February 9, 2018

The Opioid Crisis – A Challenging Opportunity for Independent Pharmacies to Save Lives

The opioid crisis is dominating news outlets and social media platforms. The startling increase in cases of opioid abuse, overdoses and casualties in the last decade elevated this health crisis to an epidemic. Healthcare providers are collaborating with policymakers to prevent and reverse opioid abuse, but it is showing no signs of slowing. A special segment of the industry that is leading the charge in this crisis is independent pharmacies. Pharmacists have an expanding role and responsibility within healthcare, and with provider status pending, this crisis is an opportunity for community pharmacists to educate, assess and screen their patients to prevent more opioid-related deaths.                                                                          

The crisis is worse than anyone predicted, and the U.S. is looking for effective reform and initiatives that both treat and prevent opioid abuse. People are looking for answers. How did we get here? What is currently being done? How will this affect our future? While there aren’t simple answers to these questions, a deeper look into the role of independent pharmacists may bring clarity to the problem and potential solutions as our nation looks to solve the opioid crisis.

 

How Did We Get Here?

It wasn’t always like this. Drug abuse has existed for centuries, but the beginnings of the current opioid crisis originated almost 40 years ago. The late 1900s introduced new opioid forms that are frequently abused like OxyContin, but many scholars and analysts refer to one published letter as the catalyst for the modern opioid crisis. A letter published in the New England Journal of Medicine in 1980[1]  advised prescribers that narcotics were safe for chronic pain treatment and that patients did not have a high risk of dependency. The letter would have lasting effects that sparked behavioral changes in healthcare professionals and patients alike. Although the effects of the letter are still debated, there is no doubt that this publication had an impact.

Opioids come in many forms – both legal and illegal – and the highly-addictive nature made it extremely difficult to avoid dependency. The severity of the epidemic differs in each state, with Kentucky, Ohio and West Virginia being among the worst. Opioids have not been proven to improve chronic pain, yet the number of prescriptions has quadrupled over the last 15 years[2]. If those numbers aren’t scary enough on their own, the number of casualties due to opioid abuse has increased 533% from approximately 2,089 to 13,219 in 14 years[3].  Though there were early signs of an issue, the problem continues to worsen.

 

What is currently being done?

Healthcare professionals like pharmacists have done their due diligence. It is clearer than ever that coordination between care teams will be crucial to preventing unnecessary casualties. Changes to our current healthcare system – everything from the introduction of Medicare Part D to the Affordable Care Act – are shaping the way the U.S. fights this opioid abuse. Healthcare professionals, policymakers, analysts and researchers are partnering to find solutions that span across the industry. Proposed solutions include education sessions within the pharmacy, reimbursable injections like Vivitrol, controlled prescribing to monitor patients for risk and history of drug abuse, and medication-assisted therapy[4].

Pharmacists are making drastic changes in their practices to do their part in battling this epidemic. Independent pharmacists are uniquely poised to make an impact on this epidemic, especially because of the access they have to patients in smaller, rural areas. Community pharmacies make up 36 percent of retail pharmacies in the U.S.[5] and the expansion of services provided is improving health outcomes for medically-underserved patients. Certain states are reimbursing independent pharmacies for opioid training and clinical services. Pharmacies that embrace technologies like Updox Pharmacy Connect and Creative Pharmacist’s STRAND platform are best equipped to create positive change, giving them access to the materials needed to be reimbursed for opioid education.

Independent pharmacists are making sure their voices are heard, as they are on the frontlines facing this epidemic head on every day. The National Community Pharmacists Association (NCPA) issued eight recommendations to Congress in November 2017 from the independent pharmacy perspective on how to combat the opioid crisis. The NCPA recommendations[6] include:

  1. Expand consumer access to Naloxone by allowing pharmacists to be able to directly prescribe it.  
  2. Establish limits on maximum day supply for certain controlled substances.
  3. Prohibit certain controlled substances from being delivered to patients via physician offices or through the mail.
  4. Expand electronic prescribing of controlled substances by mandating its use where feasible.
  5. Enhance Prescription Drug Monitoring Programs (PDMPs) by creating national standards.
  6. Increase healthcare provider education by emphasizing a verification infrastructure with minimal administrative burdens.
  7. Increase the usage and access to medication-assisted treatment.
  8. Expand the ability of pharmacies to identify individuals with substance abuse disorders by participating in Screening, Brief Intervention, and Referral to Treatment (SBIRT) activities. 

 

An Powerful Partnership to Arm Community Pharmacists for the Opioid Battle

Pharmacists are set for success when they have the best support and resources available. Every community pharmacy is different, and it is a challenge to find technologies that support the real challenges that an individual pharmacy faces. A unique partnership that was created specifically for community pharmacists is Updox for Creative Pharmacist. Beginning in 2017, the Updox Pharmacy Connect care coordination platform merged directly into the Creative Pharmacist STRAND platform, creating an all-in-one tool that provides solutions that improve the revenue and patient engagement of independent pharmacies.

Direct secure messaging, patient portals, electronic fax and other communication tools offered in the Updox suite allow pharmacists to create and send pharmacist eCare plans, send patient education materials, and bill for clinical services. The technology partnership better equips independent pharmacists to deliver the best drug intervention to the patients affected by the opioid crisis. Independent pharmacies that are ready to fight the epidemic can take advantage of counseling sessions paired with appointment reminders to improve treatment compliance. Direct messaging through DirectTrust enables pharmacists to coordinate the best treatment options, share patient medical records with prescribers and track reimbursable clinical services with Updox-Creative Pharmacist partnership. The future of the opioid crisis remains unseen, but, until nationwide legislation is passed, independent pharmacists will continue to make meaningful impacts in their local communities every day. 

Updox recently partnered with Creative Pharmacist's Co-founder and Chief of Innovation David Pope, PharmD, to host a web seminar that tackled exactly how community pharmacists can influence their own patient base in the fight against opioid abuse.

 

Sources:

[1] http://www.nejm.org/doi/pdf/10.1056/NEJM198001103020221

[2] https://www.cdc.gov/drugoverdose/data/prescribing.html

[3] https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

[4] https://www.cdc.gov/drugoverdose/prevention/treatment.html

[5] 2017 NCPA Digest

[6] http://www.ncpa.co/pdf/help-opioid-hearing.pdf

Topics: Pharmacy, Physicians, Blog

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