Opioid prescriptions fell over past decade while drug overdose deaths climbed: AMA report

Physicians have prescribed 44 percent less opioids over the past decade, yet fatal and nonfatal drug overdoses have continued to climb, according to a new report from the American Medical Association (AMA). 

The association called on lawmakers to “act now” over the overdose statistic. 

AMA’s report documented a 44.4 percent decrease in opioid prescriptions between 2011 and 2020, with a 6.9 percent reduction between 2019 and last year, with more doctors using prescription drug monitoring programs (PDMPs).

The decline in prescriptions over the years coincided with a rise in usage of programs that track controlled substance prescriptions and assist in recognizing patients who may be getting multiple prescriptions from different providers. 

Physicians used these programs more than 910 million times in 2020, compared to 750 million times the year prior and almost 61.5 million times in 2014.

But even with these efforts, drug overdoses have spiked. 

The Centers for Disease Control and Prevention (CDC) data found that more than 93,000 people died of drug overdoses in 2020, including about 69,000 from opioid overdoses. This represented a record high and an almost 30 percent increase in overall fatal overdoses from the prior year. 

AMA President Gerald Harmon said in a statement that the PDMPs operate “as a tool” but not “a panacea.”

“Patients need policymakers, health insurance plans, national pharmacy chains and other stakeholders to change their focus and help us remove barriers to evidence-based care,” he said in a statement. 

“Until further action is taken, we are doing a great injustice to our patients with pain, those with a mental illness and those with a substance use disorder,” Harmon added. 

The AMA cited the CDC, stating that the jump in overdoses can be attributed to illicit fentanyl, fentanyl analogs, methamphetamine and cocaine. 

The association called on lawmakers to end prior authorization for medications that treat opioid use disorder, to provide access to “affordable, evidence-based care for patients with pain,” to improve data collection and to back harm reduction services like needle and syringe exchange services. 

The researchers also noted that an increased number of physicians held an “X-waiver” in 2020, permitting them to give buprenorphine to assist patients struggling with opioid use disorder. But AMA said 80 to 90 percent of those with substance abuse don’t get treatment.

The COVID-19 pandemic appeared to exacerbate the opioid epidemic; every state saw an increase in overdoses, according to the report.