Taking the life of a U.S. citizen every 13 minutes, the opioid epidemic continues to devastate our country and overwhelm our communities, neighbors, coworkers, friends, and family members. This national health crisis places an undue burden on the entire healthcare system, negatively impacting health outcomes and causing significant financial strain.
While it’s well-documented that these medications remain overprescribed, opioids represent very effective options for managing pain for select chronic medical conditions like cancer and end-of-life care, and in short-term treatment of more severe acute pain where alternative therapy may not be suitable. Despite the attention drawn to the epidemic and the excess supply of these medications on the market today, we must also remain conscientious of the large numbers of patients with chronic, debilitating pain who rely on opioids to improve their quality of life and overall function, and ensure appropriate access to viable, effective, non-opioid treatment alternatives.
Opioids are powerful medications with highly addictive potential, and anyone taking them, regardless of predisposition to addiction, can find themselves struggling with reliance and dependence. An estimated 2.1 million Americans suffer from ‘documented’ opioid use disorder, according to the Substance Abuse and Mental Health Services Administration. Further, data shows the economic cost of the opioid crisis, including treatment, was $504 billion in 2015.
Given the depth and breadth of this crisis, virtually all constituents of the healthcare system hold some level of responsibility in utilizing tools and resources at their disposal to help address this epidemic. To be successful, solutions must be multidimensional, mixing evidence-based clinical programming, educational outreach, and aggressive intervention in order to curb overuse, misuse and abuse, and to protect the safety of those requiring opioid therapy. Efforts must address every step of the process and target all stakeholders including patients, pharmacists/pharmacies and physicians. The most effective actions will address the contributing factors at the epidemic’s core, with tactics spanning several components, such as:
- Prevention and education. Despite the prevalence of this issue, many don’t realize how closely tied this problem is to an inclination to overprescribe, over-demand and over-consume opioid medications. Appropriate use of opioids is achieved when pharmacists, physicians, caregivers and patients are fully informed about the risks, proper dosage, drug storage, and potential side effects.
- Minimizing early exposure. Since features of physical dependency can begin to occur within as little as a few days of initiating opioid therapy, safer non-opioid alternatives should always be considered for treating chronic and acute pain. When opioids are used, physicians and other healthcare providers who prescribe these medications should do so consistent with CDC guidelines for both dosing and length of therapy.
- Reducing inappropriate supply. Despite growing concerns regarding the epidemic, physicians and other healthcare providers issued nearly 215 million opioid prescriptions in the United States in 2016, equating to nearly one full 30-day supply for every adult U.S. citizen. By reducing the initial supply of opioids in patients newly exposed to an opioid to an acceptable amount based on a patient’s condition, physicians and prescribers can better monitor usage, and patients are less likely to abuse treatment. Applying evidence-based utilization management protocols, limiting unnecessary therapy extension, monitoring for abuse and diversion, and decreasing exposure to harmful drug interactions through routine medication screenings can help limit the inappropriate volume of opioids prescribed.