The AMA Opioid Task Force issued a 2018 progress report(www.end-opioid-epidemic.org) on May 31 that highlighted a continuing 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 naloxone.
The AMA launched the task force in 2014 to identify best practices for combatting opioid abuse and to swiftly implement those practices in medical offices and other health care facilities across the United States. The AAFP is one of 27 physician organizations that form the task force.
"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(www.drugabuse.gov) in the United States die from an opioid-related overdose," said Patrice Harris, M.D., M.A., chair of the AMA Opioid Task Force, in a news release.(www.ama-assn.org) "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."
Among the progress report's positive findings are that physicians and other health care professionals have reduced opioid prescribing nationwide for the fifth year in a row. Between 2013 and 2017, opioid prescriptions dropped by more than 55 million -- a more than 22 percent decrease nationally. All 50 states have seen declines in opioid prescribing during the past five years.
- The AMA Opioid Task Force -- which includes AAFP representation -- issued a progress report on May 31 that found, among other things, a decrease in opioid prescribing for the fifth year in a row.
- The report noted that last year, U.S. health care professionals accessed state prescription drug monitoring programs more than 300.4 million times -- a 121 percent increase from 2016.
- According to statistics cited in the report, naloxone prescriptions more than doubled in 2017-- from 3,500 to 8,000 prescriptions dispensed weekly -- and reached a record high of 11,600 dispensed between January 2018 and April 2018 alone.
In other encouraging news, PDMP registration and use continues to increase. Last year, U.S. health care professionals accessed state databases more than 300.4 million times -- a 121 percent increase from 2016. Sizeable increases were seen in both states with and without mandates to use PDMP. More than 1.5 million physicians and other health care professionals are registered in state-based PDMPs, with 241,000 signing up between 2016 and 2017 alone.
Additionally, physicians continue to seek education on opioids; nearly 550,000 physicians and other health care professionals have completed CME or similar training in pain management, substance use disorders and related areas, the report noted.
Various educational and other resources can be accessed from the AAFP's online information hub on pain management and opioid abuse, as well as from the AMA's opioid microsite(www.end-opioid-epidemic.org).
And there's more good news: Access to naloxone is increasing. According to the progress report, naloxone prescriptions more than doubled in 2017, from about 3,500 to 8,000 prescriptions dispensed weekly. And from the beginning of 2018 through April, that trend has continued, with 11,600 naloxone prescriptions filled each week -- the highest rate on record.
Finally, the task force noted that treatment capacity is increasing. As of May 2018, more than 50,000 physicians were certified to provide buprenorphine in the office setting to treat opioid use disorders -- an increase of more than 42 percent in just the past 12 months.
To help physicians fight the opioid epidemic, the progress report called for policymakers and insurers to remove barriers to caring for patients with pain, as well as for those with substance use disorders.
Specifically, said the task force, this includes a need for
- all public and private payers to ensure that their formularies include all FDA-approved forms of medication-assisted treatment and to remove administrative barriers to treatment, such as prior authorization;
- policymakers and regulators to increase oversight and enforcement of parity laws intended to guarantee appropriate care for patients with mental health and/or substance use disorders;
- all public and private payers -- as well as pharmacy benefit management companies -- to ensure that patients have access to affordable, nonopioid pain care options; and
- all stakeholders to work toward ending the stigma associated with pain management and substance use disorders.
"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 in the release.
"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."
Related AAFP News Coverage
Study Finds 22 Percent Decrease in Opioid Prescriptions
AAFP/AMA Release Medication-assisted Treatment Advocacy Resource