Public Policy Statements

ASAM's Public Policy Statements help guide its legislative and regulatory advocacy.

Public Policy Presentations Racial Justice Policy Series

Policy statements

Public Policy Statements

The Public Policy Committee (PPC) drafts ASAM's public policy public statements on emerging addiction issues. The PPC Chair selects a writing committee of ASAM members, which draft and deliberate each policy statement. In addition, every year, the PPC reviews statements that have reached five years of age for archival or revision. Final approval is subject to the ASAM Board of Directors.

The Role of Pharmacists in Medications for Addiction Treatment

Pharmacists help to ensure the safe and effective use of addiction medications, such as buprenorphine, the most commonly used medication for the treatment opioid use disorder (OUD) that can be prescribed or dispensed in clinicians’ offices. Despite buprenorphine’s distinct mechanism of action, safety, effectiveness, and lower risk classification than full opioid agonists under the Controlled Substances Act (CSA), some pharmacies still associate significant risk with ordering and dispensing buprenorphine, possibly conflating harms associated with diversion of medications like oxycodone and alprazolam with buprenorphine’s diversion risks.

Medical Ethics in Addiction Medicine

The American Society of Addiction Medicine (ASAM) has adopted the American Medical Association’s (AMA) Principles and Code of Medical Ethics (“the Principles”) that guide physicians in the ethical practice of medicine. In prefacing the Principles, the AMA describes the complex relationship between ethical values and legal principles, and acknowledges that laws sometimes permit or even mandate ethically unacceptable conduct. Given that criminal-legal consequences can be associated with substance use, and that stigma and discrimination surround addiction and its medical treatment, addiction specialist physicians (ASPs) face unique and difficult professional ethical challenges that are not addressed by the Principles, specifically. Thus, this statement elucidates the Principles to help guide ethical decision-making in the clinical practice of addiction medicine. In general, ASAM believes many of these recommendations can apply to any physician or other healthcare professional engaged in addiction treatment, even if not an ASP.

Government Strategies to Foster Ethical Addiction Treatment

The ethics of medicine and public health, however, call for upholding the individual patient-clinician relationship, informed consent, and addressing social determinants of health. Thus, ASAM urges policymakers to prioritize policies that foster quality addiction treatment and enact long-term government strategies to address persistent unethical practices.

Strengthening Good Samaritan Laws to Prevent Fatal Overdose

To encourage more individuals to call for emergency medical assistance during an overdose, ASAM supports governments enacting stronger Good Samaritan laws (GSLs) to grant appropriate protections against arrest and prosecution for certain drug-related crimes for a well-defined group of individuals. This includes protections from drug-induced homicide and drug delivery resulting in death (DIH/DDRD) laws.

Refocusing Prescription Drug Monitoring Programs (PDMPs) to Serve Public Health

The American Society of Addiction Medicine supports a wide variety of effective measures to protect public and patient health and safety, which includes a proper role for Prescription Drug Monitoring Programs (PDMPs). PDMPs manage and collect data on dispensed prescription drugs with misuse potential in a state or territory.

Prevention

The lessons the nation is learning from the past decades underscore the need to fund and deploy validated and vigorous prevention measures in medical and nonmedical settings. While the nation’s current approach to substance use prevention has value, it also has fundamental weaknesses, including its constraint by commercial influence and the need to demonstrate visible policy impacts in the short-term. The imminent challenge to governments is to substantially support research for better insight into longstanding uncertainties, including implementation fidelity and adaptation, and long-term sustainability of prevention interventions, and furthermore, to swiftly adopt and implement evidence-based prevention policies and programs at scale.

Racial Justice Beyond Health Care: Addressing the Broader Structural Issues at the Intersection of Racism, Drug Use, and Addiction

In this final public policy statement of a three-part series on advancing racial justice in the context of addiction medicine, ASAM continues its analysis of systemic racism as a social determinant of health that disproportionately damages the health and lives of Black, Indigenous, and People of Color (“BIPOC”) who use substances or have substance use disorder (SUD).

Optimizing Telehealth Access to Addiction Care

The American Society of Addiction Medicine (ASAM) is deeply committed to ensuring every person with substance use disorder (SUD) has access to high-quality, full-spectrum addiction care and to closing the addiction treatment gap.

Substance Use and Substance Use Disorder Among Pregnant and Postpartum People

ASAM strongly supports reforms to reverse the punitive approach taken to substance use and SUD during and after pregnancy and respond to the shared interests of the parent-newborn dyad by providing ethical, equitable, and accessible, evidence-based care.

Advancing Racial Justice in Health Care through Addiction Medicine

ASAM’s Public Policy Statement on Advancing Racial Justice in Health Care through Addiction Medicine is the second statement of ASAM’s policy series on racial justice. This second statement focuses on actions that healthcare professionals, healthcare systems, institutions, and organizations, professional medical entities, researchers, and health professional educators can take to help advance addiction medicine and its role in addressing health disparities for people of color.

