August 30, 2026

What happens when the FDA finally gets the opioid data everyone claimed to want—and the results don’t support the story they’ve been selling for more than a decade? Episode 62 digs into the FDA-mandated opioid Postmarketing Requirement studies, the May 2025 FDA meeting, and the extraordinary gap between OUD rates produced by raw DSM-5 criteria and a pain-adjusted tool designed to distinguish addiction from the predictable realities of chronic pain and long-term prescribed opioid therapy. We trace PROP’s influence from its 2012 FDA petition forward, examine the policy advocates and paid opioid-litigation experts helping shape the narrative, and ask the question no one seems eager to answer: if stable patients taking medication exactly as prescribed can be labeled as having opioid use disorder, are we measuring addiction—or manufacturing it on paper?