................................................................................................................................................................................ 4-Methyl-N-methylcathinone (mephedrone) ........................................................................................................................................ 4-Methyl-alpha-ethylaminopentiophenone (4–MEAP) ......................................................................................................................... 4-Methyl-alpha-pyrrolidinohexiophenone (MPHP) ............................................................................................................................... 4′-Methyl acetyl fentanyl ...................................................................................................................................................................... 4-Methyl-a-pyrrolidinopropiophenone (4-MePPP) ............................................................................................................................... 5-(1,1-Dimethylheptyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol ......................................................................................................... 5-(1,1-Dimethyloctyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol (cannabicyclohexanol or CP–47,497 C8-homolog) .......................... 5F–AB–PINACA; (1-Amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)-1H-indazole-3-carboxamide ............................................. 5F–ADB; 5F–MDMB–PINACA (methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3,3-dimethylbutanoate) .......................... 5F–CUMYL–P7AICA; 1-(5-Fluoropentyl)-N-(2-phenylpropan-2-yl)-1H-pyrrolo[2,3-b]pyridine-3carboximide ...................................... 5F–CUMYL–PINACA ........................................................................................................................................................................... 5F–EDMB–PINACA ............................................................................................................................................................................. 5F–MDMB–PICA ................................................................................................................................................................................. 5F–AMB (methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3-methylbutanoate) .................................................................. 5F–APINACA; 5F–AKB48 (N-(adamantan-1-yl)-1-(5-fluoropentyl)-1H-indazole-3-carboxamide) ....................................................... 5-Fluoro-PB–22; 5F–PB–22 ................................................................................................................................................................ 5-Fluoro-UR144, XLR11 ([1-(5-fluoro-pentyl)-1Hindol-3-yl](2,2,3,3-tetramethylcyclopropyl)methanone ............................................ 5-Methoxy-3,4-methylenedioxyamphetamine ...................................................................................................................................... VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 PO 00000 Frm 00056 Fmt 4703 Sfmt 4703 E:\FR\FM\02NON1.SGM 02NON1 20 30 10 30 30 15 30 25 10 30 30 30 30 100 30 30 25 30 30 25 25 25 30 30 30 12,000 12,000 40 5,200 35 25 30 30 30 30 5,100 25 25 30 30 25 25 150 25 25 45 25 25 30 25 50 40 25 25 25 25 25 25 25 25 25 25 25 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices 75319 Proposed 2024 quotas Basic class khammond on DSKJM1Z7X2PROD with NOTICES (g) 5-Methoxy-N,N-diisopropyltryptamine .................................................................................................................................................. 5-Methoxy-N,N-dimethyltryptamine ..................................................................................................................................................... AB–CHMINACA ................................................................................................................................................................................... AB–FUBINACA .................................................................................................................................................................................... AB–PINACA ......................................................................................................................................................................................... ADB–FUBINACA (N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)-1H-indazole-3-carboxamide) ................................. Acetorphine .......................................................................................................................................................................................... Acetyl Fentanyl .................................................................................................................................................................................... Acetyl-alpha-methylfentanyl ................................................................................................................................................................. Acetyldihydrocodeine ........................................................................................................................................................................... Acetylmethadol .................................................................................................................................................................................... Acryl Fentanyl ...................................................................................................................................................................................... ADB–PINACA (N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-pentyl-1H-indazole-3-carboxamide) ..................................................... AH–7921 .............................................................................................................................................................................................. All other tetrahydrocannabinol ............................................................................................................................................................. Allylprodine .......................................................................................................................................................................................... Alphacetylmethadol .............................................................................................................................................................................. alpha-Ethyltryptamine .......................................................................................................................................................................... Alphameprodine ................................................................................................................................................................................... Alphamethadol ..................................................................................................................................................................................... alpha-Methylfentanyl ............................................................................................................................................................................ alpha-Methylthiofentanyl ...................................................................................................................................................................... alpha-Methyltryptamine (AMT) ............................................................................................................................................................ alpha-Pyrrolidinobutiophenone (a-PBP) .............................................................................................................................................. alpha-pyrrolidinoheptaphenone (PV8) ................................................................................................................................................. alpha-pyrrolidinohexabophenone (alpha-PHP) .................................................................................................................................... alpha-Pyrrolidinopentiophenone (a-PVP) ............................................................................................................................................ Amineptine ........................................................................................................................................................................................... Aminorex .............................................................................................................................................................................................. Anileridine ............................................................................................................................................................................................ APINCA, AKB48 (N-(1-adamantyl)-1-pentyl-1H-indazole-3-carboxamide) ......................................................................................... Benzethidine ........................................................................................................................................................................................ Benzylmorphine ................................................................................................................................................................................... Betacetylmethadol ............................................................................................................................................................................... beta-Hydroxy-3-methylfentanyl ............................................................................................................................................................ beta-Hydroxyfentanyl ........................................................................................................................................................................... beta-Hydroxythiofentanyl ..................................................................................................................................................................... beta-Methyl fentanyl ............................................................................................................................................................................ beta′-Phenyl fentanyl ........................................................................................................................................................................... Betameprodine ..................................................................................................................................................................................... Betamethadol ....................................................................................................................................................................................... Betaprodine .......................................................................................................................................................................................... Brorphine ............................................................................................................................................................................................. Bufotenine ............................................................................................................................................................................................ Butonitazene ........................................................................................................................................................................................ Butylone ............................................................................................................................................................................................... Butyryl fentanyl .................................................................................................................................................................................... Cathinone ............................................................................................................................................................................................. Clonitazene .......................................................................................................................................................................................... Codeine methylbromide ....................................................................................................................................................................... Codeine-N-oxide .................................................................................................................................................................................. Crotonyl Fentanyl ................................................................................................................................................................................. Cyclopentyl Fentanyl ........................................................................................................................................................................... Cyclopropyl Fentanyl ........................................................................................................................................................................... Cyprenorphine ..................................................................................................................................................................................... d-9–THC .............................................................................................................................................................................................. Desomorphine ...................................................................................................................................................................................... Dextromoramide .................................................................................................................................................................................. Diapromide ........................................................................................................................................................................................... Diethylthiambutene .............................................................................................................................................................................. Diethyltryptamine ................................................................................................................................................................................. Difenoxin .............................................................................................................................................................................................. Dihydromorphine .................................................................................................................................................................................. Dimenoxadol ........................................................................................................................................................................................ Dimepheptanol ..................................................................................................................................................................................... Dimethylthiambutene ........................................................................................................................................................................... Dimethyltryptamine .............................................................................................................................................................................. Dioxyaphetyl butyrate .......................................................................................................................................................................... Dipipanone ........................................................................................................................................................................................... Drotebanol ........................................................................................................................................................................................... Ethylmethylthiambutene ....................................................................................................................................................................... VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 PO 00000 Frm 00057 Fmt 4703 Sfmt 4703 E:\FR\FM\02NON1.SGM 02NON1 25 11,000 30 50 30 30 25 100 30 30 25 25 50 30 790,010 25 25 25 25 25 30 30 25 25 25 25 25 30 25 20 25 25 30 25 30 30 30 30 30 25 4 25 30 15 30 25 30 40 25 30 192 25 30 20 25 900,610 25 25 20 20 25 9,300 639,954 25 25 20 3,000 25 25 25 25 75320 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices Proposed 2024 quotas Basic class khammond on DSKJM1Z7X2PROD with NOTICES (g) Ethylone ............................................................................................................................................................................................... Etodesnitazene .................................................................................................................................................................................... Etonitazene .......................................................................................................................................................................................... Etorphine .............................................................................................................................................................................................. Etoxeridine ........................................................................................................................................................................................... Eutylone ............................................................................................................................................................................................... Fenethylline .......................................................................................................................................................................................... Fentanyl carbamate ............................................................................................................................................................................. Fentanyl related substances ................................................................................................................................................................ Flunitazene .......................................................................................................................................................................................... FUB–144 .............................................................................................................................................................................................. FUB–AKB48 ......................................................................................................................................................................................... Fub-AMB, MMB-Fubinaca, AMB-Fubinaca ......................................................................................................................................... Furanyl fentanyl ................................................................................................................................................................................... Furethidine ........................................................................................................................................................................................... gamma-Hydroxybutyric acid ................................................................................................................................................................ Heroin .................................................................................................................................................................................................. Hydromorphinol .................................................................................................................................................................................... Hydroxypethidine ................................................................................................................................................................................. Ibogaine ............................................................................................................................................................................................... Isobutyryl Fentanyl ............................................................................................................................................................................... Isotonitazine ......................................................................................................................................................................................... JWH–018 and AM678 (1-Pentyl-3-(1-naphthoyl)indole) ..................................................................................................................... JWH–019 (1-Hexyl-3-(1-naphthoyl)indole) .......................................................................................................................................... JWH–073 (1-Butyl-3-(1-naphthoyl)indole) ........................................................................................................................................... JWH–081 (1-Pentyl-3-[1-(4-methoxynaphthoyl)]indole) ...................................................................................................................... JWH–122 (1-Pentyl-3-(4-methyl-1-naphthoyl)indole) .......................................................................................................................... JWH–200 (1-[2-(4-Morpholinyl)ethyl]-3-(1-naphthoyl)indole) .............................................................................................................. JWH–203 (1-Pentyl-3-(2-chlorophenylacetyl)indole) ........................................................................................................................... JWH–250 (1-Pentyl-3-(2-methoxyphenylacetyl)indole) ....................................................................................................................... JWH–398 (1-Pentyl-3-(4-chloro-1-naphthoyl)indole) ........................................................................................................................... Ketobemidone ...................................................................................................................................................................................... Levomoramide ..................................................................................................................................................................................... Levophenyacylmorphan ....................................................................................................................................................................... Lysergic acid diethylamide (LSD) ........................................................................................................................................................ MAB–CHMINACA; ADB–CHMINACA (N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(cyclohexylmethyl)-1H-indazole-3carboxamide) .................................................................................................................................................................................... MDMB–CHMICA; MMB–CHMINACA(methyl 2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido)-3,3-dimethylbutanoate) ............... MDMB–FUBINACA (methyl 2-(1-(4-fluorobenzyl)-1H-indazole-3-carboxamido)-3,3-dimethylbutanoate) .......................................... MMB–CHMICA-(AMB–CHIMCA); Methyl-2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido)-3-methylbutanoate ............................ Mesocarb ............................................................................................................................................................................................. Metodesnitazene .................................................................................................................................................................................. Metonitazene ....................................................................................................................................................................................... Marijuana ............................................................................................................................................................................................. Marijuana extract ................................................................................................................................................................................. Mecloqualone ....................................................................................................................................................................................... Mescaline ............................................................................................................................................................................................. Methaqualone ...................................................................................................................................................................................... Methcathinone ..................................................................................................................................................................................... Methiopropamine ................................................................................................................................................................................. Methoxetamine .................................................................................................................................................................................... Methoxyacetyl fentanyl ........................................................................................................................................................................ Methyldesorphine ................................................................................................................................................................................. Methyldihydromorphine ........................................................................................................................................................................ Morpheridine ........................................................................................................................................................................................ Morphine methylbromide ..................................................................................................................................................................... Morphine methylsulfonate .................................................................................................................................................................... Morphine-N-oxide ................................................................................................................................................................................ MT–45 .................................................................................................................................................................................................. Myrophine ............................................................................................................................................................................................ NM2201: Naphthalen-1-yl 1-(5-fluorpentyl)-1H-indole-3-carboxylate .................................................................................................. N,N-Dimethylamphetamine .................................................................................................................................................................. Naphyrone ........................................................................................................................................................................................... N-Ethyl-1-phenylcyclohexylamine ........................................................................................................................................................ N-Ethyl-3-piperidyl benzilate ................................................................................................................................................................ N-Ethylamphetamine ........................................................................................................................................................................... N-Ethylhexedrone ................................................................................................................................................................................ N-Ethylpentylone, ephylone ................................................................................................................................................................. N-Hydroxy-3,4-methylenedioxyamphetamine ...................................................................................................................................... Nicocodeine ......................................................................................................................................................................................... Nicomorphine ....................................................................................................................................................................................... VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 PO 00000 Frm 00058 Fmt 4703 Sfmt 4703 E:\FR\FM\02NON1.SGM 02NON1 25 30 25 30 25 30 30 30 600 30 25 25 25 30 25 29,417,000 150 40 25 150 25 25 35 45 45 30 30 35 30 30 30 30 25 25 1,200 30 30 30 25 30 30 30 6,675,000 1,000,000 30 1,200 60 25 30 30 30 5 25 25 5 5 150 30 25 25 25 25 25 10 24 25 30 24 25 25 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices 75321 Proposed 2024 quotas Basic class (g) N-methyl-3-piperidyl benzilate ............................................................................................................................................................. N-Pyrrolidino Etonitazene .................................................................................................................................................................... Noracymethadol ................................................................................................................................................................................... Norlevorphanol ..................................................................................................................................................................................... Normethadone ..................................................................................................................................................................................... Normorphine ........................................................................................................................................................................................ Norpipanone ........................................................................................................................................................................................ Ocfentanil ............................................................................................................................................................................................. ortho-Fluoroacryl fentanyl .................................................................................................................................................................... ortho-Fluorobutyryl fentanyl ................................................................................................................................................................. Ortho-Fluorofentanyl,2-Fluorofentanyl ................................................................................................................................................. ortho-Fluoroisobutyryl fentanyl ............................................................................................................................................................ ortho-Methyl acetylfentanyl .................................................................................................................................................................. ortho-Methyl methoxyacetyl fentanyl ................................................................................................................................................... Para-Chlorisobutyrl fentanyl ................................................................................................................................................................ Para-flourobutyryl fentanyl ................................................................................................................................................................... Para-fluorofentanyl ............................................................................................................................................................................... para-Fluoro furanyl fentanyl ................................................................................................................................................................. Para-Methoxybutyrl fentanyl ................................................................................................................................................................ Para-methoxymethamphetamine ......................................................................................................................................................... para-Methylfentanyl ............................................................................................................................................................................. Parahexyl ............................................................................................................................................................................................. PB–22; QUPIC ..................................................................................................................................................................................... Pentedrone .......................................................................................................................................................................................... Pentylone ............................................................................................................................................................................................. Phenadoxone ....................................................................................................................................................................................... Phenampromide ................................................................................................................................................................................... Phenomorphan .................................................................................................................................................................................... Phenoperidine ...................................................................................................................................................................................... Phenyl fentanyl .................................................................................................................................................................................... Pholcodine ........................................................................................................................................................................................... Piritramide ............................................................................................................................................................................................ Proheptazine ........................................................................................................................................................................................ Properidine ........................................................................................................................................................................................... Propiram .............................................................................................................................................................................................. Protonitazene ....................................................................................................................................................................................... Psilocybin ............................................................................................................................................................................................. Psilocyn ................................................................................................................................................................................................ Racemoramide ..................................................................................................................................................................................... SR–18 and RCS–8 (1-Cyclohexylethyl-3-(2-methoxyphenylacetyl)indole) ......................................................................................... SR–19 and RCS–4 (1-Pentyl-3-[(4-methoxy)-benzoyl]indole) ............................................................................................................ Tetrahydrofuranyl fentanyl ................................................................................................................................................................... Thebacon ............................................................................................................................................................................................. Thiafentanil .......................................................................................................................................................................................... Thiofentanyl ......................................................................................................................................................................................... Thiofuranyl fentanyl ............................................................................................................................................................................. THJ–2201 ( [1-(5-fluoropentyl)-1H-indazol-3-yl](naphthalen-1-yl)methanone) .................................................................................... Tilidine .................................................................................................................................................................................................. Trimeperidine ....................................................................................................................................................................................... UR–144 (1-pentyl-1H-indol-3-yl)(2,2,3,3-tetramethylcyclopropyl)methanone ..................................................................................... U–47700 .............................................................................................................................................................................................. Valeryl fentanyl .................................................................................................................................................................................... Zipeprol ................................................................................................................................................................................................ 30 30 25 2,550 25 40 25 25 30 30 30 30 30 30 30 25 25 30 30 30 30 5 20 25 25 25 25 25 25 30 5 25 25 25 25 30 15,000 24,000 25 45 30 15 25 25 25 30 30 25 25 25 30 25 30 khammond on DSKJM1Z7X2PROD with NOTICES Schedule II 1-Phenylcyclohexylamine .................................................................................................................................................................... 1-Piperidinocyclohexanecarbonitrile .................................................................................................................................................... 4-Anilino-N-phenethyl-4-piperidine (ANPP) ......................................................................................................................................... Alfentanil .............................................................................................................................................................................................. Alphaprodine ........................................................................................................................................................................................ Amobarbital .......................................................................................................................................................................................... Bezitramide .......................................................................................................................................................................................... Carfentanil ............................................................................................................................................................................................ Cocaine ................................................................................................................................................................................................ Codeine (for conversion) ..................................................................................................................................................................... Codeine (for sale) ................................................................................................................................................................................ d-amphetamine (for sale) .................................................................................................................................................................... d,l-amphetamine .................................................................................................................................................................................. d-amphetamine (for conversion) .......................................................................................................................................................... Dexmethylphenidate (for sale) ............................................................................................................................................................. VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 PO 00000 Frm 00059 Fmt 4703 Sfmt 4703 E:\FR\FM\02NON1.SGM 02NON1 15 25 866,746 5,000 25 20,100 25 20 60,492 942,452 19,262,957 21,200,000 21,200,000 20,000,000 6,200,000 75322 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices Proposed 2024 quotas Basic class (g) khammond on DSKJM1Z7X2PROD with NOTICES Dexmethylphenidate (for conversion) .................................................................................................................................................. Dextropropoxyphene ............................................................................................................................................................................ Dihydrocodeine .................................................................................................................................................................................... Dihydroetorphine .................................................................................................................................................................................. Diphenoxylate (for conversion) ............................................................................................................................................................ Diphenoxylate (for sale) ....................................................................................................................................................................... Ecgonine .............................................................................................................................................................................................. Ethylmorphine ...................................................................................................................................................................................... Etorphine hydrochloride ....................................................................................................................................................................... Fentanyl ............................................................................................................................................................................................... Glutethimide ......................................................................................................................................................................................... Hydrocodone (for conversion) ............................................................................................................................................................. Hydrocodone (for sale) ........................................................................................................................................................................ Hydromorphone ................................................................................................................................................................................... Isomethadone ...................................................................................................................................................................................... L-amphetamine .................................................................................................................................................................................... Levo-alphacetylmethadol (LAAM) ........................................................................................................................................................ Levomethorphan .................................................................................................................................................................................. Levorphanol ......................................................................................................................................................................................... Lisdexamfetamine ................................................................................................................................................................................ Meperidine ........................................................................................................................................................................................... Meperidine Intermediate-A .................................................................................................................................................................. Meperidine Intermediate-B .................................................................................................................................................................. Meperidine Intermediate-C .................................................................................................................................................................. Metazocine ........................................................................................................................................................................................... Methadone (for sale) ........................................................................................................................................................................... Methadone Intermediate ...................................................................................................................................................................... d,l-Methamphetamine .......................................................................................................................................................................... d-methamphetamine (for conversion) .................................................................................................................................................. d-methamphetamine (for sale) ............................................................................................................................................................ l-methamphetamine ............................................................................................................................................................................. Methylphenidate (for sale) ................................................................................................................................................................... Methylphenidate (for conversion) ........................................................................................................................................................ Metopon ............................................................................................................................................................................................... Moramide-intermediate ........................................................................................................................................................................ Morphine (for conversion) .................................................................................................................................................................... Morphine (for sale) .............................................................................................................................................................................. Nabilone ............................................................................................................................................................................................... Norfentanyl ........................................................................................................................................................................................... Noroxymorphone (for conversion) ....................................................................................................................................................... Noroxymorphone (for sale) .................................................................................................................................................................. Oliceridine ............................................................................................................................................................................................ Opium (powder) ................................................................................................................................................................................... Opium (tincture) ................................................................................................................................................................................... Oripavine .............................................................................................................................................................................................. Oxycodone (for conversion) ................................................................................................................................................................ Oxycodone (for sale) ........................................................................................................................................................................... Oxymorphone (for conversion) ............................................................................................................................................................ Oxymorphone (for sale) ....................................................................................................................................................................... Pentobarbital ........................................................................................................................................................................................ Phenazocine ........................................................................................................................................................................................ Phencyclidine ....................................................................................................................................................................................... Phenmetrazine ..................................................................................................................................................................................... Phenylacetone ..................................................................................................................................................................................... Piminodine ........................................................................................................................................................................................... Racemethorphan ................................................................................................................................................................................. Racemorphan ...................................................................................................................................................................................... Remifentanil ......................................................................................................................................................................................... Secobarbital ......................................................................................................................................................................................... Sufentanil ............................................................................................................................................................................................. Tapentadol ........................................................................................................................................................................................... Thebaine .............................................................................................................................................................................................. 4,200,000 35 115,227 25 14,100 770,800 60,492 30 32 676,062 25 1,250 27,143,545 1,951,801 30 30 25 30 20,000 26,500,000 681,184 30 30 30 15 25,619,700 27,673,600 150 485,020 47,000 587,229 53,283,000 19,975,468 25 25 2,393,200 20,805,957 62,000 25 22,044,741 1,000 25,100 250,000 530,837 33,010,750 437,827 53,658,226 28,204,371 464,464 33,843,337 25 35 25 100 25 5 5 3,000 172,100 4,000 10,390,226 57,137,944 List I Chemicals Ephedrine (for conversion) .................................................................................................................................................................. Ephedrine (for sale) ............................................................................................................................................................................. Phenylpropanolamine (for conversion) ................................................................................................................................................ Phenylpropanolamine (for sale) ........................................................................................................................................................... Pseudoephedrine (for conversion) ...................................................................................................................................................... Pseudoephedrine (for sale) ................................................................................................................................................................. VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 PO 00000 Frm 00060 Fmt 4703 Sfmt 4703 E:\FR\FM\02NON1.SGM 02NON1 41,100 3,933,336 14,878,320 7,990,000 1,000 170,360,314 Federal Register / Vol. 88, No. 211 / Thursday, November 2, 2023 / Notices The Administrator further proposes that aggregate production quotas for all other schedule I and II controlled substances included in 21 CFR 1308.11 and 1308.12 remain at zero. These proposed 2024 quotas reflect the quantities that DEA believes are necessary to meet the estimated medical, scientific, research, and industrial needs of the United States, lawful export requirements; and the establishment and maintenance of reserve stocks. DEA remains committed to conducting continuous surveillance on the supply of schedule II controlled substances and list I chemicals necessary to treat patients with COVID– 19, and, pursuant to her authority, the Administrator will move swiftly and decisively to increase any 2024 APQ that she determines is necessary to address an unforeseen increase in demand, should that occur. In accordance with 21 CFR 1303.13 and 1315.13, upon consideration of the relevant factors, the Administrator may adjust the 2024 APQ and AAN as needed. Conclusion After consideration of any comments or objections, or after a hearing, if one is held, the Administrator will issue and publish in the Federal Register a final order establishing the 2024 APQ for controlled substances in schedules I and II and establishing an AAN for the list I chemicals ephedrine, pseudoephedrine, and phenylpropanolamine, as directed by 21 CFR 1303.11(c) and 1315.11(f). khammond on DSKJM1Z7X2PROD with NOTICES Signing Authority This document of the Drug Enforcement Administration was signed on October 30, 2023, by Administrator Anne Milgram. That document with the original signature and date is maintained by DEA. For administrative purposes only, and in compliance with requirements of the Office of the Federal Register, the undersigned DEA Federal Register Liaison Officer has been authorized to sign and submit the document in electronic format for publication, as an official document of DEA. This administrative process in no way alters the legal effect of this document upon publication in the Federal Register. Scott Brinks, Federal Register Liaison Officer, Drug Enforcement Administration. [FR Doc. 2023–24282 Filed 11–1–23; 8:45 am] BILLING CODE P VerDate Sep<11>2014 16:32 Nov 01, 2023 Jkt 262001 75323 Drug Enforcement Administration findings of fact, conclusions of law, sanctions analysis, and recommended sanction as found in the RD. [Docket No. 23–17] I. Findings of Fact Isaac Sved, M.D.; Decision and Order Georgia Standard of Care DEA hired Dr. Lobel to testify as an expert in the standard of care for the practice of medicine and the prescribing of controlled substances in the state of Georgia, with a focus on pain management. RD, at 4; Tr. 105.3 Dr. Lobel defined ‘‘standard of care’’ as a ‘‘minimum level of competence or care so as not to harm the patient,’’ and described how the Georgia standard of care requires a practitioner to, prior to prescribing controlled substances, obtain a patient’s prior medical records; obtain a medical history, including family medical history and mental health history; conduct an appropriate physical examination; obtain a urine drug screen; check the PDMP; obtain informed consent from the patient; and document all information. RD, at 11; Tr. 120, 128–129, 134, 136. Further, the physical examination must be appropriate to the complaint, and for patients who have spinal pain, the practitioner should also conduct a complete neurologic exam. RD, at 11; Tr. 129–130. In addition, the Georgia standard of care requires that a practitioner determine and document the severity of pain. RD, at 11; Tr. 135– 136. Dr. Lobel testified that under the Georgia standard of care, opioids ‘‘are not first-line treatment for chronic pain,’’ so a practitioner must ‘‘weigh the risks and benefits at every visit,’’ as well as look out for adverse effects, side effects, and aberrant behavior. RD, at 11; Tr. 132–133, 136–137. According to Dr. Lobel, under the Georgia standard of care, a practitioner should consider taking a patient off of opioids when there is a ‘‘lack of functional benefit, toxic effects of the medicine where they’re having end organ damage, . . . [or] someone [] showing any signs or symptoms of addiction,’’ and patients DEPARTMENT OF JUSTICE On December 8, 2022, the Drug Enforcement Administration (DEA or Government) issued an Order to Show Cause and Immediate Suspension of Registration (OSC/ISO) to Isaac Sved, M.D. (Respondent) of Buford, Georgia. OSC/ISO, at 1. The OSC/ISO informed Respondent of the immediate suspension of his DEA Certificate of Registration, Control No. BS4103610, pursuant to 21 U.S.C. 824(d), alleging that Respondent’s continued registration constitutes ‘‘ ‘an imminent danger to the public health or safety.’ ’’ Id. (quoting 21 U.S.C. 824(d)). The OSC/ISO also proposed the revocation of Respondent’s registration, alleging that Respondent has ‘‘committed such acts as would render [his] registration inconsistent with the public interest.’’ Id. at 1, 4 (citing 21 U.S.C. 823(g)(1),1 824(a)(4)). A hearing was held before DEA Administrative Law Judge Teresa A. Wallbaum (the ALJ) who, on June 20, 2023, issued her Recommended Rulings, Findings of Fact, Conclusions of Law, and Decision (Recommended Decision or RD), which recommended revocation of Respondent’s registration. RD, at 27. Respondent did not file exceptions to the RD. Having reviewed the entire record, the Agency adopts and hereby incorporates by reference the entirety of the ALJ’s rulings, credibility findings,2 1 Effective December 2, 2022, the Medical Marijuana and Cannabidiol Research Expansion Act, Public Law 117–215, 136 Stat. 2257 (2022) (Marijuana Research Amendments or MRA), amended the Controlled Substances Act (CSA) and other statutes. Relevant to this matter, the MRA redesignated 21 U.S.C. 823(f), cited in the OSC/ISO, as 21 U.S.C. 823(g)(1). Accordingly, this Decision cites to the current designation, 21 U.S.C. 823(g)(1), and to the MRA-amended CSA throughout. 2 The Agency adopts the ALJ’s summary of each of the witnesses’ testimonies as well as the ALJ’s assessment of each of the witnesses’ credibility. See RD, at 3–17. The Agency agrees with the ALJ that the Diversion Investigator’s testimony, which was focused on the uncontroversial introduction of documentary evidence and her contact with the case, was credible in that it was sufficiently detailed, plausible, and internally consistent. Id. at 4. Further, the Agency agrees with the ALJ that the testimony from the Government’s expert witness, Dr. Steven Lobel, M.D., which was focused on the Georgia standard of care and Respondent’s prescribing to the patients listed in the OSC/ISO, was credible in that it was consistent with Georgia statutes governing the prescribing of controlled substances, especially in the pain management context, and was clear, direct, substantial, and consistent with regards to the individual patients. Id. at 4–5. Finally, the Agency agrees with the ALJ that although Respondent’s testimony was credible as to general facts, including Respondent PO 00000 Frm 00061 Fmt 4703 Sfmt 4703 volunteering information regarding prior disciplinary actions, on the issue of whether his prescriptions were within the usual course of professional practice and for a legitimate medical purpose, Respondent’s testimony was not fully credible in that his interpretations of the Georgia standard of care were inconsistent with the Georgia state statutes. Id. at 9–10. 3 During the hearing, both Government counsel and Dr. Lobel initially referenced a national standard of care established by the CDC Guidelines, see RD, at 10, but Dr. Lobel ultimately testified that the Georgia standard of care, upon which this decision is based, is grounded in the state medical board’s publications and Georgia state statutes, with the CDC Guidelines incorporated to the extent that they deal with the prescriptions of opioids. RD, at 10; Tr. 114–115, 119, 125. E:\FR\FM\02NON1.SGM 02NON1

