Doctors have reduced their prescribing of opioid painkillers for the fifth year in a row, the nation’s largest physician group announced.

The American Medical Association found that between 2013 and 2017, the number of opioid prescriptions fell by more than 55 million, a 22.2 percent decrease.

Doctors also became more likely to use a state database that tracks when patients previously have been prescribed opioids, called the prescription drug monitoring program. The database allows doctors to make sure that their patients aren’t getting multiple prescriptions from different doctors to sell or abuse them and to decline the prescription when they suspect abuse.

The findings were detailed in a report from the AMA, showing that in 2017 doctors and other medical providers used the databases more than 300.4 million times, a 121 percent increase from 2016.

More than 42,000 people died of opioid overdoses in 2016. That includes prescription painkillers, but more often the overdoses are the result of cheaper and more easily available alternatives such as heroin and fentanyl. Many of the addictions to illegal opioids begin after an initial doctor prescription to painkillers such as OxyContin or Vicodin.

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The new report also shows that doctor involvement in drug treatment and overdose reversals increased as well.

Doctors increased their prescriptions of naloxone, a drug used to reverse an opioid overdose, from 3,500 to 8,000 a week. The upward trend appears to be continuing in 2018, with weekly prescriptions at 11,600. A growing number of states require doctors to prescribe naloxone if their patients have a history of drug abuse or if they provide patients with a high amount of prescription painkillers.

More than 50,000 doctors as of May 2018 have become certified to prescribe buprenorphine, a drug that helps reduce withdrawal symptoms for people with addictions. That marks a 42.4 percent increase from a year ago.

Doctors need a special certification by law because the drug can also be abused, though lawmakers and advocacy groups hope to loosen restrictions so that more healthcare providers will be able to give the drug to patients. The AMA made the recommendation as a way to continue progress against the opioid crisis.

“What is needed now is a concerted effort to greatly expand access to high-quality care for pain and for substance use disorders,”

said Dr. Patrice Harris, chairwoman of the AMA’s Opioid Task Force. “Unless and until we do that, this epidemic will not end.”