It’s a fact invoked so frequently that it has started to become the background noise of every legislative session at the Gold Dome: America is experiencing an opioid epidemic.
As a practicing anesthesiologist and as a Georgia State Representative, I see this crisis from many perspectives. I see it at the hospital, as I take care of patients reluctant to accept opioid medications because they are anxious about the risk of overdose or dependence. I see patients in opioid addiction recovery coming in for surgery who refuse pain meds because of the fear they might relapse. And as a lawmaker, I see too many pictures, and hear too many stories, and meet far too many families shattered, after loved ones are lost too soon to opioid overdose.
Beyond that, I’m also acutely aware of the historical role the medical community has played in seeding this epidemic, when in the 1990s and early 2000s our prescription habits and readiness to prescribe opioids for pain increased patients’ risk for a lifetime of addiction and dependence.
But I’m writing this not to cast blame, I’m writing it to spur solutions. And that’s the simple reason that I introduced HB 326, The Non-Opioid Coverage Parity Act, which I hope is not just sound policy, but good medicine.
When you’ve dedicated your career to protecting health and caring for your community, even one preventable death is too many. But in 2020, opioids were responsible for 67% of drug overdose deaths in Georgia—claiming 1,309 lives. And while opioid overdose is often stigmatized and therefore underdiscussed in society, what many don’t realize is that the path to addiction can begin in ordinary medical settings.
In 2018, healthcare providers wrote 63.2 opioid prescriptions for every 100 persons in Georgia. As an anesthesiologist I well understand the complex challenge of pain management. But I also know that there are FDA approved non-opioid treatments that can effectively manage many forms of post-surgical pain without risking addiction. The problem? Patients often can’t access these safer alternatives due to cost barriers and coverage restrictions.
And this isn’t just a medical issue—it’s a fiscal crisis. Opioid use disorder and fatal overdoses cost our nation $1.02 trillion in 2017 alone. We can’t ignore how this burden falls on taxpayers. When safer alternatives exist, continuing to funnel public funds into a system that promotes addictive medications over newer, non-addictive options isn’t just poor healthcare policy—it’s fiscally irresponsible.
That’s why bills like HB 326 and its federal analog, The Alternatives to PAIN Act, are so critical. While the federal bill deals with Medicare coverage, our bipartisan state level bill HB 326 would require Medicaid and our State Health Benefit Plan to increase access to non-opioid pain management options at rates no less favorable than coverage for traditional opioids. It removes bureaucratic barriers that often force patients toward addictive medications, even when safer options exist.
As a doctor, I took an oath to “first, do no harm.” As a legislator, I have a duty to protect both public health and taxpayer resources. The Non-Opioid Coverage Parity Act accomplishes both.
It is my hope that the Georgia General Assembly takes the recommendation of this year’s House Study Committee on Alternatives to Opioids for Pain Management and supports this common-sense solution to prevent addiction, save lives, and responsibly manage public funds. Our community deserves nothing less than full access to the safest, most effective pain management options available. Let’s therefore make sure our state health coverage reflects newer, proven, effective therapies—not outdated policies that put our patients at risk while unnecessarily burdening taxpayers with the unintended consequences of their care.
Michelle Au is a practicing physician in metro Atlanta and a member of the Georgia House of Representatives
