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    The Opioid Epidemic: Well, It Ain’t My fault … Maybe?

    The opioid crisis? There is enough blame to go around.


    You can’t pick up a newspaper from the New York Times to the Tyrone Daily Herald, without coming across an article about the opioid epidemic.

    There have been town hall meetings, letters to the editors, and front page stories publicizing this national emergency. From the mayors of our small towns in central Pennsylvania to the President of the United States, everyone has an opinion as to the impact of opioids on the lives of our citizens.

    I was at such a meeting with our local state representative, Judy Ward, who is also a nurse. One member of the audience raised her hand and said, “We ought to sue those drug manufacturers. They created this problem.”  Without missing a beat, Rep. Ward pointed out there were two pharmacists in the room, and she would like to hear our opinions.

    I began by saying, “You are absolutely right. The drug companies are at fault. Let’s sue them.” 

    The drug companies will say, “We never sent out a bottle of our product to any warehouse that didn’t order it. Let’s sue the wholesalers.” 

    The wholesalers can say, “We’ve never sent out a product to stores that didn’t order it, on a special triplicate form called a DEA 222!  Let’s sue the pharmacies/pharmacists.”

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    The pharmacists can say “I’ve never ordered a bottle of narcotics that I didn’t need, and I needed them is because the physician wrote a prescription for them.  It’s the doctors fault. Let’s sue them.”

    The doctors will say, “I’ve never written a prescription for a patient who didn’t need, in my clinical judgement, an opioid. It is the patients fault for being so demanding. Let’s sue them!”

    I said I had witnessed the head of our local emergency department stand nose to nose with the Secretary of the Pennsylvania Department of Drug and Alcohol Programs.  He was saying that government patient satisfaction surveys were part of the problem in his area of practice. The government demands that the patients be happy and satisfied and giving many of these patient’s opioid prescriptions will make them happy and satisfied. So it’s the government’s fault. Let’s sue them.

    I told the crowd, that this problem is so huge, that indeed there is enough blame to go around. Suing any one of the parties will accomplish nothing.

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    • [email protected]
      As a pharmacist, I am willing to ascribe to the assertion that "there is enough blame to go around". But, in 2001, I caught a lot of flak when I maintained that the Joint Commission's concept of pain as "fifth vital sign" was the most harebrained idea I'd ever heard and that it would certainly lead down the road to the destination at which we have now arrived. And, the worst part was, that Joint Commission leadership added pain-related questions to HCAHPS, where patient pain satisfaction scores were used to determine hospital reimbursement rates. That decision rivals the cigarette companies addition of more nicotine to "improve" their products! So please, we all need to work together to get out of this disaster and, in the future, please vociferously question whether the next asinine standard the Joint Comission proposes is actually based on evidence and not a some "brilliant" marketing idea.
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