Agencies

[Federal Register Volume 88, Number 211 (Thursday, November 2, 2023)]
[Notices]
[Pages 75312-75323]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-24282]


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DEPARTMENT OF JUSTICE

Drug Enforcement Administration

[Docket No. DEA-1228P]


Proposed Aggregate Production Quotas for Schedule I and II 
Controlled Substances and Assessment of Annual Needs for the List I 
Chemicals Ephedrine, Pseudoephedrine, and Phenylpropanolamine for 2024

AGENCY: Drug Enforcement Administration, Department of Justice.

ACTION: Notice with request for comments.

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SUMMARY: The Drug Enforcement Administration (DEA) proposes to 
establish the 2024 aggregate production quotas (APQ) for controlled 
substances in schedules I and II of the Controlled Substances Act (CSA) 
and the assessment of annual needs (AAN) for the list I chemicals 
ephedrine, pseudoephedrine, and phenylpropanolamine. For the 2024 quota 
year, DEA intends to allocate procurement quotas to DEA-registered 
manufacturers of schedule II controlled substances on a quarterly 
basis. In order to address domestic drug shortages of controlled 
substances, procurement quota allocations will be divided between 
quantities authorized for domestic sales and quantities authorized for 
export sales.

DATES: Electronic comments must be submitted, and written comments must 
be postmarked, on or before December 4, 2023. Interested persons may 
file written comments on this notice in accordance with 21 CFR 
1303.11(c) and 1315.11(d). Commenters should be aware that the 
electronic Federal Docket Management System will not accept comments 
after 11:59 p.m. Eastern Time on the last day of the comment period.
    Based on comments received in response to this notice, the 
Administrator may hold a public hearing on one or more issues raised. 
In the event the Administrator decides in her sole discretion to hold 
such a hearing, the Administrator will publish a notice of any such 
hearing in the Federal Register. After consideration of any comments or 
objections, or after a hearing, if one is held, the Administrator will 
publish in the Federal Register a final order establishing the 2024 
aggregate production quotas for schedule I and II controlled 
substances, and an assessment of annual needs for the list I chemicals 
ephedrine, pseudoephedrine, and phenylpropanolamine.

[[Page 75313]]


ADDRESSES: To ensure proper handling of comments, please reference 
``Docket No. DEA-1228P'' on all correspondence, including any 
attachments. DEA encourages that all comments be submitted 
electronically through the Federal eRulemaking Portal, which provides 
the ability to type short comments directly into the comment field on 
the web page or attach a file for lengthier comments. Please go to 
https://www.regulations.gov and follow the online instructions at that 
site for submitting comments. Upon completion of your submission, you 
will receive a Comment Tracking Number for your comment. Please be 
aware that submitted comments are not instantaneously available for 
public view on Regulations.gov. If you have received a Comment Tracking 
Number, your comment has been successfully submitted, and there is no 
need to resubmit the same comment. Paper comments that duplicate 
electronic submissions are not necessary and are discouraged. Should 
you wish to mail a paper comment in lieu of an electronic comment, it 
should be sent via regular or express mail to: Drug Enforcement 
Administration, Attention: DEA Federal Register Representative/DPW, 
8701 Morrissette Drive, Springfield, Virginia 22152.

