Report Shows Decreases in Opioid Prescribing, Increases in Drug-Related Overdoses and Deaths

September 22, 2021

For the 10th consecutive year, opioid prescribing has decreased, yet more Americans than ever are dying from a drug-related overdose, according to a report released Sept. 21 by the American Medical Association (AMA). 

Minnesota’s opioid prescription rate went down 6.5 percent from 2019 to 2020. In the last decade, opioid prescribing decreased by 50.7 percent in Minnesota. Meanwhile, drug-related overdoses went up.  

“Minnesota prescribers have rightly changed their practices to prescribe opioids more judiciously; unfortunately, drug-related overdoses and deaths remain a crisis in Minnesota and the nation,” said Marilyn Peitso, MD, president of the Minnesota Medical Association (MMA). “Continued work is needed to save lives.”

To address the continuing epidemic, the MMA and the AMA are urging policymakers to join physicians to reduce mortality and improve patient outcomes by removing barriers to evidence-based care. The AMA report shows that overdoses and deaths are spiking even as physicians and other prescribers have greatly increased the use of prescription drug monitoring programs (PDMPs), the electronic databases that track controlled substance prescriptions and help identify patients who may be receiving multiple prescriptions from multiple prescribers. The report shows that prescribers and pharmacists used state PDMPs more than 910 million times in 2020.

Yet, Minnesota – like nearly every other state in the nation – continues to see increases in overdoses mainly due to illicit fentanyl, fentanyl analogs, methamphetamine and cocaine, according to the U.S. Centers for Disease Control and Prevention.  In addition, state public health, media and other reports compiled by the AMA show that the drug-related overdoses and deaths have worsened in Minnesota and nationally. Research and data from the National Institutes of Health, U.S. Substance Abuse and Mental Health Services Administration, and Indian Health Service underscore the continued challenges and inequities for Black, Latino and American Indian/Native Alaskan populations.

Actions that states can take

The AMA and the MMA urge policymakers to act now:

• Stop prior authorization for medications to treat opioid use disorder. Prior authorization is a cost-control process that health insurance companies and other payers use that requires providers to obtain prior approval from the insurer or payer before performing a service or obtaining a prescription. It is used to deny and delay services – including life-saving ones – as physicians are required to fill out burdensome forms and patients are forced to wait for approval. 
• Ensure access to affordable, evidence-based care for patients with pain, including opioid therapy when indicated. While opioid prescriptions have decreased, the AMA and the MMA are greatly concerned by widespread reports of patients with pain being denied care because of arbitrary restrictions on opioid therapy or a lack of access to affordable non-opioid pain care. 
• Take action to better support harm reduction services such as naloxone and needle and syringe exchange services. These proven harm reduction strategies save lives but are often stigmatized.  
• Improve the data by collecting adequate, standardized data to identify and treat at-risk populations and better understand the issues facing communities. Effective public health interventions require robust data, and there are too many gaps to implement widespread interventions that work.

About the Minnesota Medical Association
The Minnesota Medical Association is a non-profit professional association representing physicians, residents and medical students. With more than 11,000 members, the MMA is dedicated to being the leading voice of medicine to make Minnesota the healthiest state and the best place to practice.