AMA: U.S. Making Progress in Reversing Opioid Epidemic

U.S. physician leadership is cautiously optimistic about reversing the country’s opioid epidemic, according to a new report published by the American Medical Association (AMA).

The AMA reports that opioid prescribing continues to decrease while the use of state prescription drug monitoring programs (PDMPs) is on the rise. In addition more physicians are also now trained and certified to treat patients with an opioid use disorder. They are also prescribing Naloxone, a drug that can reverse the effect of an opioid overdose, more frequently.

“While this progress report shows physician leadership and action to help reverse the epidemic, such progress is tempered by the fact that every day, more than 115 people in the U.S. die from an opioid-related overdose,” said Patrice A. Harris, M.D., M.A., chair of the AMA Opioid Task Force.

“What is needed now is a concerted effort to greatly expand access to high quality care for pain and for substance use disorders. Unless and until we do that, this epidemic will not end.”

The main findings of the report were:

• Opioid prescribing decreased for the fifth year in a row. Between 2013 and 2017, the number of opioid prescriptions nationally decreased by more than 55 million.
• PDMP registration and use continues to increase, even in states that don’t have a mandate to use it. In 2017, U.S. healthcare professionals accessed state databases more than 300.4 million times, an increase of 121% from 2016.
• As of April, 2018, 11,600 Naloxone prescriptions are dispensed weekly, the highest rate on record so far.
• As of May 2018, more than 50,000 physicians nationwide were certified to provide buprenorphine in office for the treatment of opioid use disorders, which is a 42.4% increase in the last year.

“We encourage policymakers to take a hard look at why patients continue to encounter barriers to accessing high quality care for pain and for substance use disorders,” Harris said.

“This report underscores that while progress is being made in some areas, our patients need help to overcome barriers to multimodal, multidisciplinary pain care, including non-opioid pain care, as well as relief from harmful policies such as prior authorization and step therapy that delay and deny evidence-based care for opioid use disorder.”

As the U.S. Department of Health and Human Services Pain Management Best Practices Inter-Agency Task Force meets for the first time, the AMA calls on policymakers and insurers to remove barriers to care for pain and substance use disorders.

The AMA recommends that:

• All public and private payers ensure that their formularies include all Federal Drug Administration-approved forms of medication-assisted treatment (MAT) and remove administrative barriers to treatment, including prior authorization.
• Policymakers and regulators increase oversight and enforcement of parity laws for mental health and substance use disorders to ensure patients receive the care that they need.
• All public and private payers—as well as pharmacy benefit management companies—ensure that patients have access to affordable, non-opioid pain care.

For resources on pain management and substance use disorders, visit the AMA opioid microsite, www.end-opioid-epidemic.org.