American Medical Association adopts policies aimed at reversing opioid epidemic

At its annual meeting this week, the American Medical Association adopted new policies encourage physicians to co-prescribe naloxone to patients at risk of an overdose; promote timely and appropriate access to non-opioid and non-pharmacologic treatments for pain; and support efforts to delink payments to healthcare facilities with patient satisfaction scores relating to the evaluation and management of pain.

During the meeting, Dr. Patrice Harris, chair-elect of the AMA and chair of the AMA Task Force to Reduce Opioid Abuse, led a panel discussion on opioids that asked the question: With 78 opioid-related deaths a day, what can one physician do? Harris and the panel highlighted how to more effectively use prescription drug monitoring programs; they also emphasized the benefits of non-opioid and non-pharmacologic treatment, and the co-prescribing of naloxone. Harris urged the physicians in attendance to apply the lessons in their practices.

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The new naloxone policies will promote increased access to the overdose-reversing drug for friends and family members of patients at risk of overdose. The policy also encourages private and public payers to include all forms of naloxone on their preferred drug lists and formularies with nominal or no cost sharing. It also supports liability protections for physicians and other authorized healthcare professionals to prescribe, dispense and administer the drug. Delegates called for policies to enable law enforcement agencies to carry and administer naloxone, as many states have done.

The policy calls for "collaborative practice agreements" with pharmacists, as well as standing orders for pharmacies, where permitted by law. It also advocates for availability of naloxone to community-based organizations, law enforcement agencies, correctional settings and schools.

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In addition, delegates adopted a policy that calls on the AMA to oppose efforts that would arbitrarily restrict a patient's ability to receive personalized pain care. They also recommended  breaking the link between patient satisfaction surveys of pain treatment and payments to facilities. Supporters said eradication or total resolution of a patient's pain is often misguided and puts inappropriate pressure on clinical pain management practices that can encourage the overuse of opioids, especially since other approaches are not covered by insurance.

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"Treating pain is a priority for physicians, and we know that there are many ways to do it," said Harris in a statement. "We must ensure that patients have access to comprehensive pain care as well as reduce the stigma of pain. Judging healthcare facilities on an overly subjective measure -- that is, how well it is perceived that they treat pain -- is an overly simplistic approach to measuring clinical effectiveness."

He added that physicians should "take a leading role in reversing the tide of this epidemic."

Twitter: @JELagasse