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United States drug overdose deaths exceeded 96,000 in the 12 months leading to March 2021, amid a national decline of opioid prescriptions over the past 10 years, according to provisional figures from the Centers for Disease Control and Prevention (CDC).
Drug-related mortality increased almost 30% from March 2020, according to recent CDC figures. In the 12-month period ending March 2021, the reported number of deaths was 96,779, but the predicted number was higher at 99,106.
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Despite a national effort to increase state prescription drug monitoring programs in every state for the past five years, there has been a 44.4 % reduction in opioid prescriptions, according to a 2021 Overdose Epidemic Report released by the American Medical Association.
Prescriptions for buprenorphine and naloxone, two common medications for opiate dependence, have only slightly increased in the past three years, with 26% fewer patients filling a naloxone prescription during the pandemic, according to the report.
In response to the worsening overdose epidemic, the AMA launched the AMA Substance Use and Pain Care Task Force.
"Policymakers and other stakeholders have a choice of whether to pursue evidence-based strategies to support patients’ access to lifesaving and life affirming care," Dr. Bobby Mukkamala, chair of the AMA Substance Use and Pain Care Task Force, wrote in the report. "Every effort must be made to remove health inequities and other barriers for patients with substance use disorders, mental illness and patients with pain. More of our loved ones will suffer and die if these barriers remain."
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The report urged states to adopt more telehealth options to allow for the induction of buprenorphine at home, called for decriminalizing drug-checking supplies and urged the CDC to reconsider its 2016 opioid prescribing guideline, which provides recommendations on chronic pain management, to make it easier to "restore compassionate care for patients with pain."
In a recent AMA press release urging the CDC to overhaul the 2016 guidelines, Mukkamala wrote, "CDC’s threshold recommendations continue to be used against patients with pain to deny care. We know that this has harmed patients with cancer, sickle cell disease and those in hospice. The restrictive policies also fail patients who are stable on long-term opioid therapy."
Dr. Elie G. Aoun, an addiction forensic psychiatrist at Columbia University and a member of the American Psychiatric Association board of trustees, told Fox News that a serious intention to alter the course of the opioid epidemic would require looking beyond increasing access to treatment.
"Most people who would benefit from treatment for substance use disorder are either not interested in receiving treatment, or believe that they do not need treatment," Aoun said. "The reasons for that are complex, having to do with stigma and the fact that addiction is more than simply a disease of using, instead, it’s a disease of thinking, affecting people’s sense of agency."
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Aoun noted that formerly incarcerated individuals face a 40-fold increased risk of a drug overdose death compared to the general population. However, the vast majority of the country isn’t offering justice-involved populations evidence-based treatment interventions and psychosocial support programs, he said.
"Addressing stigma, giving people hope, a reason to live, giving them hope that they can be productive members of society is going to be very important in reversing the course of the opioid epidemic," Aoun added in part.