The American Medical Association (AMA) Opioid Task Force has released recommendations calling on policymakers to eliminate barriers to treatment and to take additional steps to end the opioid epidemic.
The task force's new recommendations focus on barriers to treatment for substance use disorder and pain and other policies that result in so few patients receiving care. These include prior authorization, step therapy and other administrative burdens as well as inadequate enforcement of state and federal laws that require insurance parity for mental health and substance use disorders.
"We need help from policymakers to ensure that more people have access to treatment. Physicians are responding to the epidemic and we are seeing results: a reduction in opioid prescribing of 33 percent since 2013, increased use of prescription drug monitoring programs, enhanced education, and greater co-prescribing of naloxone," said AMA President-elect Patrice A. Harris, MD, MA, who also is chair of the task force. "But 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 new recommendations:
- Remove prior authorization, step therapy and other inappropriate administrative burdens or barriers that delay or deny care for FDA-approved medications used as part of medication-assisted treatment for opioid use disorder.
- Support assessment, referral and treatment for co-occurring mental health disorders as well as enforce state and federal laws that require insurance parity for mental health and substance use disorders.
- Remove administrative and other barriers to comprehensive, multimodal, multidisciplinary pain care and rehabilitation programs.
- Support maternal and child health by increasing access to evidence-based treatment, preserving families, and ensuring that policies are nonpunitive.
- Support 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 original task force recommendations called on physicians to accept the responsibility to take a leadership role in ending the epidemic," Dr. 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 original task force recommendations, issued in 2015, focused on actions that physicians could take to help end the epidemic:
- Register for and use state prescription drug monitoring program;
- Enhance education and training on effective, evidence-based treatment;
- Support comprehensive care for patients in pain and those with a substance use disorder;
- Remove stigma. Patients with pain and with a substance use disorder deserve comprehensive care and compassion, not judgment;
- Expand access to naloxone in the community and through co-prescribing; and
- Encourage safe storage and disposal of opioids and all medications.
The AMA Opioid Task Force is comprised of the American Medical Association, American Osteopathic Association, and 25 specialty and state medical societies as well as the American Dental Association.