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August 20, 2020
On This Episode
Pharmacists are on the front lines of reducing the opioid crisis in addition to being on the frontlines of healthcare and COVID-19. What has been done in the recent past and what can pharmacists do to stop, or prevent, opioid overdoses and opioid addiction? Apex Pharmacy Benefit Practice Leader Erin Albert and Executive Advisor Scott Long give an update about the opioid crisis and how it is being handled in Indiana on this episode of The Point Podcast.
The 2019 CDC national data released in July noted the U.S. had 70,980 projected overdose deaths in 2019
- An increase from 70,699 in 2017
- 35 states saw overdose death increases, while only 13 recorded declines
- Fentanyl, and other synthetic opioids, are involved in more than half of all projected deaths with cocaine and methamphetamine-related deaths were also on the rise
- Prescription opioid dispensing has dropped since the CDC issued prescribing guidelines in early 2016, which resulted in less prescribing and less insurers providing coverage
In May 2020, Jennifer Sullivan, the head of the family and social services administration in Indiana, announced that naloxone – a temporary treatment to reverse opioid overdoes – was used 1,306 times in April 2020, more than any other month in the state’s history.
- There is a 35-percent statewide increase in naloxone use since 2019
- There are many other factors driving this pandemic: loss of daily structure for so many, social isolation, economic hardship, job loss and housing and food insecurity
The Indiana General assembly has placed several pieces of legislation recently to limit opioid access.
- Opioids for dispensing and prescribing has been reduced for opioids from community practice pharmacies to a seven-day supply
- Patients can request a lesser amount of a prescription opioid from the pharmacy, meaning use only what you need.
- Pharmacists and healthcare providers also have access to prescription drug monitoring program, or PDMP called INSPECT. PDMP in Indiana connects to other PDMP databases to check if patients are getting opioids filled from pharmacies, or going to multiple providers to seek opioid prescriptions
- Indiana will have legislation to have all controlled substance prescriptions, including opioids prescribed electronically
It is important to remember there’s tiny font of every drug label in Indiana that says: “Caution: Federal law prohibits transfer of this drug to any person other than the person from who it was prescribed.”
What about treatment of opioid addiction?
- Medication-Assisted Treatment (MAT) for Opioid Use can be challenging to get access to with COVID-19. There are three FDA approved treatments for MAT—methadone, buprenorphine and naltrexone, along with counseling and cognitive behavioral therapy.
- Buprenorphine can be prescribed by a federally approved healthcare provider. You can find a list of these approved providers near you at SAMHSA.gov (https://findtreatment.samhsa.gov/.)
- Naltrexone can be prescribed by any healthcare provider, but an individual must abstain from opioid use for 7-10 days before starting it.
What should people do if they have a prescription opioid unused and lying around the house?
- Talk to your pharmacist. See if they have a take back program for opioids and/or old prescription drugs. You cannot return the drugs to the pharmacy for any type of refund or reuse, but many pharmacies will take back prescription drugs and safely destroy them for you. Call or ask before you take them back.
- Also, the Drug Enforcement Administration offers a prescription drug takeback day twice each year—usually in the spring and fall.
- The next DEA drug take back day is Oct. 24, 2020. This provides a safe way to dispose of your unused prescription drugs.
Where can people and family members of those suffering from addiction get help in Indiana for drug overdose, or opioid addiction?
- Dialing 2-1-1 is a free and confidential service that helps Hoosiers across Indiana find the local resources they need.
- ISDH – Provides training and kits to local health departments to distribute in their communities.
- OptIN – Provides a list of entities that are naloxone providers.
- Overdose Lifeline- Performs first responder and community trainings.
- Bitter Pill – Naloxone training resources.
- Indiana Recovery Alliance – Distributes naloxone during daily outreach and through community trainings. The Monroe County Health Department offers naloxone through community trainings to the public as well as providing naloxone to emergency responders such as local fire departments, local police departments, community justice and local emergency departments