AMA Urges Decisive Action as Substance Use Epidemic evolves
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Despite a recent decline in opioid-related overdose deaths, the nation’s substance use crisis remains a widespread and increasingly complex public health emergency, demanding urgent and coordinated action, according to a new report from the American Medical Association (AMA). The report,released January 12,2026,outlines five key areas of concern and actionable steps to address the evolving epidemic and expand access to treatment for individuals struggling wiht pain and substance use disorders.
“While the data points to meaningful progress, it also shows the overdose epidemic is evolving in hazardous ways,” said AMA President Bobby Mukkamala, MD.”Illicitly manufactured fentanyl and polysubstance use continue to put patients at risk, while barriers to pain care and addiction treatment persist.”
A Shifting Landscape of Overdose Deaths
Opioid-related deaths decreased from over 110,000 in 2023 to 75,000 in 2025, a significant but fragile improvement. However, the crisis is far from over. According to the AMA, the vast majority of these deaths continue to be driven by illicitly manufactured fentanyl-with nearly 60% involving the use of multiple dangerous substances. the illicit drug supply is now more toxic and unpredictable than ever before.
“The bottom line: this epidemic is evolving faster than our systems are
Key Areas of Focus
Expanding Access to Medication-Assisted Treatment (MAT): The AMA advocates for removing barriers to evidence-based treatments for opioid use disorder, including methadone and buprenorphine. This includes expanded access to methadone beyond traditional opioid treatment program settings. Prescriptions for buprenorphine have risen dramatically, from 1.4 million in 2012 to 15.4 million in 2024, demonstrating a growing, but still insufficient, commitment to medication-assisted treatment.
Naloxone access: Expanding access to naloxone, a life-saving medication that can reverse opioid overdoses, is paramount. The AMA supports over-the-counter availability, distribution in emergency departments, and community-based programs to ensure timely administration.
Emerging Threats: Polysubstance use is on the rise, with individuals increasingly combining opioids with stimulants, xylazine, kratom, tianeptine, and inhalants. Additionally, cannabis use disorder is growing, posing risks to mental health and pregnancy. The AMA emphasizes the need for increased surveillance, research, and public policies to mitigate these emerging harms.
Policy priorities: The AMA is advocating for the enforcement of mental health and substance use disorder parity laws, the removal of barriers to treatment, and strengthened overdose prevention efforts, particularly for youth and high-risk populations.
State-Level Action and the Mental Health Parity Index
The need for policy changes to remove barriers to care was a central theme at the AMA State Advocacy Summit held last week in Southern California, drawing over 300 physician leaders and medical society staff. States can take concrete steps, including increasing enforcement of mental health and substance use disorder parity laws-with meaningful penalties for non-compliance-removing barriers to medications for opioid use disorder (such as prior authorization and dosage restrictions on buprenorphine), and expanding access to naloxone.
During the summit, lauren Finke, MPP, senior policy director at The Kennedy Forum, demonstrated the Mental Health Parity Index, a new data visualization tool that analyzes commercial insurance plans to assess coverage and access to mental health and substance use services compared to physical health services. The AMA collaborated with The Kennedy Forum and Third Horizon to launch a pilot of this innovative tool.
Building momentum for Change
In 2025, the AMA actively fostered collaboration among physicians, policymakers, insurers, and community organizations to increase access to care, reduce stigma, and save lives. These efforts included partnering with medical societies to urge the Food and Drug administration to clarify guidance on buprenorphine dosages, joining a coalition to address restrictions on buprenorphine dispensing, and supporting new state laws in Colorado, Illinois, Virginia, and Washington focused on pain care, parity, and naloxone access.
The AMA believes that a science-driven, compassionate approach is essential to address the evolving opioid epidemic and the broader illicit drug overdose crisis. Further information is available on the AMA’s End the Epidemic website.
