Pharmacists can address barriers to treatment, engage with patients, and advocate for change at the community and federal levels.
In 1994, the rate of people contracting HIV through dirty needles in Baltimore, Md., was 63%. Despite objections at the time from some groups that claimed that implementing a needle- sharing program would encourage more drug use, the jurisdiction became one of the first in the country to implement a needle-exchange program. Today, the rate of people in Baltimore who are contracting HIV from dirty needles is down to 7%.
It is that type of data that Batltimore City Commissioner of Health Leana S. Wen, MD, said is sorely needed to make changes in public health policy that will save lives.
In 2015, Dr. Wen signed paperwork that makes naloxone widely available to Baltimore residents. Since then, objections have surfaced from some groups about the widespread availability of naloxone, with some claiming that increased access to a medication that can revive a person who has overdosed may actually spark more drug abuse. However, Dr. Wen likened widespread naloxone availability to making EpiPen widely available.
“If someone is dying from a peanut allergy, you’re not going to say, ‘I’m sorry. I’m not giving you an EpiPen because you may start eating peanuts again,’” Dr. Wen told a packed house at a keynote address held at the The American Pharmacists Association (APhA) 2017 Annual Meeting & Exposition (APhA2017) in San Francisco this weekend.
Dr. Wen noted several key themes during her presentation, including addressing barriers to getting people the treatment they need (like those who objected to needle-exchange programs or increased naloxone access), engaging patients and getting their feedback on how health care can better treat them, and advocating for change at the community and federal levels.
Dr. Wen pointed to efforts in Baltimore and nationwide to petition the FDA to warn the public about the dangers of mixing opioids and benzodiazepines as an example of advocacy bringing about wider health care changes. The warning, issued in late 2016, noted that mixing opioids and benzodiazepines or other drugs that depress the central nervous system (CNS) can cause life-threatening adverse effects, such as slowed or difficult breathing and death.
“As a result of working with doctors, nurses, pharmacists, and public health officials, we were able to get the FDA to issue a warning about benzodiazepines and opioids,” Dr. Wen said. “For anyone who questions whether change can happen, I hope you’ll see in this example that it can. When it comes to these big challenges and certainly overprescribing, yes, there are many barriers we face, but we have to start somewhere.”
In closing her discussion, Dr. Wen quoted New Jersey Senator Cory Booker, who said: “We cannot allow our inability to do everything to undermine our choice to do something.”
Wen L. Keynote presentation: Patient to Provider - 'Hear my Story.' Presented at: American Pharmacists Association 2017 Annual Meeting & Exhibition. March 24-27, 2017; San Francisco.