AMA 2025 report on substance use and treatment

CHICAGO - The American Medical Association (AMA) today released its 2025 report (PDF) on the nation's overdose epidemic, showing that while opioid-related overdose deaths declined last year, the epidemic remains widespread and increasingly complex, driven by mixing opioids and other substances and an unpredictable illicit drug supply.

Overdose deaths declined from more than 110,000 in 2023 to about 75,000 in 2024, yet there is a tremendous amount of work to be done to sustain and accelerate this progress. The report emphasizes the life-saving role of naloxone and calls on policymakers and others to remove treatment barriers for substance use disorder and pain care.

The report highlights several key trends:

• Pain care: Opioid prescriptions have decreased (PDF) 52% since 2012, falling from 260.5 million to 125.7 million in 2024. Yet, many patients still face barriers to non-opioid pain treatments because of restrictive insurance coverage, leaving them in pain and with reduced function. The AMA advocates for individualized, patient-centered care that preserves physician discretion and expands access to the full menu of therapies.
• Treatment for opioid use disorder: Medications for opioid use disorder (MOUD), such as buprenorphine and methadone, save lives but remain underused due to stigma, regulatory barriers and insurance restrictions. Buprenorphine prescriptions increased (PDF) 83% over the past decade, though utilization has plateaued in recent years. The report highlights key local, state, and federal policies needed to expand access to MOUD and ensure timely treatment.
• Naloxone: Nearly 2 million naloxone prescriptions were dispensed in 2024 (PDF), and expanded distribution from community-based organizations continues to prevent overdose deaths. The AMA supports over-the-counter access and broader distribution from emergency departments and community settings.
• Emerging threats: Polysubstance use increasingly involves stimulants, xylazine, kratom, tianeptine and inhalants. The prevalence of cannabis use disorder is also growing, with associated mental health and pregnancy-related risks. The AMA calls for additional research and targeted policies to mitigate further harm, such as strong marketing and advertising regulations to protect young people.

"While the data points to meaningful progress, it also shows the overdose epidemic is evolving in dangerous ways," said AMA President Bobby Mukkamala, M.D. "Illicitly manufactured fentanyl and polysubstance use continue to put patients at risk, while barriers to pain care and addiction treatment persist. Every patient deserves timely, evidence-based care without stigma. State and national efforts must keep pace with the changing nature of this epidemic."

Over the past year, the AMA has worked to advance evidence-based policies to reduce overdose deaths, including efforts to eliminate prior authorization for MOUD, expand access to those medications, strengthen enforcement of parity laws for mental health and substance use coverage, and increase naloxone availability.

The AMA emphasizes that continued progress will require coordinated action among physicians, policymakers, insurers, and communities to remove barriers to care, respond rapidly to emerging threats, and save lives.