With two million people suffering from opioid addiction and 115 people dying from an opioid overdose every day in the U.S., the opioid crisis is unlike any situation the U.S. healthcare system has ever experienced. The statistics tell the story:
- Between 1999 and 2014, the sale of prescription opioid medications nearly quadrupled while the amount of pain reported by Americans remained unchanged.
- At the same time, the number of deaths related to opioid overdose increased.
- In 2016, although the national opioid prescribing rate was at the lowest it had been in over 10 years, the rate was still 66.5 opioid prescriptions per 100 people.
- With increased exposure to opioids comes an increased risk of opioid abuse and accidental overdose. Prescription opioid deaths increased from 4,400 in 2000 to 18,893 in 2014.
It’s clear that despite concerted efforts, the US is still struggling with a nationwide opioid epidemic.
The Cause of the Nationwide Opioid Problem
The growing opioid problem can partially be attributed to the lack of education regarding medications. A 2015 survey indicated that 45% of people who were prescribed pain medication did not know they were taking opioids or were unaware of their addictive properties.
Compounding the issue, the treatment of pain is fundamental to the medical profession. If pain is not well controlled, the patient’s quality of life decreases, and detrimental long-term effects can follow. Opioids can be safely prescribed and used for pain, but the clinical benefit of opioids must be weighed against the health risks with patient-specific factors in mind. Creating a culture of education around these medications, as well as taking a cautionary approach to those prescriptions that are administered, is vital to battling this crisis.
The Crucial Role of Pharmacists in Mitigating the Opioid Epidemic
In order to decrease the abuse of opioids, and ensure these prescriptions are being used safely, pharmacists have a unique opportunity to help. There are multiple areas in which pharmacists can play key roles in helping to prevent, monitor and mitigate opioid misuse and abuse, including:
Pharmacy Engagement: While pharmacists are highly accessible, they are the most underutilized members of the healthcare team. Pharmacists have access to patients’ medication profiles, uniquely positioning them to identify patients at risk and initiate the conversation on prescription opioid abuse and misuse. The appointment-based model (ABM), a model for patient-centered, outcome-focused care, would allow pharmacists to plan for better facilitation of patient conversations regarding opioid use.
Naloxone: As of 2018, 48 states and Washington, D.C. allow pharmacists to dispense naloxone without a prescription. Naloxone is a life-saving medication that can be used to reverse opioid overdose until EMT personnel arrives. It is a pure opioid antagonist that works by competitively blocking opioids from attaching to receptors in the brain, restoring breathing. Through various distribution programs, non-medical personnel can access this proven opioid antidote. While this has prompted concerns that making naloxone widely available may encourage an increase in opioid use, there is no evidence indicating the correlation.
PMDPs: PDMPs are state-run electronic databases that collect information on the prescribing and dispensing of controlled drugs (drugs monitoring varies from state to state). The purpose of the databases is to allow pharmacists, practitioners, regulatory boards, and law enforcement to monitor for abuse and diversion. PDMPs are also instrumental in helping healthcare providers identify patients at risk for drug abuse and misuse, intervene early, and therefore reduce opioid-related deaths.
Prevention, Monitoring & Management Solutions: Patient education and early intervention are paramount to solving the opioid epidemic. Medication management for controlled substance use is important in both acute and non-acute care settings, and requires care coordination by healthcare providers, particularly during care transitions. The EnlivenHealthTM Patient Engagement Platform offers multiple solutions for comprehensive care management, including opioid mitigation.
Interested in reading more about pharmacy’s role in opioid prevention, monitoring & management? Check out our latest whitepaper on the topic.