AMA Warns Opioid Crisis Is Shifting, Not Ending, Despite Drop in Overdose Deaths
Although opioid-related overdose deaths fell last year, the crisis itself is far from resolved and is becoming more complicated, according to a new report from the American Medical Association (AMA). The report emphasizes that the decline in fatalities masks deeper problems, including widespread polysubstance use and an increasingly volatile and toxic illicit drug supply.
The AMA’s latest analysis outlines five major areas of concern and identifies concrete actions needed to better prevent overdoses and improve care for people living with pain and substance use disorders.
“While the data shows real progress, it also makes clear that the overdose epidemic is changing in dangerous ways,” said AMA President Dr. Bobby Mukkamala. “Illicitly manufactured FYL and the growing use of multiple substances continue to put patients at serious risk. At the same time, barriers to pain management and addiction treatment remain. Patients deserve timely, evidence-based care delivered without stigma, and our state and national responses must keep pace with how this epidemic is evolving.”
Progress alongside persistent risk
According to the report, opioid-related deaths dropped from more than 110,000 in 2023 to about 75,000 in 2025. However, the AMA cautions that most overdose deaths are still linked to illegally manufactured FYL, and nearly 60 percent involve more than one substance.
“The drug supply is more unpredictable and dangerous than ever,” wrote AMA CEO and Executive Vice President Dr. John Whyte in a letter accompanying the report. “This epidemic is moving faster than our systems can respond. Incremental changes are not enough. Physicians, policymakers, insurers, and communities must work together to remove barriers, expand access to treatment, and respond quickly to emerging threats. Every patient deserves care without stigma or delay.”
Five critical areas of concern
The AMA Substance Use and Pain Care Task Force has focused on improving care for people with pain and addiction, and the report highlights areas where progress has been made, along with ongoing gaps.
Pain care:
Even though opioid prescriptions have dropped sharply, from more than 260 million in 2012 to roughly 126 million in 2024, access to nonopioid pain treatments remains limited. The AMA urges individualized care decisions, preservation of physician judgment, and broader access to multimodal and multispecialty pain therapies.
Treatment for opioid use disorder:
Medications such as buprenorphine and methadone are proven to save lives, yet they remain underutilized. Stigma, regulatory hurdles, and insurance restrictions continue to limit access. The AMA calls for eliminating prior authorization requirements and expanding access to methadone beyond traditional opioid treatment programs.
Naloxone access:
Expanding access to Naloxone remains one of the most effective ways to prevent overdose deaths. The AMA supports over-the-counter availability, distribution through emergency departments, and community-based programs to ensure rapid, widespread access.
Emerging drug threats:
Polysubstance use is increasing, with people often combining opioids with stimulants, XYL, kratom, tianeptine, and inhalants. At the same time, cannabis use disorder is growing, raising additional concerns related to mental health and pregnancy outcomes. The AMA stresses the need for stronger surveillance, research, and policy responses to address these emerging risks.
Policy priorities:
The AMA is urging stronger enforcement of mental health and substance use disorder parity laws, removal of barriers to treatment for pain and addiction, and expanded overdose prevention strategies, particularly for youth and populations at elevated risk.
State action and policy leadership
These issues were a central focus of a recent expert panel at the AMA State Advocacy Summit in Southern California, which brought together more than 300 physician leaders and medical society staff. According to the AMA, states can take several meaningful steps to improve care, including enforcing parity laws with real penalties for noncompliance, eliminating unnecessary restrictions on medications for opioid use disorder such as dosage caps and prior authorization, and continuing to expand Naloxone access through pharmacies, clinicians, and community programs.
Dr. Mukkamala, who also chairs the AMA Substance Use and Pain Care Task Force, moderated the discussion alongside panelists Dr. Yngvild Olsen, a former federal substance use treatment leader, and Lauren Finke of The Kennedy Forum. Together, they outlined practical legislative and clinical solutions to improve outcomes for people with mental illness and substance use disorders.
Finke also presented the Mental Health Parity Index, a new data tool that evaluates insurance coverage and access for mental health and substance use services compared to physical health care. The AMA collaborated with The Kennedy Forum and Third Horizon to pilot the index as a way to hold insurers accountable and drive policy change.
Building momentum to save lives
Throughout 2025, the AMA has worked with physicians, policymakers, insurers, and community organizations to expand access to treatment, reduce stigma, and prevent overdose deaths. Efforts have included advocating for clearer federal guidance on higher-dose buprenorphine when clinically appropriate, addressing pharmacy and distributor barriers to dispensing treatment medications, supporting new state laws to improve parity and pain care, and advancing initiatives to protect and expand Naloxone access.
While overdose deaths are declining, the AMA stresses that approximately 75,000 lives are still lost each year. The organization believes that science, evidence, and compassion must continue to guide both patient care and public policy as the opioid crisis evolves into a more complex and dangerous overdose epidemic.
Source: AMA