In a growing addiction epidemic, pharmacists play a crucial role in prevention and prescribing practices to reduce the number of people who develop addictions to pain medications.
The rates of opioid and heroin overdose deaths rise — nationally and locally — every day, and pharmacists want communities to know they are working with health care providers to stem the flow of opioid medications, educate the public about the risks of addiction and provide lifesaving help.
“The interaction between pharmacists and providers has been heightened,” said Ruth Marietta, community pharmacist and chairwoman of the New Jersey Pharmacists Association Board of Trustees. “We deal with some tough situations, because working with controlled substances is not easy.”
Health professionals have, in more recent years, highlighted the connection between prescription opioids and addiction as more people turn to heroin after becoming addicted to medications.
For some of those people, addiction ended in overdose death. State experts estimate 2016 overdose deaths eclipsed 2015’s toll of 1,587 people, most of whom died from taking heroin or prescription opioids, data from the state Medical Examiner’s Office show.
Per 100 people in New Jersey, 52.6 prescriptions were filled in 2016, according to the federal Centers for Disease Control and Prevention. That rate, however, is slowly declining, as pharmacists say more providers look to alternative pain treatments.
“This (epidemic) has been going on for a long time now, 10 years or more, and seeing what I see in the pharmacy, the prescriptions were in alarming quantities,” Marietta said. “But with the heightened sense of awareness, we’re not seeing as much of those quantities anymore.”
Linda Gooen, a certified consultant pharmacist who works with elderly populations and addiction treatment centers, said providers are seeking advice from pharmacists about alternative medications and therapies to treat patients for pain but avoid prescribing opioids.
She said pharmacists are continuously working to educate the medical community about alternatives. CDC prescribing recommendations changed in the last year to urge medical professionals to prescribe opioid pain medications only after alternatives were considered.
More than 3.7 million people in the United States in 2015 self-reported misusing a prescription pain reliever in the previous month, according to a CDC report released this year.
While the pharmacists said they hoped a focus on alternative pain management treatment would prevent further addiction rates, both said they worry about people who still need opioid medications to treat their pain.
“There are people who still really need them,” Gooen said. “I consult with older geriatrics, and some need those medications, as they are unable to do the alternatives. You always have to think about how there is an epidemic that includes opioids, and that the people who need the medications, get them.”
It’s a balancing act, Marietta said, of getting the appropriate medications and doses to people when they need it and identifying people who may be seeking opioid prescriptions because they may be addicted.
And while they are not in law enforcement, pharmacists sometimes have to wear that hat.
At an annual association conference over the weekend at Harrah’s Resort, one presentation focused on how pharmacists can protect their opioid medications from burglars, how to report prescription fraud, and what to do when a pharmacy employee is suspected of stealing opioid medications.
“Most investigations that involved prescribers came from you guys seeing the red flags,” said James Almond, associate director of law enforcement liaison and education at Purdue Pharma. “Sometimes it’s hard to find the right officer to investigate forged scripts, but try to find a partner in the community who does know how and who you can go to.”
Pharmacists said several state initiatives have helped medical professionals with prevention efforts, including the multi-state prescription monitoring program, prescribing policies that limit first-time opioid medications to five days, and new medication disposal methods.
In the end, they act to keep their customers and patients healthy and safe, the pharmacists said.
“I’ve found that people in the community have become more comfortable with talking to their pharmacists, calling us or asking questions,” Marietta said. “It really takes a team.”