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    Fighting Opioid Abuse

    How pharmacists can help fight the battle.

    “Pharmacy has a 100% commitment to patient care, and a zero tolerance for abuse and diversion,” said Chris Krese, Senior Vice President, Marketing, Communications and Media Relations for the National Association of Chain Pharmacists (NACDS).

    “We see the pendulum swing on this issue in terms of how it is discussed in the public domain. Sometimes there is more of a focus on the need to help patients gain access to needed pain medications. Sometimes there is more of a focus on the need to help reduce addiction, abuse, and diversion of pain medications,” Krese added.

    Krese noted that pharmacists are on the front lines each day and must make difficult determinations in a professional manner to simultaneously address the many complex aspects of this issue.

    John Norton, Director, Public Relations, for the National Community Pharmacists Association (NCPA), said that as the most accessible health-care professional, pharmacists are key players in fighting opioid abuse and addiction.

    “In particular, independent community pharmacists, because of the special relationship they enjoy with their patients, are in a unique position to make a difference,” said Norton.

    The CDC has released a brochure for pharmacists: Pharmacists: On the Front Lines – Addressing Prescription Opioid Abuse and Overuse.

    Its call for pharmacists to be more involved comes as municipalities and counties in the areas most hard-hit by opioids are fighting back with lawsuits against pharmacy chains and drug distributors. Within a two-year period, the town of Kermit, WV, population 400, received 9,000,000 doses of opioid drugs. The town is fighting back with a lawsuit against five wholesalers and a pharmacy owner. In March, Cabell County, WV, filed a lawsuit against drug wholesalers and several chain pharmacies. The lawsuit claims these companies disregarded an opioid epidemic and shipped large amounts of opioids to drug stores throughout the county. More than 40,000,000 doses of hydrocodone and oxycodone were sent to Cabell County pharmacies between 2007 and 2012, according to news reports.

    Related article: An Opioid Story Earns a Pulitzer

    “This is all part of the pharmacists embracing their increasing role in public health,” Norton said.

    How Pharmacists Can Help Fight the Battle

    • Counsel patients on medications to avoid while taking opioids, such as benzodiazepines.
    • Advise patients about pain control and potential side effects.
    • Identify patients at risk of overdose and dispense naloxone per state laws and regulations.
    • Access state prescription monitoring programs to identify drug abusers who are doctor and pharmacy shopping.
    • Assure compliance with new regulations on opioid prescribing by contacting the prescriber if a patient has questions or concerns.
    • Participate in state sponsored addiction recovery and treatment services; and help with disposal of excess or expired prescriptions.
    Anthony Vecchione
    Anthony Vecchione is Executive Editor of Drug Topics.

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    • Anonymous
      I've practiced pharmacy for 32 years. During my first six months, I realized that the pharmacist I went to work for had his wife filling all his nursing home prescriptions. Also when I would try to call the physician's office for a refill, I was told that his wife would call. So one day I decided to call the office right after she hung up. Guess what, she never called the office, and upon further questioning they said she has never called for refills (which wasn't legal anyway, since she wasn't even an official technician). The second incident occurred when I worked for his other pharmacist in the store built into the doctor's office. His patient came in for a refill of Phenergan VC with Codeine. It was required to document on the back of the Rx the date, qty, and pharmacist initials for each fill. Maximum refill was 5,( he filled it 11 times) and when I called the physician he said he never authorized any refills. The straw that caused me to report him to the Arkansas State Board of Pharmacy was as follows; a patient came in for a refill of Nitroglycerin 0.4 #100. It wasn't so unusual to get a refill, but when I looked at his Rx he had been getting it refilled every "3" days. I counseled him about the urgency of taking so much medicine and instructed him to make an appointment with his physician immediately and I refused to fill the Rx. He walked over to the owner/pharmacist and complained. After I left, he filled the Rx anyway. At this point I called the board and quit. The board NEVER checked up on any of my documentations and let it all slide..30 years later I had under gone 2 spinal fusions with hardware, then a Lumbar disc replacement at level 3-4 (anterior and posterior approach), 2 cerival fusions with hardware, a lamenectomy at the disc level (of which the screws worked loose) then finally another fusion and larger hardware at 3-4. This happened over a period of 10 years and my pain would resolve after the surgery for a few months, then start back up again. I currently use fentanyl 75mcg every 3days, Percocet 10/325, 2 tabs three times as needed, diazepam 10 mg 1 hour before bed for muscle spasms, bupropion 300 dl every morning for depression. And the State Board had the nerve to pull my PMP (which was insignificant for abuse), and called me a drug addict. And an Oipoid drug problem. The state was completely wrong, due diligence was not preformed, the case was not reviewed by the whole board, just 2 individuals, I never gave them the opportunity to insult me anymore, since they had no idea what trauma I had been thru, and thatmy PMP WAS PERFECT. No missing med's, no early refills, no doctor shopping. They handled the issue thru harassment and intimidation.. That's how they deal with patients in Arkansas. Guilty if you take any narcotic, and if you do (tooth extraction perhaps) you can not return to work until it is out of your system. What goes around comes around and I'm just waiting.