Bobby Mukkamala, MD

In part 2 of this episode of Crisis Point, 4 experts on pain and opioid misuse discuss continuing efforts to turn the tide.

Crisis Point: Turning the Tide in The Opioid Crisis

Our mini-docuseries has returned, taking a comprehensive look at public health crises affecting the United States today, with global implications tomorrow. If the crisis point is the moment where a crisis will worsen or begin to get better, the question remains: where are we now?

Addressing the Opioid Crisis: Efforts to Turn the Tide

This episode examines the growing and evolving opioid crisis, a public health emergency that has claimed more than half a million lives over the past 2 decades in the United States.

What began as a prescribing-driven epidemic has evolved into a more complex crisis fueled by the proliferation of illicit synthetic opioids, persistent gaps in access to treatment, and social determinants that drive vulnerability to substance use disorder.

In 2023, the overall rate of mortality from drug overdoses slightly fell for the first time since 2018.

 The decrease could be due to a number of factors, including new pharmaceutical options for treating opioid use disorder, a shift away from opioid prescribing regimens, regulatory and advocacy action, and even the COVID-19 pandemic. While the decrease is a positive sign for those working with OUD, overdose deaths related to illicitly manufactured fentanyl, fentanyl analogs, methamphetamine and cocaine remain at historic highs and the work is only beginning.

Be sure to check out part 1 of this episode, which into the complex challenges surrounding OUD, exploring how the opioid crisis has evolved and grown in recent years and how new pharmaceuticals and prescribing regimens may be helping to turn the tide.

In part 2, the conversation shifts to ongoing advocacy and regulatory action and significant progress in turning the tide in the opioid crisis so far.

Brief descriptions of the speakers featured in this project are provided below:

Angel Goenawan, MD, hospitalist at Bayhealth in Delaware

Bobby Mukkamala, MD president-elect of the American Medical Association (AMA) and chair of the AMA’s Substance Use and Pain Care Task Force

Michele J. Buonora, MD, MS, MSHS, assistant professor of medicine, Albert Einstein College of Medicine, Montefiore Einstein

Shoshana Herzig, MD, assistant professor of medicine, Harvard Medical School and Beth Israel Deaconess Medical Center

For more video content, visit our Crisis Point page to see other episodes on improving health equity in eye care, disparities in cardiovascular health, insulin access in the United States, physician burnout across healthcare, and the ongoing obesity crisis.

U.S. Overdose Deaths Decrease in 2023, First Time Since 2018. Webpage. CDC. May 15, 2024. 

https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm

AMA Substance Use and Pain Care Task Force recommendations. Webpage. AMA. 2025. 

https://www.ama-assn.org/delivering-care/nation-s-overdose-epidemic/ama-substance-use-and-pain-care-task-force

HHS Announces Transformation to Make America Healthy Again. Webpage. HHS. March 27, 2025. 

https://www.hhs.gov/press-room/hhs-restructuring-doge.html

More than a dozen states, DC sue Trump administration over ‘dismantling’ of federal health agencies. Webpage. CNN. May 5, 2025. 

https://www.cnn.com/2025/05/05/health/states-sue-trump-administration-hhs-rfk

Videos

In part 1 of this episode of Crisis Point, 4 experts on pain and opioid misuse discuss the evolving public health crisis.

Crisis Point: Prevention and Treatment in the Evolving Opioid Epidemic 

The Opioid Epidemic: Trying to Turn the Tide on an Evolving Issue

Prescribing practices have begun to change in recent years, with opioid prescriptions decreasing by 49.4% nationwide since 2012.

 This shift is supported by emerging research and is important for addressing the public health crisis, as prescription opioids are no longer the primary driver in developing OUD but can still play significant role in its development.

Other efforts to curb the crisis have included expanding access to naloxone and improving options and access for medication-assisted therapy for opioid use disorder, and approvals such as suzetrigine, a non-opioid pain option, and a labeling expansion of buprenorphine for treating opioid use disorder (OUD).

 These advances continue to shape the care landscape along with advocacy and regulatory reforms, although barriers to progress remain.

 Notably, naloxone prescription rates have remained low even for individuals at risk of OUD.

Part 1 of this episode of Crisis Point delves into the complex challenges surrounding OUD, exploring how the opioid crisis has evolved and grown in recent years and how new pharmaceuticals and prescribing regimens may be helping to turn the tide.

Office of the Commissioner. FDA approves novel non-opioid treatment for moderate to severe acute pain. U.S. Food and Drug Administration. January 30, 2025. Accessed January 30, 2025. 

https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain.

Indivior Announces FDA Approval of Label Changes for SUBLOCADE® (buprenorphine extended-release) Injection. 

https://www.prnewswire.com/news-releases/indivior-announces-fda-approval-of-label-changes-for-sublocade-buprenorphine-extended-release-injection-302382920.html

In part 1 of this episode of Crisis Point, 4 experts on pain and opioid misuse discuss the evolving public health crisis.



