An epidemic is ravaging our country and the ways in which we, as pharmacists and healthcare providers, can aid in the fight that is the “Opioid Crisis” are numerous. Take our beloved state of West Virginia for instance, where there have been 33.5 drug overdose deaths per 100,000 residents from 2011-13 compared to 22 per 100,000 residents in the years preceding. (1) “Wyoming, McDowell, Boone and Mingo [counties] lead the nation in fatal overdoses caused by pain pills, according to the U.S. Centers for Disease Control and Prevention.” (2) Over the past 6 years drug wholesalers have shipped nearly 800 million oxycodone and hydrocodone tablets drawing the attention of both the DEA and the state government. One of the nation’s largest wholesalers, Cardinal, agreed to pay over $40 million in fines to settle allegations of failure to report suspicious purchasing patterns for opioids. (3) You may find yourself asking what can I, a pharmacist, do to help?
First and foremost, counseling our patients on their medications and informing them of the potential risk of abuse is a great first step. It is important to get to know our patients and their situation so we can make sure the medications are used responsibly. Remind patients that medication is not to be shared with friends or family under any circumstances without the consult and consent of their health care provider. Inquire of your patient(s) whether the medication is working to alleviate symptoms and offer additional ways to help manage pain such as exercise, meditation, or even yoga. If needed, refer them to additional resources such as their doctor or other healthcare providers.
Secondly, inform patients about overdose protocol and the availability of lifesaving drugs such as naloxone (Narcan). Police and paramedics, who are usually the first responders to overdose victims, are also carrying naloxone to help curb loss of life. Educate individuals on the proper use of naloxone to reverse an overdose whether it accidental or intentional and where to purchase an emergency dose. Naloxone is now available by physician protocol at your local pharmacies in many states, including WV. It is imperative to instruct those who purchase naloxone that after administering a dose they must go to the hospital immediately because the effects will wear off and the victim will require hospital attention.
Pharmacists also have a responsibility to be proactive in this “Opioid Crisis” and become advocates for change in our communities. Reaching out to our state Senate and House of Representatives to promote new legislation and initiatives to curb this wave of abuse is another great step. On Wednesday January 25th 2017, DEA representatives came to the University of Charleston to host a stakeholders strategy meeting that focused on providing support for West Virginia for heroin and opioid use, and violence in our community. US Attorney Caroline Mastro has approved $500,000 for the trial portion of a program to diversify ways to help out this crisis. The DEA speakers addressed the present dismissive attitudes surrounding the subject and called out to leaders to unite with the common goal of fighting addiction in this state.
These patients are not the enemy but a casualty to what has historically been labeled a victimless crime. So the next time someone comes in a day early to fill their script or the doctor ups their dose don’t just shove them out the door replying, “it is too soon to fill” or “we don’t have any in stock.” Have a conversation with the patient to make sure they are aware that help is out there if they are ready to start their journey to recovery. Those who are abusing pain medications may be doing so in order to mask the pain of another situation and your conversation may spark the road to recovery! Please join us in the fight against the opioid epidemic.