Pharmacists and Their Role in Controlling the Opioid Epidemic

As a member of the healthcare team the pharmacist has an equally important job in deterring this opioid epidemic that is currently wreaking havoc across our country. Many physicians prescribe prescriptions painkillers for patients and they come to the pharmacy; but we are lacking a systematic control method to prevent abuse. For example, in our country it is estimated that 21-29% of people who are prescribed prescription opioids misuse them according to the National Institute of Drug Abuse. New federal policies and procedures are making the epidemic a well-known issue and the regulations they are presenting are attempting to reverse years of damage that has already been done.  

One pharmacy has chosen to take a stand which is causing increased awareness due to the limitations it is taking. CVS reported early last week that they will begin to limit opioid prescriptions to a 7-day timeframe with certain restrictions; they are incorporating all of this into a new policy. The policy itself will not take affect till February of 2018 but this is a major topic in the control of opioids. “With a presence in nearly 10,000 communities across the country, we see firsthand the impact of the alarming and rapidly growing epidemic of opioid addiction and misuse,” said Larry J. Merlo, president and CEO of CVS Health.

In addition to the new policy, they will also be increasing the number of drug disposal units in its Medication Disposal for Safer Communities Program. This will help patients who are trying to adhere to the new set guidelines and dispose of old or extra medications they may have on hand. In this effort, CVS is working to try and adhere thoroughly to the CDC opioid prescribing guidelines.  

      

Most Opioid abusers use opioid for illicit reasons. As a pharmacist or a student pharmacist working in the pharmacy there are some little things you can do to help prevent this pandemic. By identifying some of the Red Flags of opioid abuse;

  • If a patient comes in and request for a particular brand or specific color of opioid. This should give you a clue that this patient is selling his or her medication.
  • If they use slang terms (street name of the drug)
  • Insist on paying with cash instead of allowing his or her insurance to cover the cost of the drug.
  • If you have new patients form the same prescriber coming to your pharmacy to fill only opioid.
  • Lack of eye contact especially when it is a new patient filling at your pharmacy
  • If the patient is nervous, be sure to know if they are hiding something  
  • Insisting on getting a refill before the actual refill date.
  • Tampering with the prescription.

In conclusion further steps need to be taken in the battle against opioids and this is one major step in the right direction. Pharmacist should attempt to take further action because we are the final check in the process before the patient receives the prescription medication.

Resources:

http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness/conf_2013/march_2013/carter.pdf

https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/MedicaidIntegrityProgram/downloads/drugdiversion.pdf

http://vtdigger.org/2014/02/11/special-report-state-spends-millions-addiction-fighting-drug-diverted-street-sale/

https://www.drugabuse.gov/drugs-abuse/opioids/opioid-crisis

http://www.cnn.com/2017/09/22/health/cvs-prescription-restrictions-opioids-bn/index.html

 

 

Benjamin Franklin Statesman and Apothecary

Contributed by Blanche Ndifon, Class of 2019

Many people know Benjamin Franklin as one the founding fathers of the United States who helped write the most powerful document known in this country, the Declaration of Independence, but if asked, very few people will know a thing about his medical and science interests or of any contributions he made in the profession of pharmacy.  It is very well established in the books of history what a great politician Benjamin Franklin was, but his influences as a health care professional and activist usually go unstated.

franklinOn January 17 of 1706, Benjamin Franklin was born in Massachusetts Bay Colony, what is known today as Boston. He was the last of fifteenth children born to his father (Josiah Franklin) and the fifth child born to mother Abiah Folger (Says, 19). He was a very brilliant child but, at the early age of ten years old, he had to become a full-time worker at his father’s candle and soap shop. At age twelve, he was an apprentice to his brother at a printer shop, where he developed an immense passion for reading, writing and publishing despite his brother’s religious efforts to repress Franklin’s love for publishing.  Escaping from Boston, Franklin went to live in Philadelphia. He then went on to publish his first pamphlet, “A Dissertation upon Liberty and Necessity, Pleasure and Pain,”(Author name, 2015 reference1). From his numerous publications, writing of everything from politics, weather forecast, and poetry to proverbs, he become a very prominent man and got several honorary degrees from Yale, Harvard and other international institutions. He rose so fast in the world of politics that in the year 1976, he was one of only five men appointed to draft the Declaration of Independence.

Benjamin Franklin also had a rooted interest in health. Knowing Benjamin’s love for science and community service, his good friend Dr Thomas Bond approached him with the idea of starting what will be the first Hospital and hospital pharmacy (then called apothecary) so that the colonies will not have to rely on British physicians and apothecaries (Penn Medicine, 2012 ).  Franklin bough into the idea almost instantly and began writing the petitions that will make sure that was possible. He nullified resistance from the Assembly appointed to handle the subject by accepting to raise part of the money to start and the assembly would have to match what he raised dollar for dollar. With his restless efforts, enough money was raised to begin the project. In the year 1952, the first hospital pharmacy was founded where Jonathan Roberts was appointed the first apothecary (Oldfield, 2014). Although medicine and pharmacy were   commonly practiced together back then, the establishing of a hospital apothecary helped made the distinction between the two professions and allowed for pharmacy to develop in its own right separately from medicine. Today the pharmacy is practiced independently of the medical profession with Pharmacists having defined responsibilities in patient welfare. Due to the input of a well respected man like Benjamin Franklin, today over 90% of the hospitals in the United States have inpatient pharmacies employing about a fifth of all pharmacists (Penn Medicine, 2012).

Franklin’s first son died at the age of four from smallpox and for this reason he was very big supporter of vaccinations and today vaccination is something that can be done by a pharmacist. Evidently his impact in the profession is still very much appreciated today.

