AMA to ABA: Let’s work together to fight the opioid epidemic

Related story: New opioid crisis report: Legal aid, courts play critical role in solution

A top leader of the American Medical Association came to the American Bar Association on Aug. 10 to deliver an important message: Doctors and lawyers must work together to stop the nation’s deadly opioid epidemic.

Dr. Susan R. Bailey, president-elect of the AMA, delivered the message at the ABA Annual Meeting in San Francisco.

“Thank you so much for the opportunity to be here, to meet with ABA colleagues,” Bailey said.  “It’s a wonderful opportunity for medicine and the legal profession to work together.”

Bailey, a Texas physician, was welcomed by David Hoffman, a partner with Sidley Austin in Chicago and co-chair of the Legal Service Corporation’s Opioid Task Force. “This is special that we have the president-elect of the AMA here,” Hoffman said.

Bailey and Hoffman discussed solutions at a program titled “Responding to the National Opioid Crisis,” co-sponsored by the ABA Health Law Section and Senior Lawyers Division.

Hoffman began by reciting some grim facts about the epidemic:

• From 1999 to 2017, almost 400,000 people in the United States died from opioid-related overdoses. “That’s a staggering number,” Hoffman said.
• In 2017, about 130 people died every day from such overdoses.
• Approximately 2.1 million people have opioid use disorder, of which about 17% are uninsured.
• Opioid deaths now outnumber deaths caused by firearms and cars.
• Foster care systems are overwhelmed, with more than half of all children in some states requiring services due to opioid misuse in their homes.

Bailey echoed Hoffman’s sense of urgency. She noted a recent story in the San Francisco Chronicle that deaths from fentanyl, a powerful synthetic opioid, are up 150% in the region.

Then again, Bailey noted, there is also hope: The Centers for Disease Control and Prevention reported in July that deaths from prescription opioids dropped slightly in 2018. “Is this a one-year blip or is it really a trend?” Bailey asked. Either way, the number of deaths “remain at sky-high levels,” she added.

Hoffman said some legal aid organizations are fighting back by going where they are needed most – to hospitals, addiction treatment centers and social service centers. “Really where you want to go is where the people who are getting addiction treatment are going,” he said.

These medical-legal partnerships help patients and clients, Hoffman said, by treating both the physical causes and the legal consequences of addiction – lost jobs, lost homes, family and domestic issues. “These are not medical issues, they are legal issues, but they are interrelated,” he said.

Doctors and lawyers cannot succeed without help from each other, Hoffman added. Medical-legal partnerships are “an example of doctors and lawyers working together, which happens sometimes but not often enough,” he said.

Bailey said doctors need the help of lawyers to tackle larger issues beyond those of individual patients. For example, she said, “We need reforms in the civil and criminal justice system that help ensure access to high-quality, science-based, evidence-based care for opioid use disorder, including medication-assisted treatment.”

The doctor highlighted three recent legal cases that focus on opioid issues. These cases, she said, show “how legal and medical experts can work together to make sure there is evidence-based care for opioid use disorder patients in correctional settings, and that health insurance companies must use medical evidence to evaluate claims, not just financial evidence. We must work together to hold them to that standard.”

Finally, Bailey and Hoffman said that doctors and lawyers must work together to ensure that any financial payments from opioid lawsuits go directly to prevention and treatment of the disease.

In June, the AMA House of Delegates adopted a new policy on that issue. The ABA House of Delegates adopted a similar resolution at its meeting on Aug. 13.

“It’s perfectly natural that medicine and law should work together on this,” Bailey concluded.

Anne McGinness Kearse, a lawyer with the firm Motley Rice in Mount Pleasant, S.C., also presented a summary of recent litigation against opioid manufacturers and distributors. None has gone to trial, she said, but several trials are scheduled.