FOR FURTHER INFORMATION CONTACT: Scott A. Brinks, Regulatory Drafting 
and Policy Support Section, Diversion Control Division, Drug 
Enforcement Administration; Mailing Address: 8701 Morrissette Drive, 
Springfield, Virginia 22152, Telephone: (571) 776-3882.

SUPPLEMENTARY INFORMATION:

Posting of Public Comments

    Please note that all comments received in response to this docket 
are considered part of the public record. They will, unless reasonable 
cause is given, be made available by the Drug Enforcement 
Administration (DEA) for public inspection online at https://www.regulations.gov. Such information includes personal identifying 
information (such as your name, address, etc.) voluntarily submitted by 
the commenter.
    The Freedom of Information Act applies to all comments received. If 
you want to submit personal identifying information (such as your name, 
address, etc.) as part of your comment, but do not want it to be made 
publicly available, you must include the phrase ``PERSONAL IDENTIFYING 
INFORMATION'' in the first paragraph of your comment. You must also 
place all the personal identifying information you do not want made 
publicly available in the first paragraph of your comment and identify 
what information you want redacted.
    If you want to submit confidential business information as part of 
your comment, but do not want it to be made publicly available, you 
must include the phrase ``CONFIDENTIAL BUSINESS INFORMATION'' in the 
first paragraph of your comment. You must also prominently identify 
confidential business information to be redacted within the comment.
    Comments containing personal identifying information or 
confidential business information identified and located as directed 
above will generally be made available in redacted form. If a comment 
contains so much confidential business information or personal 
identifying information that it cannot be effectively redacted, all or 
part of that comment may not be made publicly available. Comments 
posted to https://www.regulations.gov may include any personal 
identifying information (such as name, address, and phone number) 
included in the text of your electronic submission that is not 
identified as directed above as confidential.
    An electronic copy of this document is available at https://www.regulations.gov for easy reference.

Legal Authority

    Section 306 of the Controlled Substances Act (21 U.S.C. 826) 
requires the Attorney General to establish production quotas for each 
basic class of controlled substances listed in schedules I and II, and 
for the list I chemicals ephedrine, pseudoephedrine, and 
phenylpropanolamine. The Attorney General has delegated this function 
to the Administrator of DEA pursuant to 28 CFR 0.100.

Analysis for Proposed 2024 Aggregate Production Quotas and Assessment 
of Annual Needs

    The proposed 2024 aggregate production quotas (APQ) and assessment 
of annual needs (AAN) represent those quantities of schedule I and II 
controlled substances, and the list I chemicals ephedrine, 
pseudoephedrine, and phenylpropanolamine, to be manufactured in the 
United States (U.S.) in 2024 to provide for the estimated medical, 
scientific, research, and industrial needs of the United States, lawful 
export requirements, and the establishment and maintenance of reserve 
stocks. These quotas include imports of ephedrine, pseudoephedrine, and 
phenylpropanolamine, but do not include imports of controlled 
substances for use in industrial processes.

Aggregate Production Quotas

    In determining the proposed 2024 APQ, the Administrator has taken 
into account the criteria of 21 U.S.C. 826(a) and 21 CFR 1303.11, 
including the following seven factors:
    (1) Total net disposal of the class by all manufacturers during the 
current and two preceding years;
    (2) Trends in the national rate of net disposal of the class;
    (3) Total actual (or estimated) inventories of the class and of all 
substances manufactured from the class, and trends in inventory 
accumulation;
    (4) Projected demand for such class as indicated by procurement 
quotas requested pursuant to [21 CFR] 1303.12;
    (5) The extent of any diversion of the controlled substance in the 
class;
    (6) Relevant information obtained from the Department of Health and 
Human Services (HHS), including from the Food and Drug Administration 
(FDA), the Centers for Disease Control and Prevention (CDC), and the 
Centers for Medicare and Medicaid Services (CMS), and relevant 
information obtained from the states; and
    (7) Other factors affecting medical, scientific, research, and 
industrial needs in the United States and lawful export requirements, 
as the Administrator finds relevant, including changes in the currently 
accepted medical use in treatment with the class or the substances 
manufactured from it, the economic and physical availability of raw 
materials for use in manufacturing and for inventory purposes, yield 
and stability problems, potential disruptions to production (including 
possible labor strikes), and recent unforeseen emergencies such as 
floods and fires.

21 CFR 1303.11(b)

    DEA formally solicited input from FDA and CDC in February of 2023 
and from the states in April 2023, as required by 21 U.S.C. 826 and 21 
CFR part 1303. DEA did not solicit input from CMS for reasons discussed 
in previous notices.\1\ DEA requested information on trends in the 
legitimate use of select schedule I and II controlled substances from 
FDA and rates of

[[Page 75314]]

overdose deaths for covered controlled substances from CDC. DEA's 
request for information from the states was made directly to the 
Prescription Drug Monitoring Program (PDMP) Administrators in each 
state as well as through the National Association of State Controlled 
Substances Authorities (NASCSA).
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    \1\ Proposed Adjustments to the Aggregate Production Quotas for 
Schedule I and II Controlled Substances and Assessment of Annual 
Needs for List I Chemicals Ephedrine, Pseudoephedrine, and 
Phenylpropanolamine for 2021, 85 FR 54414 (Sept. 1, 2020) and 
Proposed Aggregate Production Quotas for Schedule I and II 
Controlled Substances and Assessment of Annual Needs for List I 
Chemicals Ephedrine, Pseudoephedrine, and Phenylpropanolamine for 
2021, 85 FR 54407 (Sept. 1, 2020).
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Assessment of Annual Needs

    In similar fashion, in determining the proposed 2024 AAN for the 
list I chemicals ephedrine, pseudoephedrine, and phenylpropanolamine, 
the Administrator has taken into account the criteria of 21 U.S.C. 
826(a) and 21 CFR 1315.11, including the five following factors:
    (1) Total net disposal of the chemical by all manufacturers and 
importers during the current and two preceding years;
    (2) Trends in the national rate of net disposal of each chemical;
    (3) Total actual (or estimated) inventories of the chemical and of 
all substances manufactured from the chemical, and trends in inventory 
accumulation;
    (4) Projected demand for each chemical as indicated by procurement 
and import quotas requested pursuant to [21 CFR] 1315.32; and
    (5) Other factors affecting medical, scientific, research, and 
industrial needs in the United States, lawful export requirements, and 
the establishment and maintenance of reserve stocks, as the 
Administrator finds relevant, including changes in the currently 
accepted medical use in treatment with the chemicals or the substances 
manufactured from them, the economic and physical availability of raw 
materials for use in manufacturing and for inventory purposes, yield 
and stability problems, potential disruptions to production (including 
possible labor strikes), and recent unforeseen emergencies such as 
floods and fires.

21 CFR 1315.11(b)

    In determining the proposed 2024 AAN, DEA used the calculation 
methodology previously described in the 2010 and 2011 assessments of 
annual needs (74 FR 60294, Nov. 20, 2009, and 75 FR 79407, Dec. 20, 
2010, respectively).

Estimates of Medical Need for Schedule II Opioids and Stimulants

    In accordance with 21 CFR part 1303, 21 U.S.C. 826, and 42 U.S.C. 
242, HHS continues to provide DEA with estimates of the quantities of 
select schedule I and II controlled substances and three list I 
chemicals that will be required to meet the legitimate medical needs of 
the United States for a given calendar year. The responsibility to 
provide these estimates of legitimate domestic medical needs resides 
with FDA. FDA provides DEA with predicted estimates of domestic medical 
usage for selected controlled substances based on information available 
to them at a specific point in time in order to meet statutory 
requirements.
    FDA predicts that levels of medical need for schedule II opioids in 
the United States in calendar year 2024 will decline on average 7.9 
percent from calendar year 2023 levels. These declines are expected to 
occur across a variety of schedule II opioids including fentanyl, 
hydrocodone, hydromorphone, oxycodone, and oxymorphone. DEA considered 
the potential for diversion of schedule II opioids, as required by 21 
CFR 1303.11(b)(5), as well as a potential increase in demand for 
certain opioids identified as being necessary to support the previously 
postponed elective surgeries now that the COVID-19 public health 
emergency has ended, pursuant to 21 CFR 1303.11(b)(7), in developing 
the proposed 2024 APQ.
    FDA predicted an average of a 3.1 percent increase in domestic 
medical use of the schedule II stimulants amphetamine, methylphenidate 
(including dexmethylphenidate), and lisdexamfetamine, which are 
prescribed to treat patients with attention deficit hyperactivity 
disorder (ADHD) and more recently prescribed off-label to treat 
patients diagnosed with long-COVID symptoms commonly known as brain fog 
where fatigue and cognitive impairment persist 4 to 12 weeks after a 
COVID infection.\2\ FDA also raised concerns over drug shortage 
notifications it received from patients for specific ADHD medications 
containing methylphenidate and amphetamine. FDA's stated reasons for 
these specific shortages include increased prescribing potentially 
related to the growth in telemedicine, supply chain issues, 
manufacturing and quality issues, and business decisions of 
manufacturers. DEA considered FDA's concerns when determining the APQ 
for these substances. DEA believes that manufacturers will be able to 
meet the increase in domestic medical need with the APQs proposed in 
this notice.
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    \2\ New Long-Haul COVID Clinics Treat Mysterious and Ongoing 
Symptoms, Scientific American, June 30, 2021; Successful Treatment 
of Post-COVID-19 ADHD-like Syndrome-A case Report, J Atten Disord., 
2023 Aug; 27(10): 1092-1098.
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DEA Projected Trends for Certain Schedule I Controlled Substances

    There has been a significant increase in the use of schedule I 
hallucinogenic controlled substances for research and clinical trial 
purposes. DEA has received and subsequently approved new registration 
applications for schedule I researchers and new applications for 
registration from manufacturers to grow, synthesize, extract, and 
prepare dosage forms containing specific schedule I hallucinogenic 
substances for research and clinical trial purposes. DEA supports 
regulated research with schedule I controlled substances, as evidenced 
by the higher APQ proposed for 2024 as compared with APQ for these 
substances in 2023. Further, DEA published the final rule, ``Controls 
to Enhance the Cultivation of Marihuana for Research in the United 
States'' in December 2020, and the Medical Marijuana and Cannabidiol 
Research Expansion Act (Pub. L. 117-215) was enacted in December 2022. 
The agency continues to review and approve applications for schedule I 
manufacturers of marihuana that conform to the federal requirements 
contained in the CSA. See 21 CFR part 1318.
    Thus, DEA is proposing APQ for ibogaine, psilocyn, psilocybin, 
delta-9-tetrahydrocannabinol (d-9-THC), and all other 
tetrahydrocannabinols to support manufacturing activities related to 
the increased level of research and clinical trials with these schedule 
I controlled substances. Additionally, DEA proposes APQs for d-9-THC 
and all other tetrahydrocannabinols for 2024 to reflect the relocation 
of manufacturing of these controlled substances from abroad to the 
United States.

