Durbin Calls on Nation's Medical Community to Curb Over Prescription of Opioids

Letters to four leading physician associations follow Senator’s recent call on the pharmaceutical industry to help address nation’s opioid and heroin epidemic

[WASHINGTON, D.C.] – U.S. Senator Dick Durbin (D-IL) today called on the leading medical associations to take responsibility for the role that doctors, dentists, and other prescribers have in curtailing the opioid epidemic by endorsing mandatory continuing medical education programs and checking of prescription drug monitoring programs for opioid prescribers. Durbin sent letters to the heads of the American Medical Association (AMA), the American Academy of Family Physicians (AAFP), the American College of Emergency Physicians (ACEP) and the American Dental Association (ADA).

Last month, Durbin and U.S. Representative Tammy Duckworth (D-IL) called on the President and CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA) to take financial responsibility for the drug industry’s role in curtailing the opioid overdose epidemic. That letter can be found HERE.

“When it comes to the opioid and heroin crisis, each stakeholder needs to do their part,” said Durbin. “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.”

“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 continued. “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.”

Durbin noted in his letters that the medical associations could take a number of steps to address the opioid and heroin crisis by supporting evidence-based interventions including:

· Endorsing mandatory continuing medical education programs for opioid prescribers;

· Supporting initiatives that require physicians to check prescription drug monitoring programs before prescribing painkillers to patients; and

· Supporting increased transparency in physician prescribing practices and proper intervention for those who may be outliers.

Text of today’s letters is below.

May 11, 2016

Steven J. Stack, MD

President

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.

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.

Sincerely,

Richard J. Durbin

United States Senator

CC: Thomas M. Anderson, M.D.

President, Illinois State Medical Society

May 11, 2016

Wanda Filer, MD, MBA, FAAFP

President

American Academy of Family Physicians

1133 Connecticut Ave., NW
Suite 1100
Washington, DC 20036

Dear Dr. Filer:

The American Academy of Family Physicians (AAFP) is the national association of family doctors and one of the largest national medical organizations, with 120,900 members in 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, and Guam. Family medicine is often considered the most versatile of all physician specialties, with AAFP members providing comprehensive medical care to patients of all genders and ages. AAFP members work every day to improve the health of your patients.

When it comes to the opioid and heroin crisis, each stakeholder needs to do their part. The AAFP, as a leading voice in the medical community, and your members must accept greater responsibility for the role you have played, and continue to play, in the ongoing prescription opioid epidemic. The AAFP should take immediate action to reduce the number of opioids that are prescribed when not medically necessary.

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. A study published last year in the journal JAMA Internal Medicine found that the majority of opioid painkillers are not being prescribed by a small group of bad doctors. Rather, a large number of these drugs are being prescribed by run-of-the-mill family doctors and general practitioners. In 2013, family doctors collectively wrote over 15 million prescriptions for opioids – a number higher than for any other category of health care worker. It is worth noting that 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).

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 AAFP or its members to fail to take responsibility for its role in contributing to the opioid and heroin epidemic.

The AAFP could help address the opioid and heroin crisis by supporting evidence-based interventions. For instance, the AAFP 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 AAFP 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 AAFP’s mission statement is to “Improve the health of patients, families, and communities by serving the needs of members with professionalism and creativity.” 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 improve the health of patients, families, and communities than by immediately embracing changes in the medical community that would help prevent opioid and heroin drug addiction and future overdose deaths.

Sincerely,

Richard J. Durbin

United States Senator

CC: Alvia Siddiqi, MD, FAAFP

President, Illinois Academy of Family Physicians

May 11, 2016

Jay Kaplan, MD, FACEP

President

American College of Emergency Physicians

2121 K. Street, NW, Suite 325
Washington, DC 20037

Dear Dr. Kaplan:

The American College of Emergency Physicians (ACEP) represents more than 32,000 emergency physicians, residents, and medical students nationwide. Physicians who specialize in emergency medicine fill an integral role in our health care system and are often called upon to serve many patients at once with a variety of different health care problems. Each year, more than 115 million people receive care in emergency departments across the country, truly making ACEP’s members our nation’s safety net providers.

When it comes to the opioid and heroin crisis, each stakeholder needs to do their part. The ACEP, as one of the leading voices 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. Emergency department practitioners are often at the front lines of this epidemic. They must treat people for acute or chronic pain (which accounts for almost two-thirds of emergency department visits in the United States) and they must treat people for drug overdoses (two-thirds of emergency room visits involving overdoses are due to prescription drugs). The ACEP should take immediate action to reduce the number of opioids that are prescribed when not medically necessary.

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. A 2014 study published in the official journal of the Society for Academic Emergency Medicine confirmed that from 2001 to 2010, the percentage of emergency room visits during which opioids were prescribed jumped by 10 percent. It is worth noting that 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).

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 ACEP or its members to fail to take responsibility for its role in contributing to the opioid and heroin epidemic.

The ACEP could help address the opioid and heroin crisis by supporting evidence-based interventions. For instance, the ACEP 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 ACEP 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 ACEP’s mission statement is to “Promote the highest quality of emergency care.” 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 highest quality of care than by immediately embracing changes in the medical community that would help prevent opioid and heroin drug addiction and future overdose deaths.

Sincerely,

Richard J. Durbin

United States Senator

CC: Valerie Phillips, MD, FACEP

President, Illinois College of Emergency Physicians

May 11, 2016

Carol Gomez Summerhays, D.D.S.

President

American Dental Association

1111 14^th Street, N.W. Suite 1200

Washington, DC 20005

Dear Dr. Gomez Summerhays:

The American Dental Association (ADA) is our nation’s largest dental association, representing more than 159,000 dentist members from all 50 states, the District of Columbia, and Puerto Rico. The ADA is the leading source of oral health related information for dentists, and ADA members play an invaluable role in meeting the important health needs of patients nationwide.

When it comes to the opioid and heroin crisis, each stakeholder needs to do their part. The ADA, as a leading voice in the oral health community, and its members must accept responsibility for the role it has played, and continues to play, in the ongoing prescription opioid epidemic. Dentists are the third highest-prescribing profession of opioids (after general practitioners and internists). In 2009, dentists prescribed about eight percent of all opioids. The ADA should take immediate action to reduce the number of opioids that are prescribed annually when not medically necessary.

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 ADA or its members to fail to take responsibility for its role in contributing to the opioid and heroin epidemic.

The ADA could help address the opioid and heroin crisis by supporting evidence-based interventions. For instance, the ADA could endorse mandatory continuing medical education programs for opioid prescribers and support initiatives that require dentists to check prescription drug monitoring programs before prescribing painkillers to patients. It could support increased transparency in dentist prescribing practices and proper intervention for those who may be outliers. The ADA also could prioritize helping dentists to be more judicious in their prescribing of these addictive drugs while protecting access for those that need these prescriptions to manage pain.

In 2014, more than 28,000 people nationwide – 1,652 in Illinois – died from prescription opioid and heroin overdoses. We need your association, and your members, to step up and immediately embrace changes in the oral health community that would help prevent opioid and heroin drug addiction and future overdose deaths.

Sincerely,

Richard J. Durbin

United States Senator

CC: Bradley W. Barnes, DDS

President, Illinois State Dental Society

-30-

Previous Article Next Article