In addition to the ongoing challenges presented by the COVID-19 global pandemic, the nation’s opioid epidemic has grown into a much more complicated and deadly drug overdose epidemic. The AMA is greatly concerned by an increasing number of reports from national, state and local media suggesting increases in opioid- and other drug-related mortality—particularly from illicitly manufactured fentanyl and fentanyl analogs. The media reports below cite data from multiple and varied sources, including national, state and local public health agencies, law enforcement, emergency medical services, hospitals, treatment centers, research journals and others.

More than 40 states have reported increases in opioid-related mortality as well as ongoing concerns for those with a mental illness or substance use disorder. This issue brief underscores the need to remove barriers to evidence-based treatment for those with a substance use disorder as well as for harm reduction services, including sterile needle and syringe services and naloxone.

The AMA is pleased that the U.S. Substance Abuse and Mental Health Services Administration and U.S. Drug Enforcement Administration (DEA) have provided increased flexibility for providing buprenorphine and methadone to patients with opioid use disorder. The AMA is further pleased at increased flexibility provided by the DEA to help patients with pain obtain necessary medications. The AMA strongly recommends that all of the flexibilities that have been put in place by DEA during the COVID-19 PHE be kept in place at a minimum until both the COVID-19 and the opioid public health emergencies come to an end.

The AMA urges governors and state legislatures to take action

  • Adopt SAMHSA and DEA rules and guidance in-full for the duration of the national emergency—this includes flexibility for evaluation and prescribing requirements using telemedicine;
  • Support the removal of prior authorization, step therapy and other administrative barriers for medications used to treat opioid use disorder; meaningful enforcement of mental health and substance use disorder parity laws is long overdue
  • Remove existing barriers for patients with pain to obtain necessary medications. This includes removing arbitrary dose, quantity and refill restrictions on controlled substances; and
  • Implement and support harm reduction strategies, including removing barriers to sterile needle and syringe services programs.For more information, please contact Daniel Blaney-Koen, JD, Senior Legislative Attorney, AMA Advocacy Resource Center, at daniel.blaney-koen@ama-assn.org

National reports

Thousands of Northwest residents are unexpectedly dying from causes other than COVID-19. https://www.opb.org/article/2020/11/25/covid-19-oregon-washington-idaho-
excess-deaths/ December 4, 2020
  • Overdose-Related Cardiac Arrests Observed by Emergency Medical Services During the COVID-19 Epidemic. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2020.42 18 December 3, 2020
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