The American Medical Association, or AMA, recently released its “2021 Overdose Epidemic Report.” The report states that prescriptions for opioids dropped by almost seven percent between 2019 and 2020, with a nationwide decrease of nearly 45 percent over the past ten years. 

The State of the Opioid Epidemic 

Much of the progress made in reducing the number of opioid prescriptions in the United States can be traced to two task forces assembled by the AMA between 2014 and 2019. The task forces resulted in several actionable and measurable recommendations and guidelines to help fight the epidemic of opioid-related overdoses and deaths. 

The groups’ suggestions and principles have guided state and federal lawmakers, physicians, and other stakeholders to make measurable progress in several areas and led to policy-making decisions based on sound medical knowledge. For example, the AMA report shows that the changes and efforts have dramatically reduced the number of opioid prescriptions in all 50 states for the tenth consecutive year. 

Physicians and other clinicians have also dramatically increased the use of prescription drug monitoring programs, or PDMPs, in all 50 states for the past five years. In fact, according to the AMAs report, the use of PDMPs in 2020 increased to over 910 million times. This is a jump of about 21 percent from the 750 million times doctors and other professionals used PDMPs in 2019 and an increase of almost 1400 percent from the 61 million times they were used in 2014. 

In addition to the significant drop in opioid prescriptions and better monitoring, the AMA also found a substantial increase in the number of health care professionals certified to prescribe buprenorphine, a drug used to treat addiction disorders. Over 106,000 physicians and other health care professionals were authorized to prescribe buprenorphine through their office in 2020, compared to in 2017’s less than 40,000. 

Coordinated efforts have produced great strides in reducing the number of prescriptions written for opioids and the availability of evidence-based treatment. Still, the nation’s scourge of drug-related overdoses and deaths has not only continued but worsened and changed. Despite reducing opioid prescriptions and increased monitoring efforts, drug-related overdoses and deaths are higher than ever. 

While the availability of treatment has increased, millions of people with a substance abuse disorder still don’t get the evidence-based care they need. Statistics show that, while the number of overdoses and deaths from drugs has continued to rise over the past three years, there has only been a slight increase in prescriptions for buprenorphine.  

Additionally, data shows that prescriptions for naloxone, a life-saving drug used to treat narcotic overdose, increased only a small amount over the past three years. Naloxone is a proven effective emergency treatment for a narcotics overdose, with more than 3.7 million doses of the drug distributed by harm reduction and community-based organizations between 2017 and 2020. 

The Significance of the AMA Report 

The AMA’s 2021 Overdose Epidemic Report emphasizes several realities of the nation’s drug overdose and death epidemic. First, the current epidemic has evolved and, as data from the Centers for Disease Control and Prevention shows, is now being fueled by cocaine, methamphetamine, illicit fentanyl, and fentanyl analogs. Second, while the control of prescription opioids is an integral part of controlling the drug epidemic, there are other factors involved.  

Physicians from all disciplines have learned to be more cautious when prescribing opioids. Additionally, more practitioners and health care workers at all levels have been trained to recognize and treat opioid use disorder with evidence-based harm-reduction strategies. The increased use of monitoring tools such as PDMPs makes a huge difference, but reducing prescriptions and monitoring use is not a cure for the drug overdose and death epidemic. 

Data from the AMAs report suggests that the key to ending the nation’s drug-related overdose and death epidemic lies in partnership and collaboration. Patients need a commitment from policymakers, health insurance providers, national pharmacy chains, and other stakeholders to provide evidence-based treatment. In addition, implementing meaningful changes that promote individualized patient care decision-making will improve care for patients with pain, mental illness, or substance abuse disorder, reducing mortality rates and improving outcomes. 

