The American Academy of Family Physicians (AAFP) is deeply aware of the devastation caused by prescription drug abuse. Opioid abuse is destroying the lives of too many of our patients, their families and their communities—and resulting in too many deaths.

Family physicians are equally concerned that patients who require pain relief to function have access to needed treatments. These treatments vary and most often do not involve opioids. In a 2012 study of our members, four other treatment methods—physical and occupational therapy, oral non-steroidal anti-inflammatories, acetaminophen and antidepressants—were prescribed or recommended for patients dealing with non-malignant chronic pain before opioids.


Nonetheless, we must acknowledge that family physicians write more than a quarter of all opioid prescriptions. This is a reflection of the fact that family physicians conduct approximately one in five office visits, which is 192 million visits annually, or 48 percent more visits than the next-most visited specialty. Consequently, we agree that the medical profession, and family medicine especially, must lead the effort to find a comprehensive solution to this abuse.

To that end, we have strongly supported effective state prescription drug monitoring programs that facilitate the interstate exchange of registry information as called for under the National All Schedules Prescription Electronic Reporting Act. We agree that physicians should always use their state prescription drug monitoring programs before prescribing any potentially abused pharmaceutical product. However, the success of such efforts depends on state reporting systems that are accessible, timely and interoperable. We need to work together to make these systems effective for the sake of the public health.

Family physicians certainly need more tools to treat opioid abuse and addiction. For example, family physicians have advocated for expanding medication-assisted treatment to 200 individual patients with buprenorphine hydrochloride, a drug that is approved for the maintenance phase of treating opioid dependence. The current cap for such medication-assisted treatment is 100 patients per physician. That limit dramatically slows expansion of opioid addiction treatment and creates waiting lists for treatment, particularly in areas where the opioid addiction epidemic is severe.

Insurance policies also could end diversion of pain medication. Too often, patients get more opioid pills than they need and then sell or share their unused opioids with family or friends. The AAFP has urged policymakers to end the requirement that patients pay the same out-of-pocket copayments and coinsurance for a three-day prescription as they pay for a 30-day prescription. Instituting partial prescriptions would significantly reduce the potential for left-over pills ending up in the hands of abusers or on the streets.

Taken together, these policies, as well as increased funding for recovery and rehabilitation for patients addicted to opioids, can have a significant impact on solving the opioid abuse crisis facing our nation. Family physicians often have struggled to find inpatient services when their patients are receptive to such treatment.

In addition, the AAFP works hard to educate our members to ensure the safest and most effective use of long‐acting and extended‐release opioids, and help physicians recognize the signs of addiction.

In 2014, AAFP members took a minimum of nearly 134,000 hours of continuing medical education about the use and prescribing of opioid medications. We are working to increase that number by providing additional educational opportunities to our members and others. For example, our 54 constituent chapters also provide CME on prescribing opioids and managing pain.

Last fall, the AAFP joined more than 40 health professions groups in a pledge to combat opioid addiction. As part of that pledge, the AAFP committed to increasing the number of family physicians trained in opioid prescribing practices by 10,000.

In addition, we have worked closely with other federal and organizational programs focused on the reduction of opioid abuse, including the White House, the Department of Health and Human Services, the Centers for Disease Control and Prevention and the American Medical Association Task Force to Reduce Opioid Abuse. We will continue to work with those agencies to develop policies that prevent opioid abuse and addiction while protecting access to legitimate pain medicine prescriptions for life-limiting pain.

The scourge of opioid abuse and addiction must end. It will require an all-hands-on-deck effort by the entire health care community as well as national and state policy makers. Family physicians are committed to resolving this epidemic both on the front lines and as advocates for our patients.

Wanda Filer, MD, MBA, is president of the American Academy of Family Physicians and a family physician in York, Pennsylvania.