Opioid Epidemic Turning Around, AMA Says

Megan Brooks

June 08, 2018

Leadership and action by US physicians is helping reverse the opioid epidemic, according to a new report from the American Medical Association (AMA).

The report  shows a decrease in opioid prescribing and increases in the use of state prescription drug monitoring programs (PDMPs), the number of physicians trained and certified to treat patients with an opioid use disorder, and overall access to opioid reversal agent naloxone.

"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 United States die from an opioid-related overdose," Patrice A. Harris, MD, chair of the AMA Opioid Task Force, said in a statement.

"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," said Harris.

The reports main findings include the following:

  • Opioid prescribing decreased for fifth year in a row. Between 2013 and 2017, the number of opioid prescriptions fell by more than 55 million, a 22% decrease nationally. Decreases occurred in every state.

  • PDMP registration and use continued to increase, even in states without mandates to use it. In 2017, healthcare providers around the country accessed state databases more than 300.4 million times, an increase of 121% from 2016.

  • Physicians are enhancing their education. In 2017, nearly 550,000 physicians and other healthcare professionals took CME classes and other education and training in pain management, substance use disorders, and related areas.

  • Access to naloxone is growing. In 2017, naloxone prescriptions more than doubled, from about 3500 to 8000 naloxone prescriptions dispensed weekly. That upward trend has continued in 2018. As of April, 11,600 naloxone prescriptions are dispensed weekly, the highest rate on record.

  • Treatment capacity is increasing. As of May 2018, more than 50,000 physicians in the United States were certified to provide buprenorphine in office for the treatment of opioid use disorders, a 42% increase in the past year.

Additional Priorities

"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," said Harris.

"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 nonopioid 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," Harris added.

To further combat the opioid epidemic, the AMA is calling for all public and private payers to make sure their formularies include all US Food and Drug Administration (FDA)-approved forms of medication assisted treatment and remove administrative barriers to treatment, including prior authorization.

They encourage policymakers and regulators to increase oversight and enforcement of parity laws for mental health and substance use disorders to ensure patients receive the care that they need.

The AMA also asks public and private payers, as well as pharmacy benefit management companies, ensure that patients have access to affordable, nonopioid pain care.

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