Here's a pharmacist’s perspective on addressing the opioid crisis

Here's a pharmacist’s perspective on addressing the opioid crisis
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According to the Centers for Disease Control and Prevention, 2 million Americans are abusing opioids, with 91 dying each day from an overdose. By some estimates, 650,000 people could die over the next decade, which is equal to the number who have died since the HIV/AIDS epidemic began in the early 1980s. This clearly qualifies as a crisis. The Trump administration concurs, which is why the president has directed the Department of Health and Human Services to declare the opioid crisis a public health emergency.

Independent community pharmacists, many of whom practice in rural communities that are feeling the brunt of this problem (44 Americans die daily in these lightly-populated areas), are on the frontlines of this battle. They have a distinctive perspective on what does and does not work.

That’s why the National Community Pharmacists Association, which represents independent community pharmacists, has taken every opportunity to work constructively with regulators and legislators. We joined other pharmacy groups for a meeting in August with the Health and Human Services Secretary to answer questions and offer local examples of pharmacists taking the lead in addressing the opioid crisis. It’s also why in September we provided eight recommendations to Congress on how to combat the opioid epidemic.

We kept the momentum going in November by attending an invitation-only listening session with the Centers for Medicare and Medicaid Services to discuss solutions and barriers in confronting the problem with pharmacy, wholesaler, and insurance groups.

While there is no magic solution to ending the crisis, we believe there are things we can do to make a difference in the battle against opioid abuse. The suggestions, which we emphasize whenever the opportunity presents itself, cover every aspect of a potential opioid abuser’s journey, from the initial prescription to reviving a person who has overdosed.

For example, NCPA supports limiting initial fills for opioids. However, any restrictions need to have caveats for certain patients, such as those in hospice settings.

We also believe better information-sharing is critical. We must expand mandatory electronic prescribing of controlled substances and enhance Prescription Drug Monitoring Programs by creating national standards. E-prescribing limits the possibility of fraudulent written prescriptions being handed to pharmacists while creating an interconnected framework for controlled substance monitoring, which will improve the ability of pharmacists to identify potential drug abuse and diversion.

NCPA also backs increasing the use of and access to medication-assisted treatment and the expansion of screening, brief intervention and referral to treatment activities. In both programs, pharmacists can identify and intervene with patients who show signs of opioid addiction. When NCPA met with the Health and Human Services Secretary to discuss the opioid epidemic, we shared examples of several independent community pharmacists using a number of these tools to battle the epidemic in their communities.

Finally, NCPA strongly endorses further empowering pharmacists to help save lives. Naloxone rapidly reverses the effects of opioid overdoses. All 50 states have passed laws expanding access to this lifesaving drug, but only a few states give pharmacists the ability to act independently in dispensing naloxone.

I’m heartened that the final report from the President’s Commission on Combating Drug Addiction and the Opioid Crisis endorses several of these NCPA-supported concepts, including:

  • Prescriber education for controlled substances
  • Expanded access to the overdose-reversing drug naloxone
  • Greater availability to medication-assisted therapy
  • Enhancing the scope and functionality of prescription drug monitoring programs

The opioid epidemic didn’t happen overnight; the rate of deaths has quadrupled since 1999. It will take time, patience, resources, cooperation between health care professionals and law enforcement officials, and the enactment of policies that emphasize both prevention and second chances to make progress. Pharmacists bring vast experience and expertise to the table. Policymakers should listen to our advice and maximize our capabilities.

B. Douglas Hoey, MBS is a pharmacist and CEO of the National Community Pharmacists Association.