Amid an outbreak of dangerous infections by pain drug abusers, the U.S. Food and Drug Administration has asked Endo International Plc to stop sales of its powerful opioid painkiller Opana ER, the first time the agency has taken such a step.

While the drug was approved by the FDA for legitimate pain relief, it’s become a favorite of addicts. After Endo reformulated the drug to try and reduce its potential for abuse, many drug users went from crushing and snorting the pill to injecting it. That led to “a serious outbreak of HIV and hepatitis C,” the FDA said in a statement.

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