Doctors are making progress combatting the epidemic of deaths from opioid overdoses, but they need help from lawmakers and others responsible for making healthcare policy.
That was the message from the American Medical Association Opioid Task Force last week as it released updates to its earlier recommendations for addressing the crisis. The new recommendations focus on barriers to treatment and pain along with other policies that make it difficult for patients to get needed care, such as prior authorizations and step therapy. They also call for better enforcement of laws requiring insurance parity for treatment of mental health and substance use disorders.
“We need help from policymakers to ensure that more people have access to treatment,” AMA President-elect Patrice A. Harris, MD, MA, said in a statement. While noting that opioid prescribing is down by 33 percent since 2013, Harris said “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 task force’s new recommendations include:
• Eliminating prior authorization, step therapy and other administrative burdens or barriers that delay or deny care for FDA-approved medications used as part of medication-assisted treatment for opioid use disorder
• Supporting assessment, referral and treatment for co-occurring mental health disorders and enforcing state and federal laws that require insurance parity for mental health and substance use disorders
• Removing administrative and other barriers to comprehensive, multimodal, multidisciplinary pain care and rehabilitation programs
• Support for maternal and child health by increasing access to evidence-based treatment, preserving families, and ensuring that policies are nonpunitive.
• Supporting 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
The task force’s first set of recommendations, issued in 2015, encouraged doctors to register for and use state prescription drug monitoring programs, and called for enhanced education and training in effective, evidence-based treatments and expanded access to naloxone in communities and through co-prescribing.
“The original task force recommendations called on physicians to accept the responsibility to take a leadership role in ending the epidemic,” Harris said. “Yet, more people are dying each year, emphasizing the need for policymakers to protect patients’ access to evidence-based care for pain and for opioid use disorder.”
The task force is comprised of the AMA, the American Osteopathic Association, the American Dental Association, and 25 specialty and state medical societies.