by Kate Alfano, CMS Communications Coordinator
Featured in the July-August 2019 Colorado Medicine Colorado Medicine.
A new report on opioids from the American Medical Association highlights the progress physicians are making to stem an epidemic that accounts for the deaths of roughly 130 people every day. The 2019 Opioid Progress Report found that physicians and other health care professionals are taking significant actions in the face of the epidemic, and some reports suggest that prescription opioid-related mortality may be leveling off. Yet, death from heroin and illicitly manufactured fentanyl and fentanyl analogs are at historic levels.
Of note in Colorado:
Opioid prescriptions decreased. The rate of retail-filled opioid prescriptions has decreased to the lowest level in five years, cumulatively dropping almost 30 percent from 2013-2018. Almost 14 percent of that decrease happened between 2017-2018, putting Colorado efforts to decrease the rate of all retail opioid prescriptions above the national average for this time period.
PDMP use increased. Physicians and other prescribers using the Colorado Prescription Drug Monitoring Program (PDMP) has exponentially increased since 2014 by about 650 percent. Since 2017 alone that increase has almost tripled; part of this utilization can be attributed to a law mandating PDMP registration
“The opioid epidemic is at a crossroads,” said AMA President Patrice A. Harris, MD, MA, who chairs the AMA Opioid Task Force. “While physicians must continue to demonstrate leadership by taking action, it is clear that these significant reductions in opioid prescribing, increases in prescription drug monitoring program (PDMP) use and taking more education – by themselves – will not stop people from dying.”
The AMA Opioid Task Force is calling on policymakers and other stakeholders to eliminate all barriers to evidence-based treatment and to take specific steps such as removing prior authorization for medication-assisted treatment (MAT) for the treatment of opioid use disorder, enforcing state and federal laws that require insurance parity for mental health and substance use disorders, and ending health insurance company barriers to comprehensive multimodal, multidisciplinary pain care, including non-opioid alternatives.
“The report shows that to save many more lives, policymakers, payers, PBMs [pharmacy benefit managers] and pharmacy chains must remove all barriers to evidence-based care,” Harris said.
A separate dataset recently compiled by the Consortium for Prescription Drug Abuse Prevention also illustrates Colorado’s progress in decreasing certain targets set by the Centers for Disease Control and Prevention’s opioid guidelines, such as physicians writing fewer opioid prescriptions, improving prescribing practices and aiding in the reduction of patient doctor shopping. Consortium Executive Director Robert Valuck, PhD, RPh, noted that Colorado stakeholders have done a good job decreasing all of the CDC’s indicators over the past
“Taken together, these data points are very compelling in showing that Colorado doctors are taking the epidemic seriously and are changing their behaviors for the better in alignment with best practice goals and guidelines.”