Calling all pharmacists!

Prescription drug abuse of controlled substances, especially narcotics, has become epidemic in our country.

Most people would not argue with this statement. Clearly, statistics reveal we have an opiate-abuse crisis that is getting worse by the year. In 2008, hospital admissions for prescription opiate abuse increased to 5.6% of all admissions, up from 0.8% in 1992.

The bulk of the increase is occuring in the 18-34 year old age group. The article “The Prescription Drug Epidemic in The United States: The Perfect Storm,” by Jane Carlisle Maxwell, published online May 4 in Drug and Alcohol Review [Drug Alcohol Rev2011;30:264-270], attributes part of this increase to the introduction of Oxycontin in 1996.

Furthermore, according to the U.S. Department of Health and Human Services, prescription painkillers are now the second most-abused drugs, after marijuana.

The pharmacy profession needs to ask itself some difficult questions. Are we doing anything to contribute to this problem? And how can we help to turn it around?

In many states, bartenders can be held liable for serving drinks to an intoxicated patron if the patron leaves the bar, drives, and has a wreck. Is it possible that similar legislation may be in store for us?

Have we, as a profession, become complacent in our duty as gatekeepers of the medicines we dispense, passing off our responsibilities onto the prescribers and patients, because, well, it’s their own choice? This is the elephant in the room that needs to be addressed.

What about the profit we are making by dispensing all these narcotics? Are we willing to forgo some of that in order to discourage the rampant abuse of these drugs?

I believe we pharmacists need to take inventory of our own profession and point a finger at ourselves before someone else does.

I am not suggesting that we go on a witchhunt. Of course, many narcotic prescriptions are legitimate and are taken as directed for valid reasons by the patients for whom they are prescribed. But certainly, if a large percentage of the narcotics we dispense are ending up in the hands of abusers, we need to become more proactive.

Here are just a few suggestions.

• Do not let your pharmacy acquire a reputation for being an easy fill for controlled substance prescriptions.
• Keep a sharp eye out for red flags. Not only for forged prescriptions, but for multiple narcotic scripts from different clinics and doctors, or for patients who pay cash for their controlled substances but don’t get their other meds unless insurance pays.
• Ask questions, make phone calls, check and double-check anything suspicious.

This will not be easy. Obviously, it may cost us not only dollars but time.

I know, I know. Who has time to follow up on every gut feeling that something is not right? But somehow we must find the strength and commitment to take on this challenge and live up to all those surveys that count us among the most honest and trusted of all professions.

Lastly, we should let our patients/customers know that we care about them as human beings, not merely for their business. Making available Narcotics Anonymous literature and meeting schedules along with your pharmacy’s other healthcare brochures and information is also a way to offer help without accusations or confrontations.

Partner with schools, church groups, social services, and law enforcement to participate in educational activities and health fairs.

Be accessible. Make it a priority. We all need to do more to become part of the solution.

Diana Jurss has been a practicing pharmacist since she graduated from Purdue University in 1981. She now lives and works in western North Carolina. You can reach her at dlpickle31@hotmail.com.