Not all parts of the federal government agree on how to approach the issue of prescription painkiller abuse, according to the Associated Press.

The White House, Drug Enforcement Administration (DEA) and Centers for Disease Control and Prevention (CDC) are focusing on prescription drug abuse as an epidemic that needs to be stopped, while the Food and Drug Administration (FDA) wants to keep opioids accessible to people with chronic pain.

FDA Commissioner Margaret Hamburg told the AP that while opioids are overprescribed, they are also needed by the estimated 100 million Americans suffering with chronic pain. “I think we have an important balancing act of trying to assure that safe and effective drugs are available for patients who have real pain and need medical care,” she said.

According to the CDC, there was a four-fold increase in opioid sales between 1999 and 2010. During that period, opioid overdose deaths more than tripled. CDC officials have called for more limited prescribing of the drugs, the article notes. “These are dangerous medications and they should be reserved for situations like severe cancer pain where they can provide extremely important and essential palliation,” said CDC Director Tom Frieden. “In many other situations, the risks far outweigh the benefits.”

DEA officials say an oversupply of prescription painkillers is fueling the black market for the drugs and for heroin. DEA Deputy Assistant Administrator Joe Rannazzisi says the U.S. consumes 99 percent of the world’s hydrocodone, which is the most prescribed medicine in the country. “A controlled substance shouldn’t be the most widely prescribed medication in the United States,” he said. “If we believe we’re the only country that knows how to treat pain that’s a pretty arrogant attitude.”

In October, the FDA recommended tighter restrictions for products containing hydrocodone and other painkillers such as acetaminophen or aspirin. These combination products include Vicodin and Lortab.