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With more than 200 million prescriptions for opioid medications being written every year, it鈥檚 hard to escape the notion that physicians must share some of the blame for creating the opioid epidemic facing the nation.

The criticism has come from many quarters. have pointed the finger of blame, as have . More than a third of the think doctors are at fault, and even have acknowledged the unwitting complicity of physicians.

There鈥檚 no denying it. Despite our well-intentioned motivation to care for our patients and treat their pain, we physicians have played a role in this crisis.

What may be getting lost in the current conversation about opioids, however, is the change that has occurred within our profession. Physicians have recognized the damage done and are responding, and it鈥檚 important that patients and our colleagues know the extent of what we are doing 鈥� and what resources are available.

The list is long: collaborating with state officials to develop strategies; educating patients about safe storage and disposal of medications; convening policymakers and experts in and ; and encouraging use of prescription monitoring programs.

Perhaps our most notable efforts have been educating our colleagues. In 2015, our state medical society was among the first in the nation to issue , subsequently adopted by the Board of Registration in Medicine and incorporated into its comprehensive advisory to physicians on prescribing issues and practices.

Those guidelines were followed by on opioids and pain management, made available (and still) free to all prescribers. From May of 2015 through the end of February 2017, more than 9,100 individuals have completed more than 25,800 course modules on the topics. The numbers are testimony to how physicians are responding.

Additionally, together with the deans of the state鈥檚 four medical schools and state health officials, we have brought by developing core competencies for medical students, to teach them early in their careers about pain management.

The advocacy of , to reduce the amount of drugs subject to diversion, and the convening of political and healthcare leaders to have been other physician-led efforts.

Hospitals and medical schools have raised their level of response as well.

The University of Massachusetts Medical School has implemented for medical and nurse practitioner students, including interactions with standardized patients, group sessions with patients in recovery, and hands-on overdose care and naloxone rescue.

, in collaboration with the Department of Public Health and Boston Public Health Commission, with its Faster Paths to Treatment Opioid Urgent Care Center, and the with its Safe and Competent Opioid Prescribing Education program, are in the forefront of substance abuse disorder treatment. , , and are among others engaged in significant efforts.

The medical community is responding, and there is progress. In separate studies, the Massachusetts , , and the Cambridge-based have all recorded drops in prescribing.

Despite these efforts, and those of state government, , , and many others, in the Commonwealth and the nation, caused in large part by illegal, synthetic fentanyl. Here鈥檚 another ominous sign, revealed in a : more patients are taking opioids.

The rising numbers of overdoses show just how difficult it will be 鈥� and how long it might take 鈥� to claim some measure of success in reversing this epidemic.

Yet while struggling to prevent and reduce addiction, physicians face another test.

Whether , many opioids, and some have stopped prescribing altogether. The result: patients who truly need help aren鈥檛 getting the care and relief they need.

How many patients are in this situation is uncertain, but they are beginning to be heard. What is certain is that the challenges of pain management just became a lot tougher 鈥� for both the patient and the physician.

The Opioid Crisis in America

Every day in the United States more than 1,000 people are treated in emergency departments for not using prescription opioids as directed. In 2015 more than 30,000 people died from overdoses involving prescription opioids. This course challenges preconceptions about who can become addicted to opioids, attempts to reduce the stigma that exists around addiction in general, and to help people learn about the multiple pathways to treatment.