*Updated June 1, 2021 The nation’s COVID pandemic made the nation’s drug overdose epidemic worse. This issue brief highlights media and other reports showing increases in drug overdose mortality and other concerns relating to access to evidence-based care for substance use disorders, patients with pain as well as harm reduction services. The reports below cite data from multiple and varied sources, including national, state and local public health agencies, law enforcement, emergency medical services, hospitals, treatment centers, research journals and others. Every state has reported a spike or increase in overdose deaths or other problems during the COVID pandemic.
AMA advocacy and resources include support for states to adopt and promote:
• U.S. Substance Abuse and Mental Health Services Administration and U.S. Drug Enforcement Administration (DEA) increased flexibility for providing buprenorphine and methadone to patients with opioid use disorder.
• Increased flexibility provided by the DEA to help patients with pain obtain necessary medications. The AMA strongly recommends that all of the flexibilities that have been put in place by DEA during the COVID-19 PHE be kept in place at a minimum until both the COVID19 and the opioid public health emergencies come to an end.
• Support the removal of prior authorization, step therapy and other administrative barriers for medications used to treat opioid use disorder (MOUD); meaningful enforcement of mental health and substance use disorder parity laws is long overdue. Prior authorization of MOUD remains a major barrier.
• Remove existing barriers for patients with pain to obtain necessary medications. This includes removing arbitrary dose, quantity and refill restrictions on controlled substances; and
•Implement and support evidence-based harm reduction strategies, including removing barriers to sterile needle and syringe services programs as well as strengthening Good Samaritan laws. Arizona is the latest example of positive legislative action.
• Enact new laws to ensure that monies from opioid-related litigation is focused on public health, treatment and prevention efforts. Virginia and Kentucky are leading examples. Detailed policy recommendations to help patients with a substance use disorder can be found in the 2020 National Policy Roadmap issued by the AMA and Manatt Health.