AMA report shows overdose epidemic evolving, becoming deadlier

July 22, 2020

While opioid prescriptions are down, overdose deaths on illicit opioids and stimulants have shown a dramatic increase.

A report put out by the American Medical Association’s (AMA) Opioid Task Force is showing that the use of prescription opioids is on the decline while overdoses resulting from illicit opioids and stimulants are exploding.

According to a news release, the number of opioids prescribed dropped for the sixth year in a row. Between 2013 and 2019 opioid prescriptions decreased by 90 million, or 37.1 percent, across the country. Meanwhile, prescription drug monitoring program (PDMP) registrations and use increased with 1.8 million healthcare professionals accessing state PDMPs more than 739 million time. This is a 64.4 percent increased from 2018 and a more than 1,100 percent increase from 2014.

There has also been an increase in the physicians certified to treat opioid use disorder. That number currently stands at more than 85,000 physicians certified to treat patients in-office with buprenorphine, compared to 50,000 in 2017. Also, the anti-overdose drug naloxone has seen an increase in use as more than 1 million prescriptions for the drug were dispensed in 2019, which is nearly double the amount in 2018 and a 649 percent increase from 2017, according to the release.

The report cites figures from the U.S. Centers of Disease Control and Prevention (CDC) from the beginning of 2015 to the end of 2019 which show the increase in deaths caused by overdoses on:

  • Illicitly manufactured fentanyl and fentanyl analogues (from 5,766 to 36,509)
  • Stimulants like methamphetamine (from 4,402 to 16,279)
  • Cocaine (from 5,496 to 15,974)
  • Heroin (from 10,788 to 14,079)

Meanwhile, the CDC reports that deaths involving prescription opioids dropped from 12,269 to 11,904, the release says.

“The nation needs to confront the fact that the nation’s drug overdose epidemic is now being driven predominantly by highly potent illicit fentanyl, heroin, methamphetamine and cocaine, although mortality involving prescription opioids remains a top concern,” AMA Opioid Task Force Chair Patrice A. Harris, MD, MA, who also is the AMA’s immediate past president, says in the release. “If it weren’t for naloxone, there likely would be tens of thousands additional deaths. It is past time for policymakers, health insurers, pharmacy chains and pharmacy benefit managers to remove barriers to evidence-based care for patients with pain and those with a substance use disorder.”

The report also lays out how prior authorization requirements for substance use disorder services or medications and limiting access to non-opioid pain care has hamstrung the effort to end the epidemic.

A full list of actions policymakers can take to correct this issue can be found here.