The Pharmacist’s Role in Preventing Opioid Overdoses

by Jeremy Winograd on February 15, 2017

preventing opioid overdoseThe rapidly rising rate of opioid overdoses is one of the United States’ direst health crises. Addiction to illicit opioids like heroin has cast a shadow over the American health landscape for decades. However, a combination of the increasing ease of availability of powerful prescription opioids like Oxycodone and Fentanyl and rising heroin usage have caused overdose rates to skyrocket. According to the CDC, prescription opioid overdose-related deaths have quadrupled in the U.S. since 1999, reaching an astounding high of 15,000 in 2015 – even more than the 13,000 who died from heroin overdoses in the same year. Based on these overwhelming statistics, we can no longer stereotype opioid addicts. It isn’t just Bubbles from The Wire, or even Lou Reed and Keith Richards, who are in danger of suffering from a sudden and very often fatal opioid overdose anymore. Rather, it’s a growing number of average Americans all across the country. While this is a scary thought, it also means that pharmacists have more plentiful opportunities than ever to make a direct and positive impact on vulnerable patients. Here are a few ways you can help prevent opioid overdoses.

Increase Naloxone Awareness

Naloxone is an opioid antagonist that can reverse respiratory depression and other deadly symptoms associated with opioid overdoses. It is commonly used by EMTs and other emergency care professionals due to its fast-acting effectiveness and lack of negative clinical effects. Efforts to increase the drug’s obtainability, including pushes to make it available over-the-counter, have been met with controversy due to the perception that ready access to such a pharmaceutical parachute could make some less wary of using dangerous opioids. That said, even if you’re not prepared to advocate for displaying it in the cold and flu aisle at Walgreens, informing your patients who are prescribed opioids of naloxone’s benefits could save their lives.

Support Outreach Programs for Heroin Addicts

Heroin overdose rates have increased just as sharply as those related to prescription opioids recently, with the CDC estimating a more than 20% increase in heroin overdose deaths from 2014 to 2015 alone. This is no coincidence – more and more, heroin addicts were prescription opioid abusers first. Unsurprisingly, then, heroin is now often being cut with prescription opioids like Fentanyl, thus increasing its potency and, subsequently, the likelihood of overdose. Considering this frightening state of affairs, it’s critical now more than ever for you as a pharmacist to contribute whatever time, effort, or money you can spare to outreach programs that help heroin users escape the throes of addiction.

Identify Drug-Seeking Behavior

While you want to see the best in your patients, the fact is that, just based on sheer statistics, some people who come to you with opioid prescriptions are inevitably going to turn out to be abusers already. Therefore, it’s critical for you to have the skills and know-how to be able to identify the telltale signs of drug-seeking behavior or fraudulent prescriptions. Be on the lookout for erratic and demanding patients who act evasively when asked about medical history, insurance, or who their doctor is. Likewise, learn to spot fraudulent prescriptions containing unusual or inconsistent information.

Investigate Multiple Prescriptions

Of course, most prescription opioid overdoses don’t arise from duplicitous origins. Oftentimes, patients may simply be overprescribed, making accidental overdose more of a threat. If a patient comes to you with different opioid prescriptions from more than one doctor, for instance, it’s a good idea to contact those doctors to make sure they know about each other and that the multiple prescriptions aren’t redundant or dangerous. Another great way to guard against over-prescription, as well as suspected abuse, is your state’s Prescription Drug Monitoring Program (PDMP) database, which collects electronic pharmaceutical dispensing and prescription data from doctors and pharmacies. It couldn’t hurt to check if your patient’s opioid-related activity is, if not necessarily suspicious, then at least indicative of potentially unsafe prescription practices.

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