Information Received for Consideration of the Remaining Factors

    For the factors listed in 21 CFR 1303.11(b)(3) and (4), DEA 
registered manufacturers of controlled substances in schedules I and II 
provide information such as inventory, distribution, manufacturing, 
sales forecasts and quota requests to the DEA database systems. See 21 
CFR 1303.12, 1303.22, and part 1304.
    The regulation at 21 CFR 1303.11(b)(5) requires DEA to consider the 
extent of diversion of controlled substances.\3\ Diversion is defined 
as all distribution, dispensing, or other use of controlled substances 
for other than legitimate medical purposes. In order to

[[Page 75315]]

consider the extent of diversion, DEA analyzed reports of diversion of 
controlled substances from 2022 submitted to its Theft Loss Report 
database. This database is comprised of DEA registrant reports 
documenting diversion from the legitimate distribution chain, including 
employee thefts, break-ins, armed robberies, and material lost in 
transit. The data was categorized by basic drug class, and the amount 
of active pharmaceutical ingredient (API) in the dosage form was 
delineated with an appropriate metric for use in proposing aggregate 
production quota values (i.e., weight).
---------------------------------------------------------------------------

    \3\ The estimates of diversion for five ``covered controlled 
substances'' as required by 21 U.S.C. 826(i) are discussed later in 
the document.
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    In this proposed 2024 APQ, DEA also considered the lingering 
effects of the COVID-19 pandemic on the global supply chain, pursuant 
to 21 CFR 1303.11(b)(7), and specifically the continued impacts on the 
availability of raw materials for use in the domestic manufacturing 
process. Additionally, DEA considered the impact of the demand for 
surgical care for elective surgeries that were deferred during the 
COVID-19 public health emergency.

Estimates of Diversion of Covered Controlled Substances

    In establishing any quota . . . , or any procurement quota 
established by [DEA] by regulation, for fentanyl, oxycodone, 
hydrocodone, oxymorphone, or hydromorphone (in this subsection referred 
to as a ``covered controlled substance''), [DEA] shall estimate the 
amount of diversion of the covered controlled substance that occurs in 
the United States.

21 U.S.C. 826(i)(1)(A)

    In estimating diversion under that provision, DEA:
    (i) shall consider information . . . , in consultation with the 
Secretary of Health and Human Services, [it] determines reliable on 
rates of overdose deaths and abuse and overall public health impact 
related to the covered controlled substance in the United States; and
    (ii) may take into consideration whatever other sources of 
information [it] determines reliable.

21 U.S.C. 826(i)(1)(B)

    The statute further mandates that DEA ``make appropriate quota 
reductions, as determined by [DEA], from the quota [it] would have 
otherwise established had such diversion not been considered.'' \4\
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    \4\ 21 U.S.C. 826(i)(1)(C).
---------------------------------------------------------------------------

    In estimating the amount of diversion of each covered controlled 
substance that occurs in the United States, DEA considered information 
from state PDMP Administrators and from legitimate distribution chain 
participants.

Consideration of Information From Certain State PDMPs and From National 
Sales Data

    Pursuant to 21 CFR 1303.11(b)(6), DEA requested state PDMP data for 
the purpose of establishing its APQ. DEA believes state PDMPs to be an 
essential, reliable source of information for use in effectively 
estimating diversion of the five covered controlled substances. In 
April 2023, DEA sent a letter to NASCSA requesting its assistance in 
obtaining aggregated PDMP data for the five covered controlled 
substances from each state covering the years 2020-2022. The letter 
indicated that DEA was specifically interested in an analysis of 
prescription data from each state's PDMP that would assist DEA in 
estimating diversion and setting appropriate quotas in compliance with 
21 U.S.C. 826(i). In its request, DEA provided specific questions, 
discussed in detail below, based on common indicia of potential 
diversion known as ``red flags'' by physicians, pharmacists, 
manufacturers, distributors, and federal and state regulatory and law 
enforcement agencies.\5\ DEA investigators and administrative 
prosecutors also rely on Agency case law in which these red flags of 
diversion have been upheld as indicia of potential diversion.\6\ 
Certain state regulations now include red flag circumstances as 
potential indicators of illegitimate prescriptions, and thus of 
potential abuse and diversion of controlled substances.\7\ See The 
Pharmacy Place Order, 86 FR 21008, 21012 (Apr. 21, 2021) (citing 22 
Tex. Admin. Code 291.29(c)(4), specifying the geographical distance 
between the practitioner and the patient or between the pharmacy and 
the patient as a red flag).
---------------------------------------------------------------------------

    \5\ National Association of Boards of Pharmacy (NABP) coalition 
consensus document ``Stakeholders' Challenges and Red Flag Warning 
Signs Related to Prescribing and Dispensing Controlled Substances'' 
(2015). www.nabp.pharmacy/resources/reports.
    \6\ The Medicine Shoppe, 79 FR 59504, 59507, 59512-13 (2014); 
Holiday CVS, L.L.C., d/b/a CVS Pharmacy Nos. 219 and 5195, 77 FR 
62316 (Oct. 12, 2012).
    \7\ The mere indicia of red flags alone is not proof of 
violation of 21 U.S.C. 824 or any other provision of the CSA. This 
rule discusses only their use by DEA as an analytical tool to 
estimate diversion.
---------------------------------------------------------------------------

    DEA requested responses from state PDMP Administrators by June 15, 
2023. NASCSA disseminated DEA's request to its PDMP Administrators and 
provided them with a report tool to ensure that responses to DEA's 
questions were extracted consistently across all responsive states. 
Thirty states and two territories provided DEA with summarized PDMP 
data between May 3, and June 15, 2023, utilizing the standardized 
report developed by NASCSA.\8\ See Table 1a below.
---------------------------------------------------------------------------

    \8\ NASCSA formatted DEA's request into an analytics model 
developed by one of its associates, Appriss Inc.

    Table 1a--States/Territories That Responded to DEA's Data Request
------------------------------------------------------------------------
                             State/territory
-------------------------------------------------------------------------
1. Alabama
2. Alaska
3. Arizona
4. Arkansas
5. Connecticut
6. Delaware
7. District of Columbia
8. Hawaii
9. Idaho
10. Indiana
11. Iowa
12. Kansas
13. Kentucky
14. Louisiana
15. Maine
16. Maryland
17. Michigan
18. Minnesota
19. Mississippi
20. Montana
21. Nevada
22. New Jersey
23. North Carolina
24. North Dakota
25. Ohio
26. Oklahoma
27. Puerto Rico
28. Rhode Island
29. South Carolina
30. South Dakota
31. Texas
32. Utah
------------------------------------------------------------------------

    Pharmacies are required by state law to enter controlled substance 
dispensing data into the state's PDMP database, including the 
prescriber's name, registered address and DEA number; prescription 
information (such as drug name); dispensing date; dosage dispensed; 
pharmacy registered address; and patient name and address. DEA 
considers PDMP data to be an accurate representation of dispensing 
activities in states. DEA received data for the following red-flag 
metrics:
     The total number of patients who saw three or more 
prescribers in a 90-day period and were dispensed an opioid following 
each visit. For this metric, DEA requested and was provided the number 
of prescriptions for the five covered controlled substances dispensed 
to these patients, as a percentage of the total prescriptions dispensed 
for that particular covered controlled substance, as well as the 
corresponding quantity of the covered

[[Page 75316]]

controlled substance dispensed. This metric (patients being prescribed 
covered controlled substances from three or more prescribers in a 90-
day period) is used to identify potential doctor shopping, a common 
technique to obtain a high number of controlled substances, which may 
lead to abuse or diversion of controlled substances. DEA has long 
considered doctor shopping to be an indicator of potential 
diversion.\9\
---------------------------------------------------------------------------

    \9\ Frank's Corner Pharmacy, 60 FR 17574 (1995); Holiday CVS, 
L.L.C., d/b/a CVS Pharmacy Nos. 219 and 5195, 77 FR 62316 (Oct. 12, 
2012).
---------------------------------------------------------------------------

     The number of patients that were dispensed prescriptions 
for each of the five covered controlled substances that exceeded 240 
morphine milligram equivalents (MME) daily. States provided the raw 
number of such prescriptions dispensed, the number of prescriptions as 
a percentage of the total covered controlled substance prescriptions 
dispensed, and the corresponding quantity of the covered controlled 
substance dispensed. DEA believes that accounting for quantities in 
excess of 240 MME daily allows for consideration of oncology patients 
with legitimate medical needs for covered controlled substance 
prescriptions with high MME. Higher dosages place individuals at higher 
risk of overdose and death. Prescriptions involving dosages exceeding 
240 MME daily may indicate diversion, such as illegal distribution of 
controlled substances or prescribing outside the usual course of 
professional practice.
     The number of patients that paid cash for covered 
controlled substance prescriptions, without submitting for insurance 
reimbursement.\10\ States also provided the number of prescriptions 
paid entirely with cash as a percentage of the total prescriptions for 
the five covered controlled substances dispensed, as well as the 
corresponding quantity of the covered controlled substances dispensed. 
When investigating potential diversion, cash payments are one element 
considered in identifying prescriptions filled for nonmedical purposes. 
Unusually high percentages of cash payments made to a prescriber or 
pharmacy for controlled substances may indicate diversion.\11\
---------------------------------------------------------------------------

    \10\ This total does not include insurance co-payments made with 
cash.
    \11\ Suntree Pharmacy and Suntree Medical Equipment, LLC, 85 FR 
73753 (2018) (finding that the pharmacy filled prescriptions despite 
the presence of multiple unresolved red flags, including cash 
payments); Pharmacy Doctors Enterprises d/b/a Zion Clinic Pharmacy, 
83 FR 10876 (Mar. 13, 2018) (revoking pharmacy's registration for 
filling prescriptions that raised the red flag of customers paying 
cash for their prescriptions, among other red flags).
---------------------------------------------------------------------------

