A key Democratic senator is calling on the American Medical Association to support mandatory education about opioid addiction and overdose for doctors—a move they have opposed in the past.

“Too many well-meaning medical professionals have had insufficient training on opioids, including effective pain management alternatives and the risks of substance abuse disorders,” West Virginia Sen. Joe Manchin wrote to Dr. James Madara, the AMA’s chief executive officer.

“This is why it is critical that we ensure that medical professionals have the training and education they need to responsibly prescribe opioid medications to reduce the risk of opioid addiction and overdose death.  

Manchin, whose state have been ravaged by the opioid epidemic, told advocates for reform in a meeting last month that lawmakers were “scared” of going up against the powerful physician lobby.

The AMA has advocated physicians receive training about opioid prescriptions, but have stopped short of supporting any required education.

That, Manchin wrote, “is simply not enough,” noting that more than 42,000 of the 64,000 drug overdoses last year were caused by opioids or heroin.

“We also know that individuals who are using and abusing illicit drugs—like 80% of heroin users—most likely first abused prescription drugs,” he said.