A Texas Solution to Artificial Drug Shortages
How State Sovereignty Can Protect Chronic Pain Patients
by James Scott Trimm
Across the United States, millions of chronic pain patients are facing a problem that has nothing to do with medicine and everything to do with government policy: artificial drug shortages.
These shortages are not caused by a lack of medical knowledge or an inability to manufacture medication. In many cases, they are the result of federal manufacturing quotas imposed by the Drug Enforcement Administration (DEA) on medications that are already approved as safe and effective by the Food and Drug Administration (FDA).
Patients suffer. Doctors are constrained. Pharmacies run out of medication.
And all of it happens because a federal agency has decided to limit how much medicine can legally be produced.
In Texas, it is time to ask a simple question:
Why should Texans be forced to suffer because of federal manufacturing quotas?
Beyond the immediate medical consequences, these federal manufacturing quotas raise a broader question about economic freedom and state sovereignty. Texas has long embraced the principles of free enterprise, open markets, and the ability of businesses to respond to legitimate demand. Yet under the current federal quota system, pharmaceutical manufacturers are prevented from responding to real medical needs simply because a federal agency has predetermined how much medication may exist in the marketplace.
This situation creates an artificial scarcity that harms patients while simultaneously preventing businesses from meeting demand. In a free market system, shortages invite increased production. Under the federal quota system, however, shortages simply persist.
For a state like Texas, which has built its economic success on the belief that markets work best when supply can respond to demand, this situation presents both a challenge and an opportunity.
For years, chronic pain patients and physicians have warned about what many now call “Operation Bottleneck.”
Under current federal policy, the DEA establishes annual manufacturing quotas for certain medications, particularly opioid-based pain treatments. These quotas determine how much of a drug can legally be produced in the United States.
Even if there is legitimate medical demand.
Even if doctors prescribe responsibly.
Even if patients have documented medical need.
Once the quota is reached, manufacturers cannot legally produce more of the medication.
The result is predictable:
- Pharmacies cannot obtain medication.
- Doctors are forced to alter stable treatment plans.
- Patients experience uncontrolled pain or forced withdrawal.
In other words, federal policy has created a government-imposed bottleneck in the medical supply chain.
What makes this situation particularly troubling is that the medications affected by these quotas are not experimental or untested. They are medications that have already undergone extensive safety and efficacy review by the FDA and have been used responsibly for years in the treatment of legitimate medical conditions.
Yet the federal quota system treats supply as a law-enforcement variable rather than a medical one. Instead of allowing supply to respond to legitimate demand within the healthcare system, production is artificially limited at the national level.
For patients living with severe chronic pain, the consequences of these policies are not abstract. They are immediate and deeply personal.
Texas has already explored similar constitutional ideas before.
In 2021, Texas passed legislation asserting that firearm suppressors manufactured and retained entirely within Texas are not subject to federal regulation under the interstate commerce power.
The legal theory was straightforward:
If something is manufactured in Texas and never enters interstate commerce, then it falls within the sovereign regulatory authority of the State of Texas.
Whether courts ultimately accept that argument or not, the law established an important principle:
Texas does not have to help enforce federal policies that harm Texans.
That idea inspired a new proposal.
Texas has often led the nation in developing innovative policy solutions that respect both constitutional federalism and economic opportunity. By examining how intrastate commerce principles could be applied to pharmaceutical manufacturing, Texas has the opportunity to address a pressing healthcare problem while also reinforcing its commitment to free markets and economic growth.
P.A.R.T. Texas — Pain Awareness Right to Treatment — has written a proposed bill that applies this same concept to the medical supply chain.
The legislation would allow FDA-approved medications to be manufactured entirely within Texas for use only within Texas.
This proposal does not attempt to bypass FDA safety approval.
The medications involved would already be approved by the FDA as safe and effective.
The issue is not safety.
The issue is federal manufacturing limits imposed by the DEA that artificially restrict supply.
Under the proposal:
- Texas manufacturers could produce FDA-approved medications within the state.
- Those medications would remain entirely inside Texas.
- They would be clearly labeled “Made in Texas — Intrastate Use Only.”
In other words, Texas would ensure that necessary medications can be manufactured to meet legitimate patient demand within the state.
In addition to addressing the supply problem directly, the legislation would also create a more stable regulatory environment for pharmaceutical manufacturers operating in Texas. Companies seeking to produce medications that are already FDA-approved would have the opportunity to expand operations within the state without being constrained by national quota systems that do not reflect local medical demand.
for Texas
The potential benefits of this policy extend well beyond healthcare.
Encouraging pharmaceutical manufacturing within Texas could attract significant investment in new manufacturing facilities, research operations, and distribution infrastructure. Pharmaceutical production is a high-skilled, high-value sector that creates well-paying jobs and stimulates broader economic growth in surrounding communities.
Texas has long demonstrated that when businesses are given the freedom to operate within a stable regulatory environment, investment follows. The state has become a national leader in industries ranging from energy and technology to aerospace and advanced manufacturing.
By allowing intrastate pharmaceutical manufacturing, Texas could position itself as a leader in another critical sector of the modern economy.
