Opioid Addiction and Overdose: New Legislation and How Pharmacists Play a Critical Role in the Epidemic

MAY 20, 2016
Desiree’ Gaines, PharmD, and Ashley Branham, PharmD, BCACP
It is estimated that 46 individuals die of prescription opioid overdoses every day in the United States. The Centers for Disease Control and Prevention reported that more than 16,000 individuals in the United States died of opioid overdoses in 2013.1 Results from the National Survey on Drug Use and Health demonstrate that almost 2 million Americans, 12 years or older, misused or abused opioid pain relievers in 2013.2 The rise in overdose deaths resulting from the misuse and abuse of prescription drugs has been linked to overprescribing, a 300% increase in prescription opioid sales since 1999, and improper medication disposal.3,4

On March 10, 2016, the United States Senate passed a bill to combat the growing heroin and opioid epidemic throughout the nation. The Comprehensive Addiction and Recovery Act, a bipartisan bill, was passed with a vote of 94 to 1, demonstrating overwhelming support to reduce opioid addiction and related deaths. This bill will provide $725 million of federal grant money to local and state governments, and nonprofit organizations, to expand program resources, education, and monitoring programs. In addition, funds could be used to develop drug treatment programs.

“Today, Americans suffering with opioid addiction are closer than ever before to getting the help they need,” said Senator Richard Burr (R-NC). “There are thousands of North Carolina families currently grappling with this addiction, and I am encouraged that the Senate has produced bipartisan legislation that will help end the devastating crisis hurting families across the country. We can reverse this disturbing trend that has ravaged the United States over the past few decades.”

Pharmacists are equipped to play an important role in reducing opioid misuse and abuse, but are often an underused resource. Pharmacists have unique clinical knowledge, as well as an obligation to ensure that all efforts are made to prevent substance abuse in their communities by providing education, using prescription drug monitor programs, and providing patients and families with lifesaving resources.
Education Strategies
Education is a crucial first step in tackling prescription abuse. Parents and teenagers should be targeted for education due to the many misconceptions about drug use. Illegal drugs are commonly discussed, but many individuals fail to understand the risks associated with prescription drugs, especially opioids. Many parents are also unaware that teens are abusing prescription drugs and, therefore, are unsuccessful in safeguarding access to those medications in the home. In the 2009 National Survey on Drug Use and Health, 70% of individuals who reported nonmedical use of pain relievers obtained them from relatives or friends, whereas only 5% of individuals reported getting them from a drug dealer or via the Internet.5 Because opioids are commonly prescribed and are readily available in most homes, it is important to educate families on the potential abuse that can result from easy access.

Pharmacists can reach out to their communities by participating in public substance abuse education and prevention programs, collaborating with other health care providers (HCPs), and working with local, state, and federal authorities to combat controlled substance abuse. Educating patients on proper storage and disposal of excessive, unused, and expired medications should become routine practice for pharmacists. Directing patients to local drop boxes, or other safe ways to dispose of medications, can further help to prevent medication diversion and abuse.
Prescription Drug Monitoring
Statewide electronic databases, such as prescription drug monitoring programs (PDMPs), can be effective tools for pharmacists in identifying the appropriate use of controlled prescription medications. As of 2014, 49 US states have operational PDMPs in place to track the prescribing and dispensing of controlled prescription medications.6 This statewide electronic tool is used by prescribing physicians and pharmacists to provide data on prescribing and dispensing histories of controlled substance prescriptions, including opioid medications. Although this tool has proven to be useful in preventing drug diversion, it is only useful if HCPs use the system prior to prescribing and dispensing.7 Pharmacists must continue to regularly use their state PDMP  and inform other HCPs of the importance of its use. With added federal funding, additional local and state governments may be encouraged to establish effective PDMPs to monitor prescription drug use in their states.8