The FDA knew that doctors were wrongly prescribing opioid mouth sprays and lozenges (TIRFs) meant to provide immediate relief for breakthrough cancer pain in patients who have been taking opioids for long periods of time. TIRFs can kill patients who take them without having first developed tolerance. But they were prescribed to patients who had no tolerance, and for migraines or dental pain, a team at the Johns Hopkins said. The US is suffering an epidemic of opioid abuse. Opioids killed 42,000 people in 2016. The CDC reported last year, the number of prescriptions for the painkillers tripled from 1999 to 2015. “FDA had evidence as early as April 2016 that TIRFs were being prescribed for many patients who were not opioid tolerant,”, as many as 51 percent were not opioid tolerant.” A recent CNN report titled, 'The more opioids doctors prescribe, the more money they make'