The American Medical Association released a report highlighting progress but persistent challenges in addressing the nation’s overdose epidemic. Opioid-related deaths dropped from more than 110,000 in 2023 to 75,000 in 2025. However, according to AMA CEO and Executive Vice President John Whyte, MD, MPH, “the bottom line: this epidemic is evolving faster than our systems are.” Most deaths remain driven by illicitly made fentanyl, and nearly 60% involve more than one dangerous substance.
AMA President Bobby Mukkamala, MD, emphasized the need for coordinated action: “Every patient deserves timely, evidence-based care without stigma. State and national efforts must keep pace with the changing nature of this epidemic.” The report identifies progress in medication treatment: prescriptions dispensed for buprenorphine, a key treatment for opioid-use disorder, rose from 1.4 million in 2012 to 15.4 million in 2024. Meanwhile, opioid prescriptions declined from 260.5 million in 2012 to 125.7 million in 2024.
Five priority areas
The AMA’s Substance Use and Pain Care Task Force highlighted five critical areas requiring action. Pain care remains inadequate despite the decline in opioid prescriptions; the AMA advocates for multimodal, multispecialty therapies and increased access to nonopioid options. Medications for opioid-use disorder, including buprenorphine and methadone, remain underused due to stigma, regulatory barriers, and insurance restrictions. The AMA calls for eliminating prior authorization and expanding methadone access beyond opioid treatment program settings. Naloxone access requires expansion through over-the-counter availability, emergency department distribution, and community-based programs. Emerging threats include rising polysubstance use, with users taking combinations including stimulants, xylazine, kratom, and tianeptine. Additionally, cannabis-use disorder is growing, increasing mental health and pregnancy risks.
State-level solutions
Key state actions include enforcing mental health and substance use disorder parity laws, removing barriers to medications for opioid-use disorder including prior authorization, and building upon efforts to increase naloxone access. In 2025, the AMA supported new state laws in Colorado, Illinois, Virginia, and Washington addressing pain care, mental health and substance-use disorder parity, and naloxone access.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.ama-assn.org/public-health/behavioral-health/time-decisive-action-substance-use-disorder-treatment