The American Medical Association (AMA) Opioid Task Force issued a report documenting physician-driven initiatives to advance the fight against the opioid epidemic in the United States, progress to date, and recommendations to continue to help reverse the epidemic. ASCO has been an active member of the AMA Opioid Task Force since 2017.
The report found that since 2013, there has been a decrease in opioid prescribing, and during the same time period, there have been increases in the use of state prescription drug monitoring programs (PDMPs), number of physicians trained and certified to treat patients with an opioid use disorder, and in access to naloxone. Specifically:
- Opioid prescribing decreases for fifth year in a row. Between 2013 and 2017, the number of opioid prescriptions decreased by more than 55 million — a 22.2 percent decrease nationally.
- PDMP registration and use continues to increase. In 2017, health care professionals nationwide accessed state databases more than 300.4 million times – a 121-percent increase from 2016. States with and without mandates to use the PDMP saw large increases.
- Physicians enhancing their education. In 2017, nearly 550,000 physicians and other health care professionals took continuing medical education classes and other education and training in pain management, substance use disorders and related areas. Many of these resources are offered by the AMA, state, and specialty societies, and more than 350 of these resources can be found on the AMA opioid microsite, www.end-opioid-epidemic.org.
- Access to naloxone rising. Naloxone prescriptions more than doubled in 2017, from approximately 3,500 to 8,000 naloxone prescriptions dispensed weekly. That upward trend has continued as of April 2018, with 11,600 naloxone prescriptions dispensed weekly - the highest rate on record.
To further address the opioid epidemic, the task force urges policymakers and health insurers to remove barriers to care for pain and substance use disorders. These steps include:
- All public and private payers should ensure that their formularies include all Food and Drug Administration (FDA)-approved forms of medication assisted treatment (MAT) and remove administrative barriers to treatment, including prior authorization.
- Policymakers and regulators should increase oversight and enforcement of parity laws for mental health and substance use disorders to ensure patients receive the care they need.
- All public and private payers—as well as pharmacy benefit management companies—must ensure that patients have access to affordable, non-opioid pain care.
The report also emphasizes the need to de-stigmatize substance use disorders and states that patients with pain or substance use disorders deserve the same care and compassion as any other patient with a chronic medical condition.