Nov. 17, 2023: National Advocacy Update

The nation’s drug-related overdose and death epidemic continues to worsen, according to the 2023 AMA Overdose Epidemic Report (PDF), issued last week.

The annual report details many of the reasons the epidemic persists, largely due to illicitly manufactured fentanyl and the continued lack of meaningful implementation and enforcement of policies that support aff­ordable, accessible and evidence-based care for patients with substance use disorders or pain. 

The report provides an overview of national data, including:  

• Physicians and other health care professionals have decreased opioid prescribing by nearly 50% nationally since 2012. 
• State prescription drug monitoring programs (PDMP) were queried more than 1.3 billion times in 2022. 
• Buprenorphine prescriptions have increased by 90.9% since 2012. 
• Naloxone prescriptions have increased by more than 200% since just 2018. 

Despite these actions, however, the epidemic is deadlier than ever, with nearly 110,000 people dying from a drug-related overdose in the U.S. in 2022, according to the Centers for Disease Control and Prevention (CDC), primarily due to illicitly manufactured fentanyl, other synthetic opioids, stimulants and other substances. Black and Brown people, pregnant people and youth are disproportionately dying at increased rates.  

The report also highlights several positive policy-related developments supported by the AMA at the federal level over the past year—notably, the reversal of the CDC’s 2016 opioid prescribing guideline, the elimination of the X-waiver for buprenorphine prescribing, the FDA’s approval of over-the-counter naloxone, and the DEA’s extension of the ability to prescribe controlled substances via telehealth. The AMA also continues to urge support for broad harm reduction initiatives, including community naloxone distribution, syringe service programs, increased access to fentanyl test strips and other drug checking supplies, and overdose prevention sites. These and other harm reduction efforts can help minimize the negative health, social and legal impacts associated with drug use.  

“America’s physicians call on our colleagues, other health care professionals, community leaders, policymakers, faith leaders, employers and all others to work together to increase access to care for substance use disorders, pain, mental illness and harm reduction initiatives,” said Bobby Mukkamala, MD, chair of the AMA Substance Use and Pain Care Task Force. “Increasing access to care—and removing barriers to care—remains incredibly challenging, but we must continue our efforts. We urge action on the policy recommendations in this report because they are actions that will save lives. If we do not take these actions, no one should be surprised as the epidemic kills and harms more and more Americans.” 

Read the full report (PDF) for the complete list of recommendations and for additional data. 

Additionally, view state-by-state data charts: 

• 2012-2022 opioid prescribing data (PDF)
• 2012-2022 naloxone prescription data (PDF)
• 2012-2022 buprenorphine prescription data (PDF)
• 2014-2022 PDMP data (PDF)

A new report (PDF) by the AMA’s Heath Policy group examines the availability and use of telehealth in physician practices in 2022. It finds that while the availability of telehealth has decreased since the height of the COVID-19 pandemic, it remains much higher than before. Only 25.1% of physicians reported that telehealth was used in their practice in 2018. This share more than tripled to 79.0% in 2020 and fell slightly to 74.4% in 2022. 

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• Nov. 17, 2023: State Advocacy Update