National Opioid Abuse Epidemic

According to the Centers for Disease Control and Prevention, more than a half a million people died from drug overdoses from 2000 to 2015. Every day, 91 Americans die from overdosing on opioids. The United States opioid epidemic is growing more deadly.

The Role of the HCA Healthcare Pharmacist

Pharmacists at HCA Healthcare work diligently to ensure appropriate prescribing and administration of opioids and narcotic medications. HealthONE’s Sky Ridge Medical Center, an HCA facility, in Lone Tree, Colo., is one of the pilot sites for an opioid safety program. Valerie Davis, the Clinical Pharmacy Manager, tells us, “The ultimate goal of the program is to make a difference in Colorado’s opioid epidemic. Acute pain is a common reason to seek care in the emergency department, and opioid is commonly used for acute pain. Emergency departments are in a key position to help decrease opioid use in patients who are at high risk for misuse and abuse by using a multi-modal, opioid-free pain management pathway for different pain indications.”

Here are a few steps pharmacists can take to help ensure the proper administration and use of prescription medications.

Assess

  • Look for “red flags” that patients might be having problems related to opioid abuse or diversion, such as:
    • Cash payments
    • Early refills
    • Multiple prescribers
    • Altered or forged prescriptions

Verify

  • The Drug Enforcement Administration (DEA) mandates pharmacists assess whether a prescription for controlled is issued for a legitimate medical purpose in the usual course of professional practice.
  • Validate prescriber’s DEA registration number and patient identification

Consult

  • Check prescription drug monitoring program (PDMP) as well as patient records
    • Currently, 49 states plus the District of Columbia have legislation for the operation of a PDMP program to monitor controlled substance activity
  • Provide consults on appropriate management in patients with buprenorphine or naloxone – medications used to treat opioid addiction.

Communicate

  • Contact prescribers about any concerns or unusual behavior observed in patients
  • Talk to the patient for opioid abuse history, drug allergies, pain or opioid tolerance
  • Submit information as required by state law to the prescription drug monitoring program

Prevent

  • Monitor for signs of aberrant behavior, abuse, and diversion
  • Use prescription drug monitoring program to identify patients at increased risk of overdose
  • Monitor for risk of overdose, dispense naloxone, per state authority, and counsel on how to use

Educate

  • Counsel patients on the risks of opioids and saving unused medication
  • Educate patients on most common side effects and emphasize the importance of informing their prescriber or pharmacist for effective management
  • Give details on the refill requirements and the importance of using one pharmacy for all medications
  • Explain how to safely store and dispose of unused medications to prevent diversion or misuse

October is American Pharmacist Month, and October 15-21, 2017 is National Pharmacy Week. Thanks to all of the pharmacists who play an important role on the healthcare team throughout HCA Healthcare. For more information on opioids, please visit: