A new report today by the American Medical Association (AMA), Mississippi State Medical Association (MSMA), and Manatt Health shows Mississippi is adopting life-saving strategies to combat the opioid epidemic.

The report, based on data, a review of policies and discussions with key policy makers, points to policies that have helped patients with opioid use disorder as well as areas that need improvement.

The spotlight analysis found that Mississippi is making considerable progress in two key areas:

• Expanding naloxone access. The state’s efforts to expand access to naloxone, an overdose-reversing drug, saved more than 2,000 lives in 2017. MSMA supported the state policy of co-prescribing naloxone, a statewide standing order that allows people to obtain naloxone without a patient-specific prescription. The state Department of Mental Health has distributed thousands of doses of naloxone and provided education to nearly 4,000 law enforcement officers in 104 different agencies in 49 counties.
• Community engagement. StandUp Mississippi was designed to help reduce stigma and promote overdose prevention across multiple agencies, including the Department of Mental Health, Department of Public Safety, Mississippi Bureau of Narcotics, Mississippi Board of Pharmacy, Federal Bureau of Investigation, Mississippi Department of Human Services, and Drug Enforcement Agency.

“Mississippi has laid important groundwork to help end the epidemic,” said AMA President-elect Patrice A. Harris, M.D, M.A., and chair of the AMA Opioid Task Force. “But more must be done. While the state saw a decrease in deaths from prescription opioid-related causes, deaths from heroin and illicit fentanyl increased. Our report shows a pressing need for greater access to treatment for opioid use disorder and non-opioid pain care as well as strong oversight and enforcement of laws governing insurance parity.”

The spotlight analysis also found a promising program at the University of Mississippi Medical Center to increase access to opioid alternatives. The initiative focuses on treating pain with acupuncture, physical therapy, biofeedback, and other non-opioid alternatives. This approach could be promoted across other state institutions and used to expand Medicaid and commercial coverage of non-opioid pain management strategies.

“This spotlight analysis provides us with clear opportunities to help our patients receive evidence-based treatment,” said MSMA President Michael Mansour, M.D. “There are promising initiatives already under way, and we know that there is much more work to do. Collaboration is essential for success in preventing opioid overdose deaths. Medical personnel, public safety officials, mental health and substance abuse treatment providers, and community-based organizations all bring awareness and expertise to address this complex epidemic. The medical community must remain fully engaged and committed not only to address the 36 percent of overdose deaths involving prescription drugs but also to participate in the continued education and support of our colleagues, our patients, and all organizations involved in efforts to overcome this epidemic.”

A second area of progress is the work being done by the Mississippi Insurance Department to review health insurer policy forms to assess compliance with parity laws governing mental health and substance use disorder. The agency is developing materials on parity requirements for future regulatory reviews, as well as for insurers and consumers.

“Mississippi’s physicians are committed to ending the epidemic in our state,” said MSMA Executive Director Claude Brunson, M.D. “We have reduced opioid prescribing more than 20 percent since 2013 and trained 50 physicians last year to provide buprenorphine in-office for the treatment of opioid use disorder. That’s a good start—and we’re eager to work with policymakers to help increase access to evidence-based care for all Mississippians.”

Underscoring Dr. Brunson’s call for reform, the study found two specific areas the state could focus on to enhance the opioids fight:

Expanding access to medication-assisted treatment (MAT) and other treatment options. Mississippi’s decision not to expand Medicaid leaves many people affected by the epidemic without coverage or access to MAT, the evidence-based care standard for opioid use disorder. And for those who do have coverage in Medicaid or the commercial market, many face prior authorization delays or denials, making it even more difficult to connect patients to care when they need it.  

Evaluating the public health effects of the epidemic to target resources more effectively. The data clearinghouse being established at Mississippi State University could become a forum for state agencies to track key indicators of the epidemic on a regular basis to assess whether policies, programs, and other efforts in the state are working to improve patient care and reduce opioid-related harms. Greater collaboration with the MID, Medicaid, and public health experts could be helpful to strengthen surveillance efforts and help identify how to use the data to focus the state’s limited resources in areas of greatest need.

“Far too many Mississippi families and communities have suffered the devastating effects of opioid and heroin use disorder, said Diana Mikula, executive director of the Mississippi Department of Mental Health. “We hope to inspire Mississippians to work together to build healthier communities by understanding the dangers of opioids, learning the signs and symptoms of addiction, and finding out about treatment for themselves or people they know who may be suffering.”

Full report here: www.end-opioid-epidemic.org/MSspotlight