 

References:

  1. Benjamin Franklin: A Founding Father of Pharmacy. (2015, May 14). Retrieved September 26, 2016, from http://www.pharmacytimes.com/publications/career/2014/pharmacycareers_may2014/benjamin-franklin-a-founding-father-of-pharmacy
  1. Pennsylvania Hospital History: Stories – Nation’s First Hospital. (2012, August 02). Retrieved September 26, 2016, from http://www.uphs.upenn.edu/paharc/features/creation.html
  1. Says, T. R., & Says, A. (n.d.). Home. Retrieved September 26, 2016, from http://www.famousscientists.org/benjamin-franklin/

 

 

 

 

 

 

American Pharmacists Month–Polio Pioneer Dr. Albert Sabin

Contributed by Rachel Peaytt, Class of 2019 & Fall 2016 PHAR 546 Student

Albert Sabin was born on August 26, 1906 in Bialystok, Poland and passed away on March 3, 1993. He immigrated to the United States in 1921 with his family to New York. Sabin received his medical degree in 1931 from Bellevue Hospital and the Lister Institute of Preventive Medicine in London. Soon after, he traveled back to the United States to work.

Sabin began his work on the oral polio vaccine in 1939 after he started at a position as an associate professor at the Children’s Hospital Research Foundation at the University of Cincinnati. He soon formed the Department of Virology and Microbiology at the university, and this was the outlet, resources, and system of colleagues that he had to do his research on the vaccine. In 1958 and 1959, the vaccine that Sabin created was tested in millions of people. His formula was an oral vaccine that used a live but weakened version of the poliovirus, also known as an attenuated vaccine. The vaccine came into commercial use in 1961.

Albert Sabin’s polio vaccine was the second polio vaccine available to the United States. The first was an injectable vaccine of the inactivated poliovirus developed by Jonas Salk, MD in 1953. The polio epidemic in America was most serious from the 1940s to the late 1950s until the first polio vaccine was developed followed by Sabin’s oral vaccine. Polio paralyzed and/or took the lives of thousands of children and other people each year. Epidemics occurred around summertime and into early fall with no idea on how the virus was transmitted. Years later, it was found that the virus thrived in the heat and was transmitted by large bodies of water where people congregated, like swimming pools in the summer.

Salk’s vaccine was an injectable and inactivated vaccine that was 80-90% effective. Polio was still not eradicated after the administration of the Salk vaccine although it was proven “safe, effective, and potent” and saved thousands of lives still. It was not until after Sabin’s vaccine was developed and administered that polio was almost completely eradicated in the United States. Salk’s vaccine was entirely phased out by 1968. The oral polio vaccine was more beneficial since volunteers instead of trained professionals that had to inject it could easily give it. The Sabin vaccine was also relatively inexpensive. Both of these factors were paramount when it came to administering the vaccine to people in developing countries. Sabin’s vaccine was also safe, effective, and induced long-lasting immunity to all three types of poliovirus as opposed to Salk’s vaccine. Salk’s injectable vaccine only stimulated systemic immunity, instead of mucosal immunity, and therefore did not interrupt the transmission of poliovirus. Salk’s vaccine protected individuals from the symptoms that occurred with the virus only. This was the reason for its less than perfect effectiveness that still allowed transmission. Sabin’s vaccine, on the other hand, provided protection from person to person transmission and eventually led to the eradication of the poliovirus in the United States by 1979.

Worked Cited

Klein, C. (2014, February 28). 8 Things You May Not Know About Jonas Salk and the Polio Vaccine. Retrieved September 12, 2016, from http://www.history.com/news/8-things-you-may-not-know-about-jonas-salk-and-the-polio-vaccine 

Polio Place. (n.d.). Retrieved September 12, 2016, from http://www.polioplace.org/people/albert-b-sabin-md

 

UCSOP Launches Generation Rx with Kanawha & Boone County Schools

DurinAPhM_Twitter_Icong October 2016, American Pharmacist Month, over 100 students from the University of Charleston School of Pharmacy will be educating students throughout Kanawha and Boone counties on the dangers of prescription drug misuse. Pharmacy students will reach over 500 children by visiting over fifteen 5th grade classrooms at six Kanawha County elementary schools and three Boone County elementary schools throughout the month to deliver an intervention and prevention program called Generation Rx. This evidence based program was developed in collaboration with the Cardinal Health Foundation, the American Pharmacists Association (APhA), and The Ohio State University School of Pharmacy. The Generation Rx curriculum is designed to increase public awareness of prescription medication abuse and medication safety http://www.generationrx.org.

“The program focuses on positive-decision making and social norming as tools for combatting prescription drug abuse,” said Andrew VanDuesen, Class of 2018 genrxand president of the UCSOP APhA student chapter (ASP)

West Virginia middle and high school students are making poor decisions in regard to substance abuse and particularly with prescription medications. According to the 2013 Youth Risk Behavior Survey, 16.% of high school students have taken a prescription drug—such as oxycontin, vicodin, adderall, ritalin, or xanax—without a prescription one or more time sin their life. Early education is key to prevention.

“As a prevention and outreach program, Generation Rx, is designed to help students of all ages, identify and address prescription drug misuse in their homes and communities,” said Dr. Susan Gardner, assistant dean for professional and student affairs. 

In addition, to the elementary school outreach, pharmacy students will educate undergraduate students at the University of Charleston by visiting every UNIV 101 classroom on October 10, 2016 to deliver the college-level Generation Rx curriculum to freshmen. 

For more information contact: Dr. Susan Gardner, susangardner@ucwv.edu.