Advancing Evidence-Based Opioid Treatment

The is no shortage of discussion surrounding the national crisis known as the opioid epidemic. Unprecedented rates of opioid use disorder and the burden it places on limited industry resources have stakeholders clamoring for solutions that will improve prescribing practices and advance best-practice treatment protocols.

The opioid issue is both complex and multi-faceted, requiring industry strategies from many vantage points including prescribing patterns and treatment. The good news is that a recent report from the American Medical Association (AMA) Opioid Task Force conveyed a continued decrease in opioid prescribing and an increase in state prescription drug monitoring programs, the number of physicians certified to treat opioid use disorder and overall access to the opioid blocker naloxone.

Continuing its strategic push to end the crisis, the AMA recently took steps to advance the role of standardized care based on the latest evidence for patients with opioid use disorders. At its annual meeting in June, AMA President-elect Patrice Harris, M.D., the current chair of the AMA Opioid Task Force, underscored the need for removing administrative barriers to medication assisted treatment (MAT)—combining both behavioral and medication therapy—across all care settings including clinics, drug treatment facilities, hospitals, correctional settings and physicians’ offices.

Use of MAT as a whole-person approach to treatment has been proven effective in:

  • Decreasing opioid use, opioid-related overdose deaths, criminal activity and infectious disease transmission
  • Increasing social functioning and retention in treatment
  • Reducing symptoms of neonatal abstinence syndrome and length of hospital stay for opioid-dependent pregnant women

According to Dr. Nora Volkow, director of the National Institute on Drug Abuse, medications have become an essential part of any ongoing treatment plan that enables those impacted by opioid use disorder to regain control of their lives. In addition, the National Institutes of Health have deemed that the value of MAT is “unequivocally established,” and that medications, including buprenorphine (Suboxone®, Subutex®, Probuphine®), methadone and extended release naltrexone (Vivtrol®), are effective for the treatment of opioid use disorders.

As part of its efforts to minimize variations in treatment and advance evidence-based practice, the AMA advocates removing barriers to the administration of MAT. These include requirements for prior authorization, which causes delays and potential denials of care. The group is also calling for enforcement of mental health and substance use disorder parity laws. In addition, the AMA recommends physician training for treating patients with a substance use disorder and that all payers ensure their formularies include all forms of MAT.

Other key movements from the AMA annual meeting include policies that:

  • Advocate for legislation to ensure that patients have access to all FDA-approved medications or therapies in all settings such as drug treatment clinics or facilities. It also called for a public campaign to increase awareness of MAT as a first-line treatment for opioid use disorder.
  • Advance collaboration with the American Hospital Association and other relevant organizations to identify best practices to treat opioid use disorder as a chronic disease.
  • Advocate for the expansion and improved access to evidence-based treatment for substance use disorders during pregnancy.
  • Ensure medical students, physicians-in-training, and practicing physicians receive education on opioid prescribing. The policy calls for the AMA to develop opioid education resources in conjunction with the Association of American Medical Colleges, American Osteopathic Association, Commission on Osteopathic College Accreditation, Accreditation Council for Graduate Medical Education and other professional organizations.

The AMA currently offers nearly 400 resources and educational material for physicians related to opioid prescribing and treatment on its website - endtheopioidepidemic.org.

 

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