June 10, 2019
Area(s) of Interest: Public Health
The number and strength of opioids prescribed by physicians has fallen for the fifth year in a row, according to the 2019 progress report from the American Medical Association (AMA) Opioid Task Force. Between 2013 and 2018, the number of opioid prescriptions decreased by more than 80 million — a 33% decrease nationally, with every state seeing a decrease in opioid prescriptions. California saw a 33.5% decrease during that time period.
The AMA Opioid Task Force is now calling on policymakers to eliminate barriers to treatment and to take additional steps to end the opioid epidemic. The California Medical Association (CMA) is a member of the AMA task force, which recently released new recommendations that focus on barriers to treatment for substance use disorder and pain and other policies that result in so few patients receiving care. These include prior authorization, step therapy and other administrative burdens, as well as inadequate enforcement of state and federal laws that require insurance parity for mental health and substance use disorders.
“We need help from policymakers to ensure that more people have access to treatment. Physicians are responding to the epidemic and we are seeing results: a reduction in opioid prescribing of 33 percent since 2013, increased use of prescription drug monitoring programs, enhanced education, and greater co-prescribing of naloxone,” said AMA President-elect Patrice A. Harris, M.D., who also is chair of the task force. “But we cannot enforce parity laws, or eliminate administrative barriers without the help of state and federal authorities, and that’s what is limiting treatment now.”
The new recommendations:
- Remove prior authorization, step therapy and other inappropriate administrative burdens or barriers that delay or deny care for FDA-approved medications used as part of medication-assisted treatment for opioid use disorder.
- Support assessment, referral and treatment for co-occurring mental health disorders as well as enforce state and federal laws that require insurance parity for mental health and substance use disorders.
- Remove administrative and other barriers to comprehensive, multimodal, multidisciplinary pain care and rehabilitation programs.
- Support maternal and child health by increasing access to evidence-based treatment, preserving families, and ensuring that policies are nonpunitive.
- Support reforms in the civil and criminal justice system that help ensure access to high quality, evidence-based care for opioid use disorder, including medication-assisted treatment.
AMA’s original task force recommendations, issued in 2015, focused on actions that physicians could take to help end the epidemic.