Although the U.S. recorded a decline in opioid-related overdose deaths in 2024, the overdose epidemic is dangerously evolving, according to American Medical Association President Bobby Mukkamala, MD.
In a report published Jan. 12, the AMA outlines growing concerns about the national overdose epidemic, including barriers to nonopioid pain care, stigma, regulatory challenges, insurance restrictions and the increases in polysubstance use and cannabis use disorder.
Here are five takeaways from the 24-page report:
1. Between 2023 and 2024, annual U.S. overdose deaths declined from more than 110,000 to approximately 75,000. The AMA attributed most of these deaths to illicit fentanyl use and other substances, particularly methamphetamine and cocaine.
2. Opioid prescriptions have declined 51.7% since 2012. However, access to medications for opioid use disorder is uneven amid health insurance barriers, stigma and restrictive state laws, according to the AMA.
“[W]hile there has generally been a positive increase in policies to remove barriers for medications for opioid use disorder, prescriptions for buprenorphine to treat opioid use disorder have remained level since 2019,” the report said.
Other access barriers to nonopioid pain care include high costs and “the need to balance access with daily activities such as child care, employment and related social determinants of health.”
3. The prevalence of cannabis use disorder is growing, as is polysubstance use, which involves stimulants, xylazine, kratom, tianeptine and inhalants.
In 2023, 6.8% of individuals aged 12 years and older — about 19.2 million people — met criteria for cannabis use disorder.
4. In 2024, 15.4 million buprenorphine prescriptions were dispensed in the U.S. — a slight decrease from the 15.7 million in 2023. The AMA said the reasons for this decline could include more use of long-acting medications, payer restrictions such as prior authorizations, or state laws that scrutinize physicians who prescribe buprenorphine.
5. The distribution of naloxone has significantly increased in recent years. However, there is substantial variation in naloxone access across states and inequities in the number of naloxone prescriptions for Black individuals and women, compared to other patients.
