U.S. Senator Dick Durbin (D-IL) is calling on leading medical associations to crack down on the over-prescription of pain medication, which he alleges has been a primary factor in America’s heroin addiction crisis.
He wants those associations, including the American Medical Association, to adopt mandatory continuing medical education programs and checking of prescription drug monitoring programs for opioid prescribers, among other things. In addition to the AMA, the American Academy of Family Physicians (AAFP), the American College of Emergency Physicians (ACEP) and the American Dental Association (ADA) also received letters, a copy of which is included below.
“There are a number of reasons why we have seen such a sharp rise in the number of opioids being prescribed over the past two decades,” Durbin said in a statement. “However, none of these factors should be an excuse for [doctors] to fail to take responsibility for [their] role in contributing to the opioid and heroin epidemic. The best way to reduce the number of Americans with an opioid addiction – which oftentimes leads to life-long opioid dependency, overdose, and death – is to ensure that patients never become addicted in the first place.”
Last month, Durbin along with Rep. Tammy Duckworth, who is running for the other U.S. Senate seat from Illinois, called on drug makers to help curtain the pain killer addiction program by setting up financial incentives to get old or unused opioid medications off the street and disposed of safely.
Letter from Sen. Dick Durbin to AMA:
May 11, 2016
Steven J. Stack, MD
American Medical Association
25 Massachusetts Avenue, NW Suite 600
Washington, DC 20001
Dear Dr. Stack:
Our nation is in the midst of a prescription opioid and heroin crisis that is destroying the lives of our friends, our neighbors, and our family members. There is no town too small and no suburb too wealthy to escape this problem. Efforts to halt this widespread epidemic will not be successful unless we commit ourselves to a comprehensive solution.
The American Medical Association (AMA) is the largest association of physicians and medical students in the United States. Its members are some of the best and brightest in the medical profession and are responsible for saving countless lives.
When it comes to the opioid and heroin crisis, each stakeholder needs to do their part. The AMA, as the leading voice of the medical community, and its members must accept responsibility for the role it has played, and continues to play, in the ongoing prescription opioid epidemic. The AMA should take immediate action to reduce the number of opioids that are prescribed when not medically necessary.
First, let me stipulate that there are many patients suffering from acute and chronic pain. They need effective and compassionate pain management. We can also agree that since pain in many cases is a subjective element, doctors face a challenge in evaluating its existence or severity. Nevertheless, the current situation regarding pain management is out of control.
Over the past 25 years, the number of opioid pain relievers prescribed in the United States has skyrocketed. According to the National Institute on Drug Abuse, the number of opioid prescriptions have risen dramatically from approximately 76 million in 1991 to more than 245 million in 2014. The United States is by far the largest consumer of these drugs – accounting for almost 100 percent of the world total consumption of hydrocodone (e.g. Vicodin) and 81 percent of oxycodone (e.g. OxyContin).
The increased frequency with which prescription opioids have been prescribed in recent years has played a major factor in our nation’s escalating heroin epidemic, including an alarming increase in opioid-related emergency room visits, opioid-related treatment admissions for abuse, and opioid-related overdose deaths. Between 2002 and 2013, the rate of heroin-related overdose deaths nearly quadrupled, with more than 8,200 people dying from heroin in 2013. According to the federal government’s National Survey on Drug Use and Health, four out of five current heroin users report that their opioid use began with prescription opioids.
There are a number of reasons why we have seen such a sharp rise in the number of opioids being prescribed over the past two decades: the introduction of OxyContin (an extended released formulation of oxycodone that is extremely addictive), increased attention on identifying and treating pain, the large volume of opioids being developed and mass produced by drug companies, the perceived financial incentives to over-treat pain, and the lack of insurance coverage for alternative pain treatment modalities. However, none of these factors should be an excuse for the AMA or its members to fail to take responsibility for its role in contributing to the opioid and heroin epidemic.
The best way to reduce the number of Americans with an opioid addiction – which oftentimes leads to life-long opioid dependency, overdose, and death – is to ensure that patients never become addicted in the first place.
The AMA could help address the opioid and heroin crisis by supporting evidence-based interventions. For instance, the AMA could endorse mandatory continuing medical education programs for opioid prescribers and support initiatives that require physicians to check prescription drug monitoring programs before prescribing painkillers to patients. It could support increased transparency in physician prescribing practices and proper intervention for those who may be outliers. The AMA also could prioritize helping physicians to be more judicious in their prescribing of these addictive drugs while protecting access for those that need these prescriptions to manage pain.
The AMA’s mission statement is to “Promote the art and science of medicine and the betterment of public health.” In 2014, more than 28,000 people nationwide – 1,652 in Illinois – died from prescription opioid and heroin overdoses. I can think of no better way to promote the public health than by immediately embracing changes in the medical community that would help prevent opioid and heroin drug addiction and future overdose deaths.
Richard J. Durbin
United States Senator
CC: Thomas M. Anderson, M.D.
President, Illinois State Medical Society