    DEA received PDMP data from the states in a standardized format 
that allowed DEA to aggregate the data. The PDMP data sample represents 
a population of approximately 150.7 million people, which is 
approximately 45 percent of the U.S. population. DEA believes this 
sample is sufficient to derive a reasonable nationwide estimate.
    While PDMP data is useful in estimating diversion, it is not 
conclusive. Further investigation would be required before concluding 
that any of the subject prescriptions were actually diverted. DEA 
continues to evaluate its methodologies in estimating diversion in an 
effort to adjust quotas more efficiently. State participation is 
crucial to accurate data analysis, and DEA anticipates working closely 
with states, as well as other federal and state entities, in future 
quota determinations.
    To calculate a national diversion estimate for each of the covered 
controlled substances from the responses received from state PDMP 
Administrators, DEA relied upon the number of individuals who received 
a prescription for a covered controlled substance that met any of the 
three red-flag metrics for each of calendar years 2020-2022. Using the 
population of the states responding to DEA's request, DEA then 
calculated the percentage of the population issued a prescription with 
a red flag. Using this estimated percentage for 2020-2022, DEA analyzed 
trends in the data to predict the estimated percentage of patients who 
would be expected to be included in these red-flag metrics for 2024.
    DEA also reviewed aggregate sales data for each of the covered 
controlled substances, which it extracted from IQVIA's National Sales 
Perspective.\12\ IQVIA sales data was selected to help quantify 
diversion at the national level because it reflects the best national 
estimate for all prescriptions written and filled, including the total 
quantity available for diversion or misuse. DEA analyzed trends in 
IQVIA sales data from January 2020--April 2023, in order to predict the 
estimated national sales for 2024.
---------------------------------------------------------------------------

    \12\ DEA has purchased this data from IQVIA for decades and 
routinely uses this information to administer several regulatory 
functions, including the administration of DEA's quota program.
---------------------------------------------------------------------------

    To estimate diversion for each of the covered controlled 
substances, DEA multiplied the forecasted percentage of patients likely 
to receive a prescription for a covered controlled substance that meet 
any of the three red-flag metrics in 2024 by the forecasted sales data 
from IQVIA for 2024. The resulting estimate of diversion from data 
submitted by state PDMP Administrators is summarized below in Table 1b. 
This data contributed to the final diversion estimate set forth in 
Table 3.

   Table 1B--Diversion Estimates for 2024 Based on State PDMP Data for
              Covered Controlled Substances From 2020-2022
------------------------------------------------------------------------
                  Controlled substance                          (g)
------------------------------------------------------------------------
Fentanyl................................................              18
Hydrocodone.............................................          83,823
Hydromorphone...........................................             356
Oxycodone...............................................         150,684
Oxymorphone.............................................               0
------------------------------------------------------------------------

Consideration of Registrant Reported Diversion in the Legitimate 
Distribution Chain

    DEA extracted data from its Theft Loss Report database and 
categorized it by each basic drug class. DEA calculated the estimated 
amount of diversion by multiplying the quantity of API in each finished 
dosage form by the total amount of units reported stolen or lost to 
estimate the metric weight in grams of the controlled substance being 
diverted. This estimate of diversion from the legitimate supply chain 
for each of the covered controlled substances is displayed in Table 2. 
This data contributed to the final diversion estimates set forth in 
Table 3.

  Table 2--Diversion Estimates Based on Supply Chain Diversion Data for
                      Covered Controlled Substances
------------------------------------------------------------------------
                  Controlled Substance                          (g)
------------------------------------------------------------------------
Fentanyl................................................              74
Hydrocodone.............................................          12,454
Hydromorphone...........................................             481
Oxycodone...............................................          31,698
Oxymorphone.............................................             252
------------------------------------------------------------------------

    In accordance with 21 U.S.C. 826(i), DEA's estimate of diversion 
for the five controlled substances was calculated by combining the 
values in Tables 1b and 2. DEA reduced the APQ for each covered 
controlled substance by the quantities listed in Table 3.

 Table 3--Total Estimates of Diversion for Covered Controlled Substances
                     To Be Applied to the 2024 APQs
------------------------------------------------------------------------
                  Controlled substance                          (g)
------------------------------------------------------------------------
Fentanyl................................................              92
Hydrocodone.............................................          96,277
Hydromorphone...........................................             838

[[Page 75317]]

 
Oxycodone...............................................         182,382
Oxymorphone.............................................             252
------------------------------------------------------------------------

Forthcoming Regulatory Changes and Administration of Individual Quotas 
for 2024

    DEA is committed to ensuring that all Americans can access 
appropriately prescribed medications. As part of this commitment, DEA 
undertook work to understand the supply chain dynamics for controlled 
substances subject to quotas over the last year and a half, especially 
in highly genericized markets. Based on that review, DEA observed 
various challenges in the quota allocation process stemming from the 
lack of real-time inventory and sales data accessible to DEA, the lack 
of information on manufacturers' production lead times, and issues of 
timeliness in ARCOS reporting.
    Relatedly, beginning in the latter half of 2022, the DEA and FDA 
observed an increase in the number of drug shortages reported by 
manufacturers of schedule II stimulants including mixed-salt 
amphetamine products starting in April 2022 and lisdexamfetamine and 
methylphenidate starting in July 2023. As DEA and FDA stated in their 
open letter,\13\ we remain committed to doing all we can to prevent 
stimulant drug shortages, limit their impact, and resolve them as 
quickly as possible.
---------------------------------------------------------------------------

    \13\ Both DEA and FDA released this letter on Aug. 1, 2023. It 
is available at: https://www.dea.gov/sites/default/files/2023-08/DEA%20and%20FDA%20Issue%20Joint%20Letter%20to%20the%20Public.pdf.
---------------------------------------------------------------------------

    DEA commissioned two reports by IQVIA \14\ in order to understand 
the demographic shifts impacting the prescribing of schedule II 
stimulants. The reports provided valuable insights. Chief among those 
insights was the observed increase in prescriptions dispensed for 
mixed-salt amphetamine products to adults between the ages of 31-40 
years, particularly women, and older patients (71-80 years old), 
particularly during the COVID-19 pandemic (i.e. 2020 and 2021). In 
contrast, during 2022, dispensed prescriptions for products containing 
methylphenidate HCl and dexmethylphenidate HCl had a higher annual 
increase in 2022 (than in 2021) as compared to mixed-salt amphetamine 
products which may be indicative of product switching from amphetamine 
to methylphenidate and dexmethylphendiate. Neither DEA nor FDA 
anticipated these changes.
---------------------------------------------------------------------------

    \14\ Both reports are available at: https://www.deadiversion.usdoj.gov/drug_chem_info/stimulants/.
---------------------------------------------------------------------------

    In addition to these demographic shifts in prescribing, DEA also 
evaluated inventory, manufacturing, and sales data submitted by 
manufacturers through ARCOS and through reports submitted to DEA's 
Quota Management System. That analysis revealed that dosage 
manufacturers of amphetamine did not utilize the full extent of their 
authorized quotas. DEA authorized amphetamine medication dosage form 
manufacturers across the entire market to purchase and use 38,418 
kilograms of amphetamine but those manufacturers initially \15\ 
reported the purchase of only 31,539 kg. Of that quantity, dosage 
manufacturers only shipped 26,953 kg of amphetamine medications.
---------------------------------------------------------------------------

    \15\ In July 2023, several manufacturers who--according to their 
reporting to DEA--had failed to use their full amphetamine 
procurement quotas in 2022 received correspondence from DEA and FDA 
asking them to confirm that they would use their full 2023 
procurement quotas. Upon receiving that correspondence--
approximately seven months after the close of calendar year 2022--
one such manufacturer then revised its 2022 reporting to DEA to 
reflect that it had, in fact, used nearly all of its 2022 
amphetamine procurement quota.
---------------------------------------------------------------------------

    This ongoing work has led DEA to conclude that changes to its 
regulations likely will be useful in developing more precise quotas 
that will provide for the estimated medical, scientific, research, and 
industrial needs of the United States, for lawful export requirements, 
and for the establishment and maintenance of reserve stocks, while also 
reducing opportunities for diversion. For instance, DEA believes that 
changes to reporting requirements are necessary to improve both the 
type of data collected and the timeliness of that data, allowing DEA to 
be more nimble in its administration of the quota program. Future 
regulatory changes may seek to address the lack of real-time inventory 
and sales data accessible to DEA, the lack of information on production 
lead times, and issues of timeliness in ARCOS reporting, by 
considering, for example, requiring manufacturers to provide 
anticipated production timelines and monthly ARCOS reporting. DEA is 
not seeking comments on these concepts through this notice, but will 
publish detailed proposals for comment in the future.
    DEA also will seek additional information that will assist the 
agency to more accurately forecast export requirements, especially for 
those substances that are not controlled internationally.\16\ DEA 
understands that manufacturers have contractual obligations that 
dictate business decisions regarding the quantities of finished dosage 
forms they will produce under a single DEA-issued quota, which applies 
to products manufactured with an active ingredient, whether for 
domestic or foreign markets. DEA also is exploring the purchase of 
third-party data to improve its understanding of the dynamic changes in 
foreign markets. Building off the recently issued quota management 
rule,\17\ DEA also intends to add new subcategories to individual 
manufacturing quotas and procurement quotas, to distinguish between 
domestic requirements and export requirements.
---------------------------------------------------------------------------

    \16\ While amphetamine and methylphenidate are currently 
recognized as schedule II controlled substances under the Convention 
on Psychotropic Substances of 1971, lisdexamfetamine is not. 
Additional details may be found at: https://www.incb.org/incb/en/psychotropics/1971_convention.html.
    \17\ Management of Quotas for Controlled Substances and List I 
Chemicals, 88 FR 60117 (Aug. 31, 2023) (effective Nov. 29, 2023).
---------------------------------------------------------------------------

    DEA also is considering methods by which it might increase 
transparency in its quota setting process. Future regulatory proposals 
may define additional steps, including such concepts as public 
notification and an opportunity for public input when prescribing rates 
for controlled substances deviate substantially from FDA's estimate of 
future use. Furthermore, DEA is considering regulatory changes which 
will authorize it to reduce a manufacturer's individual manufacturing 
or procurement quota in order to apportion it to another manufacturer. 
As with the regulatory changes mentioned above, DEA will welcome 
comment on detailed proposals in the future, and is not requesting 
comment on these general concepts in this notice.
    The abovementioned regulatory changes will take time. In the 
meantime, for the 2024 quota year, DEA intends to allocate procurement 
quotas to DEA-registered manufacturers of schedule II controlled 
substances on a quarterly basis. In order to address domestic drug 
shortages of controlled substances, procurement quota allocations for 
schedule II controlled substances will be divided between quantities 
authorized for domestic sales and quantities authorized for export 
sales. DEA will be sending a letter to each manufacturer with 
instructions on the data that will be necessary to allow DEA to process 
subsequent quarterly procurement quota allocations. DEA may publish or 
post how many companies have been allocated quota in

[[Page 75318]]

a given calendar year, and how many of those companies have utilized 
their allocated quota. Further, DEA may publish or post the names of 
the companies that have been allocated quota.
    The Administrator, therefore, proposes to establish the 2024 APQ 
for certain schedule I and II controlled substances and AAN for the 
list I chemicals ephedrine, pseudoephedrine, and phenylpropanolamine, 
expressed in grams of anhydrous acid or base, as follows:

------------------------------------------------------------------------
                                                           Proposed 2024
                                                              quotas
                       Basic class                       ---------------
                                                                (g)
------------------------------------------------------------------------
                               Schedule I
------------------------------------------------------------------------
-[1-(2-Thienyl)cyclohexyl]pyrrolidine...................              20
1-(1-Phenylcyclohexyl)pyrrolidine.......................              30
1-(2-Phenylethyl)-4-phenyl-4-acetoxypiperidine..........              10
1-(5-Fluoropentyl)-3-(1-naphthoyl)indole (AM2201).......              30
1-(5-Fluoropentyl)-3-(2-iodobenzoyl)indole (AM694)......              30
1-[1-(2-Thienyl)cyclohexyl]piperidine...................              15
2'-fluoro 2-fluorofentanyl..............................              30
1-Benzylpiperazine......................................              25
1-Methyl-4-phenyl-4-propionoxypiperidine................              10
2-(2,5-Dimethoxy-4-ethylphenyl)ethanamine (2C-E)........              30
2-(2,5-Dimethoxy-4-methylphenyl)ethanamine (2C-D).......              30
2-(2,5-Dimethoxy-4-nitro-phenyl)ethanamine (2C-N).......              30
2-(2,5-Dimethoxy-4-n-propylphenyl)ethanamine (2C-P).....              30
2-(2,5-Dimethoxyphenyl)ethanamine (2C-H)................             100
2-(4-Bromo-2,5-dimethoxyphenyl)-N-(2-                                 30
 methoxybenzyl)ethanamine (25B-NBOMe; 2C-B-NBOMe; 25B;
 Cimbi-36)..............................................
2-(4-Chloro-2,5-dimethoxyphenyl)ethanamine (2C-C).......              30
2-(4-Chloro-2,5-dimethoxyphenyl)-N-(2-                                25
 methoxybenzyl)ethanamine (25C-NBOMe; 2C-C-NBOMe; 25C;
 Cimbi-82)..............................................
2-(4-Iodo-2,5-dimethoxyphenyl)ethanamine (2C-I).........              30
2-(4-Iodo-2,5-dimethoxyphenyl)-N-(2-                                  30
 methoxybenzyl)ethanamine (25I-NBOMe; 2C-I-NBOMe; 25I;
 Cimbi-5)...............................................
2,5-Dimethoxy-4-ethylamphetamine (DOET).................              25
2,5-Dimethoxy-4-n-propylthiophenethylamine..............              25
2,5-Dimethoxyamphetamine................................              25
2-[4-(Ethylthio)-2,5-dimethoxyphenyl]ethanamine (2C-T-2)              30
2-[4-(Isopropylthio)-2,5-dimethoxyphenyl]ethanamine (2C-              30
 T-4)...................................................
3,4,5-Trimethoxyamphetamine.............................              30
3,4-Methylenedioxyamphetamine (MDA).....................          12,000
3,4-Methylenedioxymethamphetamine (MDMA)................          12,000
3,4-Methylenedioxy-N-ethylamphetamine (MDEA)............              40
3,4-Methylenedioxy-N-methylcathinone (methylone)........           5,200
3,4-Methylenedioxypyrovalerone (MDPV)...................              35
3-FMC; 3-Fluoro-N-methylcathinone.......................              25
3-Methylfentanyl........................................              30
3-Methylthiofentanyl....................................              30
4,4'-Dimethylaminorex...................................              30
4-Bromo-2,5-dimethoxyamphetamine (DOB)..................              30
4-Bromo-2,5-dimethoxyphenethylamine (2-CB)..............           5,100
4-Chloro-alpha-pyrrolidinovalerophenone (4-chloro-alpha-              25
 PVP)...................................................
4-CN-Cumyl-Butinaca.....................................              25
4-Fluoroisobutyryl fentanyl.............................              30
4F-MDMB-BINACA..........................................              30
4-FMC; Flephedrone......................................              25
4-MEC; 4-Methyl-N-ethylcathinone........................              25
4-Methoxyamphetamine....................................             150
4-Methyl-2,5-dimethoxyamphetamine (DOM).................              25
4-Methylaminorex........................................              25
4-Methyl-N-methylcathinone (mephedrone).................              45
4-Methyl-alpha-ethylaminopentiophenone (4-MEAP).........              25
4-Methyl-alpha-pyrrolidinohexiophenone (MPHP)...........              25
4'-Methyl acetyl fentanyl...............................              30
4-Methyl-[alpha]-pyrrolidinopropiophenone (4-MePPP).....              25
5-(1,1-Dimethylheptyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-               50
 phenol.................................................
5-(1,1-Dimethyloctyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-                40
 phenol (cannabicyclohexanol or CP-47,497 C8-homolog)...
5F-AB-PINACA; (1-Amino-3-methyl-1-oxobutan-2-yl)-1-(5-                25
 fluoropentyl)-1H-indazole-3-carboxamide................
5F-ADB; 5F-MDMB-PINACA (methyl 2-(1-(5-fluoropentyl)-1H-              25
 indazole-3-carboxamido)-3,3-dimethylbutanoate).........
5F-CUMYL-P7AICA; 1-(5-Fluoropentyl)-N-(2-phenylpropan-2-              25
 yl)-1H-pyrrolo[2,3-b]pyridine-3carboximide.............
5F-CUMYL-PINACA.........................................              25
5F-EDMB-PINACA..........................................              25
5F-MDMB-PICA............................................              25
5F-AMB (methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-                   25
 carboxamido)-3-methylbutanoate)........................
5F-APINACA; 5F-AKB48 (N-(adamantan-1-yl)-1-(5-                        25
 fluoropentyl)-1H-indazole-3-carboxamide)...............
5-Fluoro-PB-22; 5F-PB-22................................              25
5-Fluoro-UR144, XLR11 ([1-(5-fluoro-pentyl)-1Hindol-3-                25
 yl](2,2,3,3-tetramethylcyclopropyl)methanone...........
5-Methoxy-3,4-methylenedioxyamphetamine.................              25

[[Page 75319]]

 
5-Methoxy-N,N-diisopropyltryptamine.....................              25
5-Methoxy-N,N-dimethyltryptamine........................          11,000
AB-CHMINACA.............................................              30
AB-FUBINACA.............................................              50
AB-PINACA...............................................              30
ADB-FUBINACA (N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-             30
 (4-fluorobenzyl)-1H-indazole-3-carboxamide)............
Acetorphine.............................................              25
Acetyl Fentanyl.........................................             100
Acetyl-alpha-methylfentanyl.............................              30
Acetyldihydrocodeine....................................              30
Acetylmethadol..........................................              25
Acryl Fentanyl..........................................              25
ADB-PINACA (N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-               50
 pentyl-1H-indazole-3-carboxamide)......................
AH-7921.................................................              30
All other tetrahydrocannabinol..........................         790,010
Allylprodine............................................              25
Alphacetylmethadol......................................              25
alpha-Ethyltryptamine...................................              25
Alphameprodine..........................................              25
Alphamethadol...........................................              25
alpha-Methylfentanyl....................................              30
alpha-Methylthiofentanyl................................              30
alpha-Methyltryptamine (AMT)............................              25
alpha-Pyrrolidinobutiophenone ([alpha]-PBP).............              25
alpha-pyrrolidinoheptaphenone (PV8).....................              25
alpha-pyrrolidinohexabophenone (alpha-PHP)..............              25
alpha-Pyrrolidinopentiophenone ([alpha]-PVP)............              25
Amineptine..............................................              30
Aminorex................................................              25
Anileridine.............................................              20
APINCA, AKB48 (N-(1-adamantyl)-1-pentyl-1H-indazole-3-                25
 carboxamide)...........................................
Benzethidine............................................              25
Benzylmorphine..........................................              30
Betacetylmethadol.......................................              25
beta-Hydroxy-3-methylfentanyl...........................              30
beta-Hydroxyfentanyl....................................              30
beta-Hydroxythiofentanyl................................              30
beta-Methyl fentanyl....................................              30
beta'-Phenyl fentanyl...................................              30
Betameprodine...........................................              25
Betamethadol............................................               4
Betaprodine.............................................              25
Brorphine...............................................              30
Bufotenine..............................................              15
Butonitazene............................................              30
Butylone................................................              25
Butyryl fentanyl........................................              30
Cathinone...............................................              40
Clonitazene.............................................              25
Codeine methylbromide...................................              30
Codeine-N-oxide.........................................             192
Crotonyl Fentanyl.......................................              25
Cyclopentyl Fentanyl....................................              30
Cyclopropyl Fentanyl....................................              20
Cyprenorphine...........................................              25
d-9-THC.................................................         900,610
Desomorphine............................................              25
Dextromoramide..........................................              25
Diapromide..............................................              20
Diethylthiambutene......................................              20
Diethyltryptamine.......................................              25
Difenoxin...............................................           9,300
Dihydromorphine.........................................         639,954
Dimenoxadol.............................................              25
Dimepheptanol...........................................              25
Dimethylthiambutene.....................................              20
Dimethyltryptamine......................................           3,000
Dioxyaphetyl butyrate...................................              25
Dipipanone..............................................              25
Drotebanol..............................................              25
Ethylmethylthiambutene..................................              25

[[Page 75320]]

