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    Community Pharmacists Praise New Opioid Measures

    In the war against the opioid epidemic, pharmacists are excited about their seat at the table.

    NCPA issued a statement praising the new initiatives from the President’s Commission on Combating Drug Addiction and the Opioid Crisis. These initiatives include easier access to naloxone and enhancing prescription drug monitoring programs.

    The Commission is proposing that federal agencies and pharmacy associations work collaboratively to train pharmacists on best practices for evaluating the legitimacy of opioid prescriptions, rather than penalize pharmacists for denying inappropriate prescriptions.

    “It’s important to assure that remedies implemented through legislation or regulation allow patients with legitimate pain management needs to access appropriate medication. That means that compliance requirements should not overreach so that needful patients are made to suffer,” said NCPA CEO B. Douglas Hoey, RPh.

    Read more: The Other Side of Opioid Limits

    The commission also called for a nationwide system of drug courts, which are an alternative criminal system that aims to get treatment for substance abusers rather than put them in jail. Other proposals include a requirement that doctors who prescribe opioids must show they have received training in their safe prescribing, greater availability to medication-assisted therapy, and more scrutiny and restrictions on certain controlled substances delivered through the mail. The commission is chaired by Governor Chris Christie (R-NJ).

    NCPA is “heartened” by the commission’s report, which includes many ideas that had been proposed by NCPA. “Independent community pharmacists share the American public’s concern about the opioid crisis. We are on the frontlines of this battle and are committed to doing everything we can to help.”

    Meanwhile, the commission declined to endorse the use of marijuana for pain. Research by the National Institute on Drug Abuse “found that marijuana use led to a two-and-a-half times greater chance that the marijuana user would become an opioid user and abuser, Christie wrote.

    Christine Blank
    Contributing Editor Christine Blank is a freelance writer based in Florida.

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      The Commission wrongly blames pain management for deaths and is mistaken on several crucial points. Endorsing it will lead to greater restricted access for responsible Chronic Pain Patients who have a very low risk of overdose death. Objective rather than subjective reporting bears this out time and time again. Meanwhile, big chains implement subjective blacklisting of doctors and unlawful mandates that usurp the professional judgment of their pharmacists coercing refusal of valid and legitimate pain prescriptions resulting in endangerment of public safety and violations of Patients' Guaranteed Bills of Rights under HHS, CMS, and ADA. Florida State regulatory agencies turn a blind eye to these practices failing to protect both the residents of Florida and the integrity of the Profession of Pharmacy. Incarceration doesn’t work. Medication Assisted Therapy and mental health care helps. Shifting the funding from jails to early abstinence education and MAT programs will go a long way to saving lives. Limiting prescription Opioid supply only drives people to seek out the less expensive more readily available fentanyl laced heroin that is responsible for the majority of overdoses and deaths will escalate. The indigent uninsured do not have access to the uber expensive gold standards of addiction care and are the majority incarcerated. These standards of Care are only available to about 10% of patients leaving the majority with few choices. Failure of Medicaid and Insurance to cover MAT is major hurdle in treating addiction effectively. When Insurance does pay it requires burdensome prior authorizations that delay or prevent access to MAT even once initiated. The majority of aberrant use does NOT result from the direct prescribing of opioids to responsible patients. Most addicts start aberrant uses of illicit substances in their teenage years. They obtained the Prescription Opioids from the street not from a responsible prescriber. Reportedly, 2-15% of prescribed patients will exhibit aberrant use of their prescription opioids, in all but the lowest percentage of this group, addiction started at an age long before they ever had an event/trauma that required their first narcotic prescription. Trump’s and Session’s tactics are doomed to fail. In the interim, those chronic pain patients that use their medications responsibly suffer due to the media hysteria of the illicit drug crisis. Restrictions on prescription quantities and dose limitations will again push these responsible patients to the pusher Man to seek relief of their pain. Suicide actually starts to become an option for these patients and that is a travesty. Let the sound professional judgment of responsible doctors and pharmacists prevail in ensuring access to beneficial medications for those in need. Blaming drug manufacturers for addiction is like blaming distilleries and breweries for alcoholism. Where is the Crisis and Emergency for this. Alcohol kills many more than opioids. Both alcoholism and addiction, it must be admitted lies in a conscious choice to abuse the offending substance. Not taking ownership and responsibility for one’s own downfall and shifting the blame to manufacturers demanding they reduce production will not work. There must be balance of control and access in this battle. One option I believe that would be effective is to create specialty community pharmacies with especially trained pharmacists that service card carrying DEA registered patients to track and prevent unscrupulous doctors, pharmacies and patients from fueling street level supplies. Drug Return Programs to remove unused quantities need to be in common place. Responsible prescribing and dispensing for responsible patients should be allowed. In this scenario if a patient’s physical dependence begins to transition to aberrant behavior interventions can be initiated. It would be a win-win.