Hepatitis C Virus, Substance Use, and Addiction

Opioid use disorder (OUD) and infectious diseases are intertwined public health crises; hepatitis C virus (HCV) is the most prevalent bloodborne infection associated with drug use. Incidence and prevalence of HCV infection have increased significantly as a result of increasing rates of injection drug use, yet the introduction of curative direct acting antiviral (DAA) HCV therapies offer promise in reducing disease burden and transmission.

Recognition and Role of Addiction Specialist Physicians in Health Care in the United States

Addiction specialist physicians (ASPs) include physicians from multiple different primary specialties. Four medical subspecialty certifications for ASPs demonstrate and define expertise in addiction treatment: Subspecialty board certification in addiction medicine by the American Board of Preventive Medicine (ABPM); Subspecialty board certification in addiction psychiatry by the American Board of Psychiatry and Neurology (ABPN); Subspecialty board certification in addiction medicine by the American Osteopathic Association (AOA); or Certification by the American Board of Addiction Medicine (ABAM).

Morphine Milligram Equivalents for Medications for Opioid Use Disorder (MOUD)

This difference in doses of methadone and buprenorphine used to treat addiction and opioids used to treat pain may cause confusion among policymakers and payers attempting to set policies to prevent opioid overdose by limiting MME, as well as among state medical board officials attempting to enforce clinical guidelines and stem the over-prescription of opioid analgesics.

Regulation of the Treatment of Opioid Use Disorder with Methadone

This policy statement outlines existing regulatory barriers that prevent broader access to methadone treatment for OUD and summarizes current challenges to optimizing the quality of care offered by OTPs. Recommendations address ways to improve both access to, and the quality of, methadone treatment for OUD by making such treatment more patient-centered and integrated with other medical care. Such improvements are expected to reduce overdose deaths and improve health outcomes.

Overdose Prevention Sites

The United States has seen staggering increases in drug overdose deaths since the beginning of the 21st century. The 12 months ending in May 2020 witnessed the largest number of drug overdose deaths for a 12-month period ever recorded.

Patient Review and Restriction (PRR) Programs

Patient Review and Restriction (PRR) programs, also known as pharmacy “lock-in” programs, allow payers, including State Medicaid programs and commercial insurers, to curb a beneficiary’s overutilization, and possible misuse, of physician services and/or prescription medications by restricting the patient to a single designated provider, pharmacy, or both.

Use of Naloxone for the Prevention of Opioid Overdose Deaths

Naloxone is a remarkably effective, inexpensive and safe medication. It acts quickly, has no addictive potential, may be dispensed by injection (preferably intramuscular) or intranasally, and has mild side effects (other than precipitating opioid withdrawal) when used at the lowest effective dosage for reversal.

Advancing Racial Justice in Addiction Medicine

This is the first of a series of policy statements on racial justice through which ASAM reiterates the fundamental axiom that systemic racism is a social determinant of health that has had profound, deleterious effects on the lives and health of BIPOC.

Access to Medications for Addiction Treatment for Persons Under Community Correctional Control

Individuals under community correctional control include those on probation or parole. People on probation may have been sentenced to a term of supervision in the community or may be serving their sentence in the community in lieu of incarceration, the latter of which includes those involved with problem-solving courts such as drug courts, mental health courts, and veterans’ courts, among others.

Cannabis

Cannabis is a plant that has been used for its intoxicating effects for at least a century in the United States and for longer in other cultures. It also has a long history of use around the world for purported medical benefits. More than 100 different cannabinoids have been identified in cannabis.

Treatment of Opioid Use Disorder in Correctional Settings

This policy statement describes the standard of care that ASAM believes all detained and incarcerated individuals with OUD should receive. ASAM also advocates for systemic changes to ensure universal access to such care within correctional institutions.

Third-Party Payment for Addiction Treatment

This policy statement addresses some of the key issues facing clinicians and third-party payers as they work together for the benefit of patients to solve the real-world practical problems of access to care, reimbursement for professional services, insurance benefit design, and health plan clinician network adequacy.

E-Cigarettes

Electronic cigarettes, also referred to as e-cigarettes, vaporizers or electronic nicotine delivery systems (ENDS), are non-standardized, battery-operated devices that use a “liquid” that most commonly would contain nicotine, as well as varying compositions of flavorings, in addition to propylene glycol, vegetable glycerin as vehicle forming a vaping cloud when exhaled, and other ingredients.

Physicians and Other Healthcare Professionals with Addiction

This policy statement articulates the American Society of Addiction Medicine’s recommendations for promoting the health of healthcare professionals with addiction and thereby contributing to their safe practice.