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Rx16 vs ama_tues_800_harris
The document outlines the American Medical Association's (AMA) Task Force on Opioid Abuse initiatives aimed at reducing opioid abuse through increased registration and use of prescription drug monitoring programs (PDMPs), safe prescribing practices, and comprehensive pain management. It addresses the stigma surrounding pain and substance use disorders while advocating for increased access to naloxone and treatment options. The document highlights the alarming rise in opioid-related deaths and the need for urgent action to improve physician education and patient access to care.
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Rx16 vs ama_tues_800_harris
- 1. AMA Task Forceto Reduce Opioid Abuse Patrice A. Harris, MD, MA Chair-elect American Medical Association March 29, 2016
- 2. © 2015 AmericanMedical Association. All rights reserved. • AMA Task Force to Reduce Opioid Abuse – Increase registration and use of PDMPs – Ensure safe, evidence-based prescribing – Support comprehensive pain care; reduce the stigma of pain – Reduce the stigma of substance use disorder; increase access to treatment – Increase access to naloxone to save lives from overdose; support broad Good Samaritan protections • www.ama-assn.org/go/endopioidabuse 2
- 3. © 2015 AmericanMedical Association. All rights reserved. Drug Poisoning Deaths Involving Opioid Analgesics and Heroin: United States, 1999–2014 Sources: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 opioid analgesics 4030 4400 5528 7456 8517 9857 10928 13723 14408 14800 15597 16651 16917 16007 16235 18893 heroin 1960 1842 1779 2089 2080 1878 2009 2088 2399 3041 3278 3036 4397 5925 8257 10574 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 20,000
- 4. © 2015 AmericanMedical Association. All rights reserved. 4
- 5. © 2015 AmericanMedical Association. All rights reserved. Increase registration and use of PDMPs • Quickly and accurately access your patient's prescription history • Support delegate(s) in your practice to access the PDMP • Interstate interoperability • Create alerts for your patients • Contain referral information for co-occurring mental health or substance use disorders 5
- 6. © 2015 AmericanMedical Association. All rights reserved. Physicians say that PDMPs can help provide important information about a patient’s prescription history 6 4% 3% 8% 10% 45% 43% 42% 44% Agree completely Agree somewhat Disagree somewhat Disagree competely Perceptions of state PDMPs in helping physicians to … Be fully informed about your patients’ prescription history Identify when patients receive multiple prescriptions Agree 87% Agree 87%
- 7. © 2015 AmericanMedical Association. All rights reserved. Ensure safe, evidence-based prescribing • American Academy of Family Physicians • American Academy of Hospice and Palliative Medicine • American Academy of Pain Medicine • American Academy of Physical Medicine and Rehabilitation • American College of Emergency Physicians • The American College of Physicians • American Congress of Obstetricians and Gynecologists • American Dental Association • American Society of Anesthesiologists • American Society of Addiction Medicine • American Osteopathic Association • American Society of Interventional Pain Physicians 7
- 8. © 2015 AmericanMedical Association. All rights reserved. Total Primary care Specialists (2130) (1219) (911) Safe opioid prescribing 69% 68% Pain management with opioid alternatives 54% 56% Treatment and prevention of substance use disorder 45% 35% Prevention of diversion 30% 22% PDMPs 17% 17% Naloxone 16% 17% Medication assisted treatment 14% 15% Other 5% 5% 68% 55% 40% 26% 17% 17% 15% 5% 7 in 10 physicians took education on safe opioid prescribing, and more than half on pain management with alternatives. 8 Education taken by physicians
- 9. © 2015 AmericanMedical Association. All rights reserved. Support comprehensive pain care; reduce the stigma of pain 9
- 10. © 2015 AmericanMedical Association. All rights reserved. Reduce the stigma of substance use disorder; increase access to treatment 1. Stigma – misunderstanding of the disease 2. Capacity – lack of trained and willing providers 3. Access – treatment limits imposed by policymakers & insurers “Over the last decade, the vast majority ― about 8 in 10 ― of all individuals with an opioid use problem were not receiving any treatment at a given point in time, and rates of treatment did not improve over the decade despite a dramatic increase in deaths related to prescription drugs.” - Brendan Saloner, PhD Saloner B and Karthikeyan S. Changes in Substance Abuse Treatment Use Among Individuals With Opioid Use Disorders in the United States, 2004-2013. JAMA. 2015; 314(14):1515-1517.
- 11. © 2015 AmericanMedical Association. All rights reserved. Increase access to naloxone; co-prescribe naloxone; support broad Good Samaritan protections Questions for physicians to consider before co-prescribing or prescribing naloxone: • Is my patient on a high opioid dose? • Is my patient also on a concomitant benzodiazepine prescription? • Does my patient have a history of substance use disorder? • Does my patient have an underlying mental health condition that might make him or her more susceptible to overdose? • Does my patient have a medical condition, such as a respiratory disease or other co- morbidities, which might make him or her susceptible to opioid toxicity, respiratory distress or overdose? • Might my patient be in a position to aid someone who is at risk of opioid overdose? 11
- 12. © 2015 AmericanMedical Association. All rights reserved. • AMA Task Force to Reduce Opioid Abuse – Increase registration and use of PDMPs – Ensure safe, evidence-based prescribing – Support comprehensive pain care; reduce the stigma of pain – Reduce the stigma of substance use disorder; increase access to treatment – Increase access to naloxone to save lives from overdose; support broad Good Samaritan protections • www.ama-assn.org/go/endopioidabuse 12
Editor's Notes
- #11 Let me first thank our colleagues at the American Society for Addiction Medicine for this slide. Like patients with pain, patients with a substance use disorder often face debilitating stigma. They are called “junkies,” “addicts”, “stoners” and much worse. A patient with a substance use disorder often cannot find treatment. On one hand, that is due to the fact that there are too few physicians and other health care professionals to provide treatment. But just like treatment for pain, treatment for substance use disorder is often subject to limits imposed by insurers and others. Medical illness is not something that fits neatly into a 10- 20- or 30-visit box. Administrative barriers do not help us treat our patients. It is distressing to me when I hear my colleagues talk about the prior authorization, step therapy and fail first protocols that often accompany MAT therapy. We need to work together to ensure that policies support optimal treatment. That is why we need to change the national discussion – And we also need to advocate for policies such as lifting the cap on treating patients in our offices with buprenorphine; Patients with substance use disorders deserve care and compassion, not judgment. I know that those attending this conference understand– But we need to carry this important message beyond this conference. That is how and when we will reduce the treatment gap that you see on this slide. That is how we will turn the corner on this national epidemic that is killing 78 people per day.