American Medical Association Recommendations 

The AMA recommends several steps that physicians, lawmakers, and stakeholders should implement immediately to end the overdose epidemic: 

• Allow the federal telehealth program to prescribe buprenorphine to patients at home. 
• Decriminalize drug checking supplies and provide better support for harm reduction services, such as needle and syringe exchanges and access to naloxone. While these harm reduction services are often criticized and stigmatized, they have proven effective harm reduction strategies that save lives. 
• Stop the need for prior authorization for the treatment of an opioid-use disorder. 
• Remove or revise the Centers for Disease Control and Prevention’s arbitrary threshold set in its 2016 opioid prescribing guidelines and restore compassionate care for patients with pain. 
• Ensure that funds received from opioid litigation settlements are used solely for public health purposes. 
• Secure the removal of structural inequities that create barriers in care for historically marginalized and minority communities. 
• Ensure that all patients have access to evidence-based care, including opioid therapy for patients with pain when indicated. 
• Collect sufficient patient data to properly identify, treat, and provide services to at-risk populations and better understand the needs of the community 

According to President of the AMA, Gerald E. Harmon, MD, “To make meaningful progress towards ending this epidemic, a broad-based public health approach is required.” Dr. Harmon and the AMA  

believe that national efforts to end the drug overdose and death epidemic must change focus. Until a shift is made and further action is taken, Harmon said, we are doing a great injustice to our patients with pain, those with a mental illness, and those with a substance use disorder.” 

The AMA firmly believes that this shift in approach must consider the many patients that have a legitimate need for comprehensive pain management services that include: 

• Access to non-opioid pain care, including opioid analgesics, when clinically appropriate 
• Reasonable efforts to promote appropriate prescribing and reduce diversion or misuse 
• Promote the belief that substance abuse disorders are chronic ailments that respond well to evidence-based treatment 
• Expand access to treatment for individuals with substance abuse disorders 

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How the American Medical Association is Fighting the Drug Overdose and Death Epidemic 

The AMA has been leading the fight against the drug overdose and death epidemic for years. The 2021 Overdose Epidemic Report highlights how the organization has worked with policymakers, health care professionals, and other stakeholders in the fight against the drug overdose epidemic from 2020 to 2021. 

One of their initiatives is the frequent publication of national, state, and local news and reports. The AMA briefs help keep involved parties and the public aware of current trends and issues affecting the drug overdose epidemic. 

The AMA joined with many state and local organizations to help enact dozens of laws and regulations that improve patient access to medications used to treat opioid abuse disorder. For example, the AMA worked with the medical community and patient advocates in Oklahoma and Colorado to pass legislation removing barriers to evidence-based care for patients with pain, including opioid therapy and non-opioid pain treatments. Collaboration also helped enact legislation decriminalizing drug checking supplies and enabled the Rhode Island Medical Society to sanction a pilot program for the nation’s first harm reduction center. 

A collaboration with the Johns Hopkins School of Public Health and over 50 national leaders from a dozen states led to legislation ensuring a commitment that funds from opioid litigation will primarily address public health issues. The AMA also joined forces with Manatt Health to publish a comprehensive guide for political and bureaucratic officials with measurable actions to increase patient access to evidence-based care. 

The AMA worked with the U.S. Drug Enforcement Administration and the Milken Institute to provide employers with recommendations for increasing access to evidence-based care for pain, substance abuse disorder, and harm reduction services. 

Along with the nonpartisan and objective research organization, NORC at the University of Chicago, the AMA performed an in-depth analysis of electronic health records. The study identified gaps in states’ overdose reporting systems and urged steps to develop a nationally standardized reporting system. Better reporting and tracking of key metrics related to drug use, such as fatal and non-fatal overdoses, will help move the nation’s answer to the drug epidemic from crisis response to a framework based on public health needs. 

The Procentive Solution 

The recent AMA report makes it clear that while many factors are affecting the evolution of the drug overdose and death epidemic. Research shows that Electronic Health Records are a critical element of reducing the mortality associated with the drug epidemic and identifying and treating at-risk patients.  

At Procentive, we offer clients award-winning EHR solutions that enable you to manage clients better and ensure your compliance with EHR requirements. We provide solutions for providers of all sizes that can optimize your practice and the care you provide with powerful tools, including clinical charting and scheduling modules. Contact us today to schedule a free demo and learn how our solutions can benefit your organization.