Mukkamala discussed other priorities the AMA’s Substance Use and Pain Care Task Force is tackling with OUD.

The Shifting Field of Care of Opioid Use Disorder, with Bobby Mukkamala, MD

Last month, the FDA approved the prior supplement submission for Indivior’s 

buprenorphine extended-release injection 

(SUBLOCADE) to treat opioid use disorder (OUD) almost 1 year after its initial approval for treating treat moderate to severe OUD.

The new labeling expands the approved subcutaneous injection site of the abdomen to the thigh, buttock, and back of the upper arm for induction and maintenance.

In another shift, the current 7-day minimum on transmucosal buprenorphine will be amended to a single dose of transmucosal buprenorphine with a 1-hour observation period to confirm tolerability and patients will be allowed to receive a second 300 mg dose 1 week after the initial 300 mg injections.

spoke with otolaryngologist Bobby Mukkamala, MD, who is serving as president-elect of the American Medical Association (AMA) and chair of the AMA’s Substance Use and Pain Care Task Force, to learn more about the labeling change. He also shared other priorities in the shifting world of care for OUD.

“We would really encourage folks that are trying to take care of their communities and trying to take care of their patients to look and see what comes from our task force. It's a very useful, but one of many sources of knowledge so we can take better care of our communities and our patients,” Mukkamala said.

Conversations about supporting treatment for OUD are especially pertinent as Congress just a couple of days ago failed to address payment cuts imposed in the CY25 Medicare Physician Fee Schedule (MPFS), comprising care for vulnerable patient populations.

Mukkamala has no relevant disclosures to report.

Indivior Announces FDA Approval of Label Changes for SUBLOCADE® (buprenorphine extended-release) Injection. PR Newswire. February 24, 2025. https://www.prnewswire.com/news-releases/indivior-announces-fda-approval-of-label-changes-for-sublocade-buprenorphine-extended-release-injection-302382920.html. Accessed March 17, 2025.

Braeburn's BRIXADI™ (buprenorphine) Extended-Release Subcutaneous Injection (CIII) Receives FDA Approval for Moderate to Severe Opioid Use Disorder. PR Newswire. May 23, 2023. 

https://www.prnewswire.com/news-releases/braeburns-brixadi-buprenorphine-extended-release-subcutaneous-injection-ciii-receives-fda-approval-for-moderate-to-severe-opioid-use-disorder-301832521.html 

Congress Fails to Address Medicare Fee Schedule in Continuing Resolution. News release. American Physical Therapy Association. March 17, 2025. https://www.apta.org/news/2025/03/17/congress-fails-to-address-fee-schedule

Mukkamala also discussed the importance of expanding non-opioid pain relief options.

New Buprenorphine Label Allows Physician-Informed Treatment of Opioid Use Disorder, with Bobby Mukkamala, MD

The FDA approved the prior supplement submission for Indivior’s 

buprenorphine extended-release injection 

(SUBLOCADE) to treat opioid use disorder (OUD) this past Monday, February 24, 2025.

The news comes almost 1 year after its initial approval for treating treat moderate to severe OUD

 and expands the approved subcutaneous injection site of the abdomen to the thigh, buttock, and back of the upper arm for induction and maintenance.

Notably, the updated label also reduces treatment induction time from the current 7-day minimum on transmucosal buprenorphine to a single dose of transmucosal buprenorphine with a 1-hour observation period to confirm tolerability and allows patients to receive a second 300 mg dose 1 week after the initial 300 mg injections.

spoke with otolaryngologist Bobby Mukkamala, MD, who is serving as president-elect of the American Medical Association (AMA) and chair of the AMA’s Substance Use and Pain Care Task Force, to learn more about why the labeling change is an important step in treating OUD. He also stressed the importance of adding more non-opioid pain management strategies to the market, such as suzetrigine, which was approved in January 2025.

“Everything changes from year to year, and that number needs to change if we're going to be able to take care of our patients. And that's something that a physician will decide, because they know the patient. They know what the use history is. They know what the need for treatment is, and the amount of that need, is it 24 milligrams? Is it 32 milligrams? That's something that shouldn't be limited by regulations. It should be the decision of the physician,” Mukkamala said.

Indivior Announces FDA Approval of Label Changes for SUBLOCADE® (buprenorphine extended-release) Injection. PR Newswire. February 24, 2025. 

Braeburn's BRIXADI™ (buprenorphine) Extended-Release Subcutaneous Injection (CIII) Receives FDA Approval for Moderate to Severe Opioid Use Disorder. PR Newswire. May 23, 2023. 

https://www.prnewswire.com/news-releases/braeburns-brixadi-buprenorphine-extended-release-subcutaneous-injection-ciii-receives-fda-approval-for-moderate-to-severe-opioid-use-disorder-301832521.html 

Office of the Commissioner. FDA approves novel non-opioid treatment for moderate to severe acute pain. U.S. Food and Drug Administration. January 30, 2025. Accessed January 30, 2025.

 https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain.

Bobby Mukkamala, MD

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