Physicians’ Progress Toward Ending the Nation’s Drug Overdose and Death Epidemic

The American Medical Association’s Opioid Task Force report shows a dramatic increase in fatalities involving illicit opioids, stimulants (e.g. methamphetamine), heroin and cocaine and a similarly dramatic drop in the use of prescription opioids. 

The changing landscape of the opioid epidemic poses challenges for the health care system, which must pivot to treat people in danger of overdose from all drugs. The AMA is calling on stakeholders—including health insurers and policymakers—to remove barriers to evidence-based care. Red tape and misguided policies are grave dangers to pain patients and those with an opioid-use disorder.

Physicians have reduced opioid prescribing, increased use of state prescription drug monitoring programs (PDMP) and increased the prescribing of naloxone. Physicians also have continued to educate themselves on safe prescribing, pain management and recognizing signs of addiction. More than 50,000 physicians and other health care professionals have become certified to provide treatment for opioid use disorder in the past three years. Yet, illicit drugs are now the dominant reason why drug overdoses kill more than 70,000 people each year.

According to the U.S. Centers of Disease Control and Prevention (CDC), from the beginning of 2015 to the end of 2019:

• Deaths involving illicitly manufactured fentanyl and fentanyl analogs increased from 5,766 to 36,509
• Deaths involving stimulants (e.g. methamphetamine) increased from 4,402 to 16,279
• Deaths involving cocaine increased from 5,496 to 15,974
• Deaths involving heroin increased from 10,788 to 14,079
• At the same time, deaths involving prescription opioids decreased from 12,269 to 11,904. (Deaths involving prescription opioids reached their high in July 2017 with 15,003)

Key points from the 2020 report:

• Opioid prescribing decreases for a sixth year in a row. Between 2013 and 2019, the number of opioid prescriptions decreased by more than 90 million—a 37.1 percent decrease nationally.
• Prescription Drug Monitoring Program (PDMP) registrations and use continue to increase. In 2019, health care professionals nationwide accessed state PDMPs more than 739 million times—a 64.4 percent increase from 2018 and more than an 1,100 percent increase from 2014. More than 1.8 million physicians and other health care professionals are registered to use state PDMPs.2\
• More physicians are certified to treat opioid use disorder. More than 85,000 physicians (as well as a growing number of nurse practitioners and physician assistants) now are certified to treat patients in-office with buprenorphine—an increase of more than 50,000 from 2017.
• Access to naloxone increasing. More than 1 million naloxone prescriptions were dispensed in 2019—nearly double the amount in 2018, and a 649 percent increase from 2017.