Overdose Epidemic

Harm-reduction efforts needed to curb overdose epidemic

Andis Robeznieks , Senior News Writer

The U.S. drug-overdose epidemic continues to worsen as the number of deaths grew by nearly 15% in 2021—a grim total fueled by a 23% rise in the number of deaths linked to illicitly manufactured fentanyl—highlighting a need to encourage harm-reduction measures, according to a resolution presented at the 2022 AMA Interim Meeting.

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“Fentanyl test strips are a point-of-care test that identifies fentanyl contamination in a drug supply with a specificity of 87.5% and a sensitivity of 95.2%,” notes a resolution from the AMA Resident and Fellow Section, but “possession of fentanyl test strips is explicitly legal in only 22 states.”

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To address the problem, the AMA House of Delegates modified existing policy to:

  • Encourage state and county medical societies to advocate for harm-reduction policies that provide civil and criminal immunity for the possession, distribution and use of “drug paraphernalia” designed for harm reduction from drug use, including but not limited to drug-contamination testing and injection-drug preparation, use and disposal supplies.
  • Support efforts to increase access to fentanyl test strips and other drug-checking supplies for the purpose of harm reduction.

“The AMA has strongly supported increased use of a broad array of harm-reduction efforts to reduce death and other harms from nonmedical use of drugs, including for people who inject drugs,” said AMA Trustee Thomas J. Madejski, MD. “These efforts include greater access to naloxone, syringe services programs and pilot programs for overdose prevention sites/supervised injection-use facilities. Fentanyl strips are part of this effort, and we urge states to take steps to help a vulnerable population.”

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How to use opioid-settlement funds

A separate resolution, introduced by the Washington State Medical Association, notes a shortage of “physicians in the U.S. actively prescribing medications for opioid-use disorder, especially in rural areas,” while adding that the $26 billion in opioid-settlement funds could help change that.

Delegates modified existing policy to “advocate that any opioid-settlement funds paid to the states be used exclusively for research, education, prevention, and treatment of overdose, opioid-use disorder, and pain, as well as expanding physician training opportunities to provide clinical experience in the treatment of opioid-use disorders.”

“States are receiving billions of dollars in settlement funds. Not only do patients need counseling and medication to help them with their opioid-use disorder, but they also need access to physicians trained in the field. We strongly urge states to invest in building an addiction medicine and addiction psychiatry workforce,” Dr. Madejski said.

Read about the other highlights from the 2022 AMA Interim Meeting.