The opening recommendation of an American Medical Association (AMA) task force examining the opioid crisis urges physicians to participate fully in states' prescription drug monitoring programs (PDMPs) designed to identify possible opioid misuse that places patients at risk. In an interview with Addiction Professional this week, the AMA's board chair-elect said PDMPs became the first topic in a planned series of recommendations because it largely inspired the most energy among the 27 physician organizations represented on the task force.
Patrice A. Harris, MD, who serves as public health director for Fulton County, Ga., government, adds that while states should have leeway to design PDMPs to meet their specific needs, a few foundational concepts ideally should apply to all monitoring programs. “They should have a public health focus,” she says, and be housed in health agencies. She adds, “They should be fully funded so that they are user-friendly,” meaning that doctors are able to access patient data at the point of care and integrate use of the PDMP comfortably into their workflow.
In addition, “There should be some sharing of information across state lines,” Harris says, to avert situations in which patients are able to access prescription opioids from providers in multiple bordering states.
PDMPs currently operate in every state except Missouri, although the task force sees them as varying significantly in effectiveness from state to state at present. “We can learn about what works,” Harris says, adding, “Physicians want to use tools that are effective and evidence-based.”
The AMA's efforts related to PDMPs will include a resource web page that will house information on the programs and their usefulness for physician practices. In addition, there will be a national marketing and social media campaign to make physicians aware of all of the resources available to them to enhance appropriate prescribing.
Harris says the task force, which includes representation from 17 specialty medical societies, has not set out a timetable for release of further recommendations. Yet she offers a glimpse into some of the future areas of focus, suggesting that the medical community has a role in ensuring that certain populations are not stigmatized as a result of the opioid crisis. These would include persons dealing with chronic pain and individuals with substance use disorders.
Harris adds that broadening awareness of the benefits of the overdose reversal medication naloxone also will be a priority for the panel.
She says of the response to the crisis in general, “This is going to require a comprehensive, multifaceted, interdisciplinary approach.”