Illicit online sales of addictive substances are filling the gap created by successful efforts to reduce legal opioid prescriptions, FDA Commissioner Scott Gottlieb said last week at an agency-hosted summit on reducing the availability of illicit opioids online.

In many cases, drugs sold online are particularly dangerous pressed forms of fentanyl, leading to an increase in overdoses even as prescribing plummets, according to Gottlieb. 

To deal with the crisis, the agency is focused on three main areas:  reducing exposure, encouraging the use of less addictive drugs and increasing enforcement.

“We have been one step behind this crisis and we don’t want to be caught here again,” Gottlieb said.