AMA report shows increase in overdoses despite decreased opioid prescribing
The AMA released a report that showed a 44.4% decrease in opioid prescribing in the U.S. in the past 10 years, despite the country experiencing significant increases in drug-related overdoses and deaths.
“The nation’s drug overdose and death epidemic has never just been about prescription opioids,” AMA President Gerald E. Harmon, MD, said in a press release. “Physicians have become more cautious about prescribing opioids, are trained to treat opioid use disorder and support evidence-based harm reduction strategies. We use [prescription drug monitoring programs] as a tool, but they are not a panacea.”
Harmon said patients need policymakers, health insurance plans, national pharmacy chains and other stakeholders to shift focus and help physicians remove barriers to evidence-based care.
According to the release, physicians and others utilized state prescription drug monitoring programs more than 910 million times in 2020 and approximately 750 million times in 2019. However, the U.S. has continued to experience more overdoses, largely because of illicit fentanyl, fentanyl analogs, methamphetamine and cocaine, per CDC data.
The AMA compiled state public health, media and other reports and found that drug-related overdose and death have worsened across the country. NIH, U.S. Substance Abuse and Mental Health Services Administration, and Indian Health Service data highlighted the ongoing challenges and inequities for Black, Latino and American Indian/Native Alaskan populations.
In addition to the decreases of 44.4% between 2011 and 2020 and 6.9% between 2019 and 2020 in opioid prescriptions, as well as the increases in prescription drug monitoring programs, the report also showed that more than 104,000 physicians and other health care professionals had an “X-waiver” permitting them to prescribe buprenorphine as an opioid use disorder treatment. This latter number marked an increase of 70,000 providers since 2017; however, 80% to 90% of individuals with a substance use disorder receive no treatment.
The AMA urged policymakers to do the following:
- stop prior authorizations for opioid use disorder medications;
- ensure access to affordable, evidence-based care for patients with pain;
- help support harm reduction services, including naloxone and needle and syringe exchange services; and
- collect adequate, standardized data to identify and treat at-risk populations and gain a deeper understanding of problems facing communities.
“With record-breaking numbers of overdose deaths across the country, these are actions policymakers and other stakeholders must take,” Harmon said. “The medical community will continue to play its part, and, overall, the focus of our national efforts must shift. Until further action is taken, we are doing a great injustice to our patients with pain, those with a mental illness and those with a substance use disorder.”