Despite the existence of severe punishments for illegal possession of narcotics, opioid-related deaths remain at crisis levels in the U.S. One reason for this is that precious few policies have been put in place that align the needs of individuals and communities suffering from opioid-use disorder with clinical evidence. Such evidence-based harm-reduction practices rely heavily on care continuity, and they can be easily thwarted by the failed but ongoing war on drugs.
The July issue of AMA Journal of Ethics® (@JournalofEthics) expands on the August 2020 issue examining opioids and public health. It explores how harm-reduction strategies—which respect and emphasize bodily autonomy, freedom of choice and person-centered care—have faced resistance from policymakers and the public, as well as why these strategies are needed now more than ever.
The AMA Journal of Ethics is an editorially independent, peer-reviewed journal devoted to helping students and clinicians navigate ethical decisions in service to patients and communities. The July issue of AMA Journal of Ethics includes the following articles:
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“When Medication Treatment for Opioid-Use Disorder Gets Disrupted by Extra-Clinical Variables, How Should Clinicians Respond?”
- Physicians and other health professionals caring for patients with opioid-use disorder should plan for possible disruptions of treatment caused by arrests and pretrial confinements.
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“What Should the U.S. Learn From New York’s and Portugal’s Approaches to the Opioid Crisis?”
- Some U.S. localities are trying interventions modeled on international approaches to decriminalization.
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“How Should the Use of Opioids Be Regulated to Motivate Better Clinical Practice?”
- Reconsider regulatory and clinical frameworks for prescribing long-term opioid therapy for pain and prescribing opioids to treat opioid use disorder.
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“What Would Equitable Harm Reduction Look Like?”
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Structural determinants of health frameworks must be person centered and express antiracism to be effective.
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Listen and learn
The journal’s July “Ethics Talk” podcast features a discussion with Jim Withers, MD, medical director at Pittsburgh Mercy’s Operation Safety Net and medical director and founder of the Street Medicine Institute, and Dave Lettrich, founder and executive director of Bridge to the Mountains and the Bridge Outreach program, also in Pittsburgh. They explored how street-outreach programs help mitigate harms of drug use among people without homes.
The July issue also features nine author-interview podcasts. Listen to previous episodes of the “Ethics Talk” podcast or subscribe in iTunes or other services.
Also, CME modules drawn from this month’s issue are collected at the AMA Ed Hub™ AMA Journal of Ethics webpage.
Win up to $5,000 for your essay, artwork
Submissions for the 2024 Conley Contests are being accepted through Sept. 23.
Those eligible to submit entries are:
- U.S. MD and DO students.
- Resident physicians or fellows in programs accredited by the Accreditation Council for Graduate Medical Education or American Osteopathic Association.
- Early career physicians who have completed advanced training within the last five years.
The winning prize for the best essay and artwork, respectively, is up to $5,000.
Learn more about the Ethics Essay Contest and the Art of Medicine Contest.
A look ahead
The next issue of the journal will focus on standards in medical-legal partnerships. Sign up to receive email alerts when new issues are published.
