The opioid epidemic: What is the physician’s responsibility?

In the mid-to-late 1990s, manufacturers of prescription opioids assured physicians that these drugs would not make patients with pain become patients with substance use disorders. As a result, some physicians prescribed opioids without appropriate regard for their addictiveness. This contributed to prescription and street opioid misuse that has reached alarming proportions. With a multiyear public health emergency declaration for opioids, there is an ongoing need for physicians to understand the ethics involved in this crisis.

The August issue of AMA Journal of Ethics^® (@JournalofEthics) considers ethical questions that contextualize the opioid epidemic from social, cultural, and policy-based perspectives and gives you an opportunity to earn CME credit.

Articles include:

1. Advocacy and action to end the opioid epidemic by the AMA Opioid Task Force

   Six recommendations focus on specific actions to help reverse the nation’s opioid epidemic.

2. Should “pain clearance” be routine for elective surgery?

   Considering chronic opioid use when planning elective surgery would likely enhance team communication, decrease stigma, and facilitate care transitioning and long-term planning.

3. Do physicians have collective, not just individual, obligations to respond to the opioid crisis?

   Mandating processes that are not evidence based generates distress among patients and clinicians, so physician advocacy in national, state, and local policymaking is key.

4. What does good pharmacist-physician pain management collaboration look like?

   Both physicians and pharmacists have responsibilities to ensure that opioids are prescribed and dispensed for legitimate medical purposes and to meet legal requirements.

In the journal’s August podcast, Travis Reider, PhD, director of the master of bioethics degree program at the Johns Hopkins Berman Institute of Bioethics, discusses his own experiences with opioids and the ethical challenges of “legacy patients.” Reider is also the author of In Pain: A Bioethicist’s Personal Struggle With Opioids.

The episode also features Stephanie Zaza, MD, MPH, president of the American College of Preventive Medicine. On the podcast, Dr. Zaza discusses the future of opioid research priorities.

Listen to or watch previous episodes of the podcast, “Ethics Talk,” or subscribe in iTunes or other services.

The AMA Journal of Ethics CME module, “Revisiting the WHO Analgesic Ladder for Surgical Management of Pain,” is designated by the AMA for a maximum of 1 AMA PRA Category 1 Credit™.

Additionally, the CME module, “Ethics Talk: The Ongoing Opioid Epidemic,” is designated by the AMA for a maximum of 0.75 AMA PRA Category 1 Credit™.

The offerings are part of the AMA Ed Hub™, an online learning platform that brings together high-quality CME, maintenance of certification, and educational content—in one place—with relevant learning activities, automated credit tracking and reporting for some states and specialty boards.

Learn more about AMA CME accreditation. 

The journal’s editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians. Submit a manuscript for publication.

The 2020 John Conley Ethics Essay Contest and the Conley Art of Medicine Contest are now open for submission. Read the essay prompt and see visual media requirements on the AMA Journal of Ethics website.

Apply to become a theme issue editor to help the journal develop theme issues on interested and neglected topics.

Visit the journal’s COVID-19 Ethics Resource Center for articles, podcasts, and videos relevant to the ethical challenges of the current pandemic.

Upcoming issues of the AMA Journal of Ethics will focus on behavioral architecture in health care as well as caring for Native Americans. Sign up to receive email alerts when new issues are published.