By Chris Adams

The medical community has often been blamed for helping spur the opioids crisis, with what critics call loose prescribing standards that put powerful pills into the hands of people who didn’t need them.

Today, though, the nation’s physicians are seeking to help mitigate the epidemic – and are seeing some success in doing so.

Dr. Patrice Harris, a psychiatrist from Atlanta and a former chair of the American Medical Association Board of Trustees, detailed for National Press Foundation fellows how doctors are working to help control prescriptions of drugs such as oxycodone and fentanyl. Harris recently led a task force for the AMA on the issue.

“This epidemic is evolving,” she said, “and it’s incumbent upon all of us to look for solutions as it evolves.”

The task force included 26 medical societies. It began in 2014 and issued six recommendations. Among them:

  • Urging physicians to use physician drug monitoring programs, or PDMPs, which are electronic databases that track controlled substance prescriptions in a state. According to the U.S. Centers for Disease Control and Prevention, PDMPs can provide health authorities timely information about prescribing and patient behavior.
  • Boosting education for physicians in three areas: opioids, substance use disorders and pain.
  • Working to improve access to medication-assisted treatment options, which are still only haphazardly used around the nation.
  • Seeking to decrease the stigma associated with substance use disorders. Too often, Harris said, people think those who have such disorders are morally weak. People need to be reminded – or taught – that these are brain disorders. “Patients with chronic pain say they feel like criminals when they get their prescriptions filled,” she said. “They are quite worried when there are limits on doses.”
  • Making the overdose-reversal drug naloxone more available.
  • Securing safe options for storage and disposal of opioids.

Harris said physicians are acting to help mitigate the opioids crisis. PDMPs are being used more and retail opioids prescriptions are dropping. But there is much more to do be done, she said.

On medication-assisted treatment, for example, Harris showed a map of the U.S. that highlighted counties with substance abuse facilities offering all three forms of effective medication-assisted treatment. Out of more than 3,000 counties in the U.S., only a few dozen were filled in.

She also addressed the issue of people who continually run into drug problems. As she was asked recently: What about the person who has been brought to the emergency department 10 times because of overdoses?

“When is enough enough?” she said. “And my response to that was, ‘Every life is worth saving, every time.’ ”

Opioids 2018 Tuesday Lo-3