As America’s opioid epidemic continues to impact communities large and small, new trends are raising new challenges for doctors and policymakers.
While opioid-related overdose remains a top concern, the epidemic now is driven by illicitly manufactured fentanyl, heroin, cocaine, and methamphetamine. In 2017, more than 70,000 people died from drug-related overdoses, according to the U.S. Centers for Disease Control and Prevention, primarily from illegal drugs. That included 928 deaths in Arizona, of which 174 were in Pima County.
Since its founding in 2014, the American Medical Association Opioid Task Force has sought ways that practicing physicians can play a role in ending the epidemic. The task force recommendations include urging physicians to enhance their own education and advocate for comprehensive care for patients in pain, and for those with a substance use disorder.
Thanks in part to these efforts, more than 700,000 physicians and other health care providers took opioid-related courses in 2018. Between 2013 and 2018, the number of opioid prescriptions decreased by more than 80 million — a 33 percent decrease nationally — with every state individually decreasing opioid prescriptions over the past five years.
When it comes to helping patients with substance use disorder lead satisfying, productive lives, the science shows what works: medication prescribed by a physician or dispensed at special opioid treatment centers, combined with behavioral counseling and other services.
Despite certain positive trends and clear science, of the 20.3 million people nationwide with a substance use disorder, 90 percent receive no treatment, according to federal officials.
“The opioid crisis today is a national tragedy that requires the same resolve we muster for other public health epidemics. Those with substance use disorders deserve no less,” says AMA President Patrice A. Harris, M.D. M.A. “Most people agree we need access to treatments that include medication. Unfortunately, that’s not readily available for many patients, and this epidemic will not be reversed until we deal with access issues and stigma associated with opioid misuse.”
The AMA stresses that while doctors are leading in areas where they can have an influence, they cannot end the epidemic alone. To combat the issue at the state and national level, the organization issued a national “roadmap” to policymakers focused on specific actions:
• Patients and physicians should have conversations about safe storage and disposal of opioids and all medications.
The Drug Enforcement Agency holds semi-annual national takeback days in April and October. Unused, unwanted, and expired drugs may be properly disposed of Saturday, Oct. 26 in Tucson from 10 a.m. at Tucson police and sheriff departments, and many Fry’s, Walmart, Target, and Walgreens outlets.
• Increase access to the opioid overdose reversal medication, naloxone, to patients at risk of overdose.
• Insurance providers should remove barriers preventing patients from obtaining affordable medication-assisted treatment and counseling.
• Policymakers and regulators should enforce laws requiring mental health benefits to be on par with other health benefits, broadening access to treatment related to mental health and substance use disorders.
• Health insurance providers and pharmacy benefit managers should ensure patient access to affordable, non-opioid pain care.
To learn more about efforts to end the opioid epidemic, visit www.end-opioid-epidemic.org.
AJP Assistant Editor Debe Campbell contributed to this story.