In December 2017, in a letter to Food and Drugs Administration Commissioner Scott Gottlieb, Manchin called for changes in the FDA's response to the opioid crisis including mandatory and continuing education for healthcare providers, reviewing every opioid product on the market, and removing an older opioid from the market for every new opioid approved. Manchin cited the over 33,000 deaths in the United States from opioid overdoses in 2015 and over 700 deaths of West Virginians from opioid overdoses in 2016 as his reason for supporting the establishment of the Opioid Policy Steering Committee by the FDA.