The largest medical society in the nation is calling for a bevy of actions that would ease physicians' prescriptions of alternatives to opioids and support tools for preventing overdose.
On the last day of the American Medical Association's annual meeting in Chicago, 500 delegates representing 192 entities throughout the country voted on a number of resolutions aimed at helping curb the effect of opioid abuse and misuse in the country.
Dr. Andrew Gurman, who Wednesday was sworn in as the new president of the association, acknowledged physicians have played a role in creating the epidemic.
“We have taken ownership of that, and physicians have taken ownership of being part of the solution,” Gurman said. “But it doesn't happen in a vacuum.”
The AMA House of Delegates called for the group to oppose any barriers that could limit patient access to evidence-based non-opioid and non-pharmacological pain therapies.
The group also voted in favor of efforts to remove pain as a vital sign in professional standards, as well as disconnecting patient satisfaction scores from questions related to the evaluation and management of pain.
In an interview with Modern Healthcare, Gurman argued physicians have been tied to this score which amounts to 2% to 5% of the overall satisfaction score.
“There's institutional pressure for the doctors to comply with patient wishes even if it's not best medicine,” Gurman said.
The delegates Wednesday also adopted new policies promoting greater access to naloxone, a drug that can counter the effects of drug overdose. The new policy calls on private and public payers to include naloxone on their preferred drug lists and formularies with little or no cost-sharing, and supports liability protections for physicians and other healthcare professional who prescribe, dispense and administer the drug.
Other provisions within the new policy include the AMA advocating for having standing orders for naloxone for pharmacies and having the drug available to community-based organizations, correctional settings, schools and law enforcement agencies, some of which already use the drug.
“These policies will save lives. That's the bottom line,” new AMA Board Chair Dr. Patrice Harris said in a written statement. “Time and time again, we have seen naloxone save lives once it is in the hands of first responders. We just have to make sure that we are co-prescribing it when clinically indicated, and that it is affordable for the community and available at local pharmacies.”
More than 47,000 deaths occurred in 2014 as a result of a drug overdose, according to the Centers for Disease Control and Prevention, with more than 18,000 of those incidents involving the use of prescription pain relievers.
Addressing the opioid epidemic capped a wide range of public health-related issues addressed by the delegates this year.
An issue that has traditionally been contentious—fighting gun violence—was addressed with delegates overwhelmingly approved adopting new policies in the wake of a deadly mass shooting at an Orlando, Fla., nightclub over the weekend that killed 50. The new policy calls for the AMA to describe gun violence as a “public health crisis,” and to lobby Congress to lift its federal funding ban on the CDC to conduct gun violence research.
Gurman, however, stopped short of advocating for more internal review of the impact of gun violence on physicians. The issue is something that not widely researched or addressed, even though the U.S. has one of the highest rates of gun violence among developed countries.
Some of the other public health policies adopted at this year's meeting included calls for:
• The pharmaceutical industry to fund a program to dispose of unwanted medications as hazardous waste
• Eliminating the sales tax on feminine hygiene products
• Improving education of physicians on the effective use of pre-exposure prophylaxis to prevent HIV acquisition in high-risk individuals
• Equal healthcare access and coverage to treat eating disorders
• Recognition of the public health benefits of paid sick leave and other discretionary time off
• Quick congressional action to provide sufficient funding to combat the Zika virus
• Timely reporting of all public water system testing results presented on a public website
• Middle school and high schools to start no later than 8:30 a.m. to improve adolescent wellness
• A redesign of detergent pods to make them less attractive to children and help prevent accidental exposure or ingestion
• The Occupational Safety and Health Administration to require healthcare employers to implement workplace violence prevention programs