 
Ethylone................................................              25
Etodesnitazene..........................................              30
Etonitazene.............................................              25
Etorphine...............................................              30
Etoxeridine.............................................              25
Eutylone................................................              30
Fenethylline............................................              30
Fentanyl carbamate......................................              30
Fentanyl related substances.............................             600
Flunitazene.............................................              30
FUB-144.................................................              25
FUB-AKB48...............................................              25
Fub-AMB, MMB-Fubinaca, AMB-Fubinaca.....................              25
Furanyl fentanyl........................................              30
Furethidine.............................................              25
gamma-Hydroxybutyric acid...............................      29,417,000
Heroin..................................................             150
Hydromorphinol..........................................              40
Hydroxypethidine........................................              25
Ibogaine................................................             150
Isobutyryl Fentanyl.....................................              25
Isotonitazine...........................................              25
JWH-018 and AM678 (1-Pentyl-3-(1-naphthoyl)indole)......              35
JWH-019 (1-Hexyl-3-(1-naphthoyl)indole).................              45
JWH-073 (1-Butyl-3-(1-naphthoyl)indole).................              45
JWH-081 (1-Pentyl-3-[1-(4-methoxynaphthoyl)]indole).....              30
JWH-122 (1-Pentyl-3-(4-methyl-1-naphthoyl)indole).......              30
JWH-200 (1-[2-(4-Morpholinyl)ethyl]-3-(1-                             35
 naphthoyl)indole)......................................
JWH-203 (1-Pentyl-3-(2-chlorophenylacetyl)indole).......              30
JWH-250 (1-Pentyl-3-(2-methoxyphenylacetyl)indole)......              30
JWH-398 (1-Pentyl-3-(4-chloro-1-naphthoyl)indole).......              30
Ketobemidone............................................              30
Levomoramide............................................              25
Levophenyacylmorphan....................................              25
Lysergic acid diethylamide (LSD)........................           1,200
MAB-CHMINACA; ADB-CHMINACA (N-(1-amino-3,3-dimethyl-1-                30
 oxobutan-2-yl)-1-(cyclohexylmethyl)-1H-indazole-3-
 carboxamide)...........................................
MDMB-CHMICA; MMB-CHMINACA(methyl 2-(1-(cyclohexylmethyl)-             30
 1H-indole-3-carboxamido)-3,3-dimethylbutanoate)........
MDMB-FUBINACA (methyl 2-(1-(4-fluorobenzyl)-1H-indazole-              30
 3-carboxamido)-3,3-dimethylbutanoate)..................
MMB-CHMICA-(AMB-CHIMCA); Methyl-2-(1-(cyclohexylmethyl)-              25
 1H-indole-3-carboxamido)-3-methylbutanoate.............
Mesocarb................................................              30
Metodesnitazene.........................................              30
Metonitazene............................................              30
Marijuana...............................................       6,675,000
Marijuana extract.......................................       1,000,000
Mecloqualone............................................              30
Mescaline...............................................           1,200
Methaqualone............................................              60
Methcathinone...........................................              25
Methiopropamine.........................................              30
Methoxetamine...........................................              30
Methoxyacetyl fentanyl..................................              30
Methyldesorphine........................................               5
Methyldihydromorphine...................................              25
Morpheridine............................................              25
Morphine methylbromide..................................               5
Morphine methylsulfonate................................               5
Morphine-N-oxide........................................             150
MT-45...................................................              30
Myrophine...............................................              25
NM2201: Naphthalen-1-yl 1-(5-fluorpentyl)-1H-indole-3-                25
 carboxylate............................................
N,N-Dimethylamphetamine.................................              25
Naphyrone...............................................              25
N-Ethyl-1-phenylcyclohexylamine.........................              25
N-Ethyl-3-piperidyl benzilate...........................              10
N-Ethylamphetamine......................................              24
N-Ethylhexedrone........................................              25
N-Ethylpentylone, ephylone..............................              30
N-Hydroxy-3,4-methylenedioxyamphetamine.................              24
Nicocodeine.............................................              25
Nicomorphine............................................              25

[[Page 75321]]

 
N-methyl-3-piperidyl benzilate..........................              30
N-Pyrrolidino Etonitazene...............................              30
Noracymethadol..........................................              25
Norlevorphanol..........................................           2,550
Normethadone............................................              25
Normorphine.............................................              40
Norpipanone.............................................              25
Ocfentanil..............................................              25
ortho-Fluoroacryl fentanyl..............................              30
ortho-Fluorobutyryl fentanyl............................              30
Ortho-Fluorofentanyl,2-Fluorofentanyl...................              30
ortho-Fluoroisobutyryl fentanyl.........................              30
ortho-Methyl acetylfentanyl.............................              30
ortho-Methyl methoxyacetyl fentanyl.....................              30
Para-Chlorisobutyrl fentanyl............................              30
Para-flourobutyryl fentanyl.............................              25
Para-fluorofentanyl.....................................              25
para-Fluoro furanyl fentanyl............................              30
Para-Methoxybutyrl fentanyl.............................              30
Para-methoxymethamphetamine.............................              30
para-Methylfentanyl.....................................              30
Parahexyl...............................................               5
PB-22; QUPIC............................................              20
Pentedrone..............................................              25
Pentylone...............................................              25
Phenadoxone.............................................              25
Phenampromide...........................................              25
Phenomorphan............................................              25
Phenoperidine...........................................              25
Phenyl fentanyl.........................................              30
Pholcodine..............................................               5
Piritramide.............................................              25
Proheptazine............................................              25
Properidine.............................................              25
Propiram................................................              25
Protonitazene...........................................              30
Psilocybin..............................................          15,000
Psilocyn................................................          24,000
Racemoramide............................................              25
SR-18 and RCS-8 (1-Cyclohexylethyl-3-(2-                              45
 methoxyphenylacetyl)indole)............................
SR-19 and RCS-4 (1-Pentyl-3-[(4-methoxy)-benzoyl]indole)              30
Tetrahydrofuranyl fentanyl..............................              15
Thebacon................................................              25
Thiafentanil............................................              25
Thiofentanyl............................................              25
Thiofuranyl fentanyl....................................              30
THJ-2201 ( [1-(5-fluoropentyl)-1H-indazol-3-                          30
 yl](naphthalen-1-yl)methanone).........................
Tilidine................................................              25
Trimeperidine...........................................              25
UR-144 (1-pentyl-1H-indol-3-yl)(2,2,3,3-                              25
 tetramethylcyclopropyl)methanone.......................
U-47700.................................................              30
Valeryl fentanyl........................................              25
Zipeprol................................................              30
------------------------------------------------------------------------
                               Schedule II
------------------------------------------------------------------------
1-Phenylcyclohexylamine.................................              15
1-Piperidinocyclohexanecarbonitrile.....................              25
4-Anilino-N-phenethyl-4-piperidine (ANPP)...............         866,746
Alfentanil..............................................           5,000
Alphaprodine............................................              25
Amobarbital.............................................          20,100
Bezitramide.............................................              25
Carfentanil.............................................              20
Cocaine.................................................          60,492
Codeine (for conversion)................................         942,452
Codeine (for sale)......................................      19,262,957
d-amphetamine (for sale)................................      21,200,000
d,l-amphetamine.........................................      21,200,000
d-amphetamine (for conversion)..........................      20,000,000
Dexmethylphenidate (for sale)...........................       6,200,000

[[Page 75322]]

 
Dexmethylphenidate (for conversion).....................       4,200,000
Dextropropoxyphene......................................              35
Dihydrocodeine..........................................         115,227
Dihydroetorphine........................................              25
Diphenoxylate (for conversion)..........................          14,100
Diphenoxylate (for sale)................................         770,800
Ecgonine................................................          60,492
Ethylmorphine...........................................              30
Etorphine hydrochloride.................................              32
Fentanyl................................................         676,062
Glutethimide............................................              25
Hydrocodone (for conversion)............................           1,250
Hydrocodone (for sale)..................................      27,143,545
Hydromorphone...........................................       1,951,801
Isomethadone............................................              30
L-amphetamine...........................................              30
Levo-alphacetylmethadol (LAAM)..........................              25
Levomethorphan..........................................              30
Levorphanol.............................................          20,000
Lisdexamfetamine........................................      26,500,000
Meperidine..............................................         681,184
Meperidine Intermediate-A...............................              30
Meperidine Intermediate-B...............................              30
Meperidine Intermediate-C...............................              30
Metazocine..............................................              15
Methadone (for sale)....................................      25,619,700
Methadone Intermediate..................................      27,673,600
d,l-Methamphetamine.....................................             150
d-methamphetamine (for conversion)......................         485,020
d-methamphetamine (for sale)............................          47,000
l-methamphetamine.......................................         587,229
Methylphenidate (for sale)..............................      53,283,000
Methylphenidate (for conversion)........................      19,975,468
Metopon.................................................              25
Moramide-intermediate...................................              25
Morphine (for conversion)...............................       2,393,200
Morphine (for sale).....................................      20,805,957
Nabilone................................................          62,000
Norfentanyl.............................................              25
Noroxymorphone (for conversion).........................      22,044,741
Noroxymorphone (for sale)...............................           1,000
Oliceridine.............................................          25,100
Opium (powder)..........................................         250,000
Opium (tincture)........................................         530,837
Oripavine...............................................      33,010,750
Oxycodone (for conversion)..............................         437,827
Oxycodone (for sale)....................................      53,658,226
Oxymorphone (for conversion)............................      28,204,371
Oxymorphone (for sale)..................................         464,464
Pentobarbital...........................................      33,843,337
Phenazocine.............................................              25
Phencyclidine...........................................              35
Phenmetrazine...........................................              25
Phenylacetone...........................................             100
Piminodine..............................................              25
Racemethorphan..........................................               5
Racemorphan.............................................               5
Remifentanil............................................           3,000
Secobarbital............................................         172,100
Sufentanil..............................................           4,000
Tapentadol..............................................      10,390,226
Thebaine................................................      57,137,944
------------------------------------------------------------------------
                            List I Chemicals
------------------------------------------------------------------------
Ephedrine (for conversion)..............................          41,100
Ephedrine (for sale)....................................       3,933,336
Phenylpropanolamine (for conversion)....................      14,878,320
Phenylpropanolamine (for sale)..........................       7,990,000
Pseudoephedrine (for conversion)........................           1,000
Pseudoephedrine (for sale)..............................     170,360,314
------------------------------------------------------------------------


[[Page 75323]]

    The Administrator further proposes that aggregate production quotas 
for all other schedule I and II controlled substances included in 21 
CFR 1308.11 and 1308.12 remain at zero.
    These proposed 2024 quotas reflect the quantities that DEA believes 
are necessary to meet the estimated medical, scientific, research, and 
industrial needs of the United States, lawful export requirements; and 
the establishment and maintenance of reserve stocks. DEA remains 
committed to conducting continuous surveillance on the supply of 
schedule II controlled substances and list I chemicals necessary to 
treat patients with COVID-19, and, pursuant to her authority, the 
Administrator will move swiftly and decisively to increase any 2024 APQ 
that she determines is necessary to address an unforeseen increase in 
demand, should that occur.
    In accordance with 21 CFR 1303.13 and 1315.13, upon consideration 
of the relevant factors, the Administrator may adjust the 2024 APQ and 
AAN as needed.

Conclusion

    After consideration of any comments or objections, or after a 
hearing, if one is held, the Administrator will issue and publish in 
the Federal Register a final order establishing the 2024 APQ for 
controlled substances in schedules I and II and establishing an AAN for 
the list I chemicals ephedrine, pseudoephedrine, and 
phenylpropanolamine, as directed by 21 CFR 1303.11(c) and 1315.11(f).

Signing Authority

    This document of the Drug Enforcement Administration was signed on 
October 30, 2023, by Administrator Anne Milgram. That document with the 
original signature and date is maintained by DEA. For administrative 
purposes only, and in compliance with requirements of the Office of the 
Federal Register, the undersigned DEA Federal Register Liaison Officer 
has been authorized to sign and submit the document in electronic 
format for publication, as an official document of DEA. This 
administrative process in no way alters the legal effect of this 
document upon publication in the Federal Register.

Scott Brinks,
Federal Register Liaison Officer, Drug Enforcement Administration.
[FR Doc. 2023-24282 Filed 11-1-23; 8:45 am]
BILLING CODE P
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