Instead of allowing federal quotas to suppress supply, Texas could encourage companies to expand production capacity where legitimate demand exists. This would strengthen the state’s economy while simultaneously addressing a pressing healthcare need.
Return to Work
The economic benefits of improved access to pain treatment extend beyond manufacturing.
Millions of Americans living with chronic pain are not unwilling to work. Many are unable to work because their medical conditions are not adequately treated.
When patients lose access to effective treatment, the consequences ripple outward. Workers leave the workforce. Families lose income. Disability claims increase. Employers lose experienced employees whose skills and knowledge are difficult to replace.
Improving access to legitimate medical treatment can help some Texans regain stability and independence. For many patients, effective pain management can mean the difference between permanent disability and the ability to participate in the workforce again.
In this way, policies that restore access to necessary medications can also strengthen the broader economy by enabling more citizens to contribute productively to their communities.
The proposed legislation also includes a key constitutional mechanism: state non-cooperation.
Texas agencies, employees, and political subdivisions would be prohibited from assisting federal enforcement actions that conflict with the intrastate pharmaceutical system established by the bill.
This reflects the long-recognized anti-commandeering principle of American constitutional law:
The federal government may enforce its own laws, but it cannot require states to enforce them.
Texas therefore has the authority to say:
Texas will regulate the medical care of its own citizens.
and Patients
The bill also includes a powerful protection mechanism.
It requires the Texas Attorney General to defend:
- Texas pharmaceutical manufacturers
- prescribing physicians
- pharmacists and dispensers
- insurers complying with Texas law
- Texas residents acting within the law
against federal enforcement actions that attempt to interfere with the state’s intrastate pharmaceutical system.
The Attorney General would be authorized to:
- seek injunctions and declaratory relief
- intervene in federal court proceedings
- provide legal representation
- fund legal defense where appropriate
In other words, Texans acting in compliance with Texas law to provide legitimate medical care would not be left alone to face federal litigation.
The State of Texas itself would stand behind them.
At its core, this proposal reflects principles long embraced in Texas:
- limited government
- free markets
- respect for the doctor-patient relationship
- compassion for those who suffer
Artificial manufacturing quotas imposed by a federal agency violate all four.
If a medication has already been approved by the FDA and there is legitimate medical demand for it, there should be no bureaucratic bottleneck preventing its production.
Allowing manufacturers to respond to demand is not only good medicine; it is also consistent with the economic principles that have helped make Texas one of the most dynamic economies in the United States.
According to federal public health data:
- More than 50 million Americans live with chronic pain.
- Millions experience severe, life-limiting pain.
These are not abstract numbers.
They are our neighbors.
Our family members.
Our friends.
Many simply want to live with dignity and manage their medical conditions under the care of their doctors.
They should not be collateral damage in a federal quota system.
Texas has never been a state that waits for Washington to solve its problems.
When federal policies harm Texans, the state has both the authority and the responsibility to act.
The legislation written by P.A.R.T. Texas offers one possible path forward — restoring access to necessary medications while defending the rights of doctors and patients.
Sometimes the solution is straightforward.
If a medication is:
- approved for medical use
- manufactured in Texas
- prescribed by Texas physicians
- dispensed by Texas pharmacies
- and used by Texas patients
then Texans should not be denied access because of a federal manufacturing quota.
Texas can — and should — ensure that the medical needs of its citizens come first.
Texas has often served as a proving ground for policies that later spread across the nation. When a state identifies a problem that harms its citizens and develops a lawful and principled solution, that solution does not need to stop at its borders.
The legislation proposed by P.A.R.T. Texas is designed first and foremost to protect Texans suffering from chronic pain and other serious medical conditions. However, the underlying principle is not unique to Texas.
Every state has citizens who depend on medically necessary medications.
Every state has physicians trying to care for their patients responsibly.
And every state is affected by federal manufacturing quotas that can restrict the supply of medications regardless of legitimate medical demand.
If Texas demonstrates that an intrastate pharmaceutical manufacturing system can restore access to necessary medications while maintaining safety standards and respecting the doctor-patient relationship, there is no reason other states cannot adopt similar policies.
Federal systems often change only after the states lead the way.
Texas has the opportunity to start that process.
If this approach proves successful, other states may choose to enact their own intrastate pharmaceutical manufacturing laws, creating a broader movement to ensure that Americans suffering from chronic pain and other serious conditions are not denied treatment because of artificial supply limits.
Texas can lead.
Others can follow.
And together, the states can help restore a medical system that puts patients first.
You can help this work by donating to P.A.R.T. Texas by donating here:
https://parttexas.com/donations/fundraising-campaign/
Disclosure: The author serves as President of P.A.R.T. Texas, a 501(c)(4) nonprofit organization advocating for the rights of chronic pain patients and the physicians who treat them. He has been involved in conservative political activism in Texas for more than forty years and previously served as a legislative staffer.
You can view the actual bill here:
https://parttexas.com/wp-content/uploads/2026/03/Break-the-Bottleneck-Act.pdf






