Overdose Epidemic

AMA: Remove barriers to opioid-use disorder treatment

Andis Robeznieks , Senior News Writer

On Monday, U.S. Surgeon General Jerome Adams, MD, called on his fellow AMA member physicians to work toward eliminating stigma associated with substance-use disorder and removing barriers to treatment. Then, over the course of the next two days, the AMA House of Delegates did just that in voicing support for policies to raise public awareness of, and improve patient access to, substance-use disorder treatments.

“The AMA wants all physicians to be leaders in the fight against the opioid epidemic,” said AMA President-elect Patrice A. Harris, MD, chair of the AMA Opioid Task Force. “This means they must fight to end stigma surrounding substance use disorder and medication assisted treatment, which has been shown to decrease overdose mortality, reduce transmission of infectious disease and reduce general health care expenditures.”

Delegates at the 2018 AMA Annual Meeting in Chicago adopted new policy aimed at eliminating barriers to medication-assisted treatment (MAT) for substance-use disorder.

The AMA will:

  • Advocate for legislation that eliminates barriers to, increases funding for, and requires access to all appropriate FDA-approved medications or therapies used by licensed drug treatment clinics or facilities.
  • Develop a campaign to increase public awareness that medical treatment of substance-use disorder with medication-assisted treatment is a first-line treatment for this chronic medical disease.

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In another action, the HOD called for identifying best practices and enhancing access to high quality, evidence-based treatment of opioid use disorder.

Specifically, delegates called for:

  • The AMA Opioid Task Force to work with the American Hospital Association and other relevant organizations to identify best practices being used by hospitals and others to treat opioid-use disorder as a chronic disease—including identifying patients with this condition.
  • Initiating or providing opioid agonist or partial agonist therapy in inpatient, obstetric and emergency department settings.
  • Providing cognitive and behavioral therapy as well as other counseling as appropriate.
  • Establishing appropriate discharge plans—including education about opioid-use disorder.
  • Participating in communitywide systems of care for patients and families affected by this chronic medical disease.
  • Additionally, delegates directed the AMA to advocate that states evaluate current programs or those that have received federal or state funding to assist physicians, hospitals and their communities to coordinate care for patients the chronic disease of opioid-use disorder.

The AMA also was directed to seek clarification of DEA regulations concerning prescribing buprenorphine in the inpatient setting as well as filling a prescription for buprenorphine from a hospital inpatient pharmacy.

In separate action, the HOD called on the AMA to support legislative and other appropriate efforts to expand and improve pregnant women’s access to evidence-based treatment for substance-use disorders.

In its report, the reference committee noted delegates’ strong support that pregnant women should not be penalized for having a medical disease.

There was further testimony that the AMA does not condone criminal activity or drug use during pregnancy, but that “the focus on treatment for substance-use disorders must remain squarely in the medical realm, with a clear focus on supporting treatment based on the best medical evidence.”

Read more news coverage from the 2018 AMA Annual Meeting.