The opioid crisis has been ongoing for several years, if not decades. It results from doctors liberally prescribing the medication to patients, who then develop a dependence, and then an addiction.
It has ravaged households nationwide and caused irreparable damage to patients’ health. The opioid crisis is nothing new for both independent pharmacists and patients.
It has drastically changed your workflow regarding how you fill and even input those prescriptions.
No matter how familiar you are with the ongoing opioid crisis, it’s essential to know what opioid abuse looks like. You can see signs from your patient, and your pharmacy software system can detect early signs of addiction. You just need to know what to look out for.
Here’s how you can handle opioid abuse, both from up close and afar.
The Current Crisis
The opioid crisis constantly has new developments, but its harm has never wavered.
A New York Times report found that opioids were the leading cause of fatal poisonings among children ages 5 years old and younger.
The report cites a study from Pediatrics, where they found 41% of these poisonings were deemed accidental, while 18% were considered deliberate.
The American Medical Association highlighted the recent uptick in opioid deaths.
Though the number of opioid-related prescriptions has lowered over the past five years, the AMA has noticed a new change in the opioid crisis.
Deaths and overdoses are mainly coming from illegally obtained fentanyl. Fentanyl is an extremely potent drug. It is carefully prescribed by physicians to treat extreme cases of chronic pain.
Street-made fentanyl naturally increases the risk of overdose and death. News sites have also reported that some batches are laced with other drugs, further increasing the likelihood of overdose or death.
Handling opioid prescriptions is stressful enough. You have to adhere to CDC guidelines that might prevent you from filling the prescription based on the daily dosage.
Even when a prescription does follow CDC guidelines, you then have to determine if that particular dose is safe and effective for your patient.
Dispensing opioid medications is very much a tightrope act. It’s never an easy endeavor. But you can make it a little easier among the usual chaos of pharmacy work.
How to Detect and Handle Opioid Abuse
You can detect opioid abuse from two settings: from the (relative) comfort of your pharmacy software system and when talking to the patient themself. Let’s start with the latter.
Don’t ever accuse a patient of abusing or misusing opioids. Simply raise concern that a prescription has too high of a dose or they’re getting the medication more frequently than usual.
It also helps to view your patient’s profile. Your pharmacy software system should give a comprehensive look at your patient’s fill history.
Let’s start with the physical signs of opioid abuse. Per John Hopkins Medicine, some of the physical symptoms of opioid use include:
- Sweating
- Chills
- Anxiety
- Nausea
- Agitation
- Muscle Aches
Though these symptoms aren’t unique to opioid abuse or withdrawal, they can give you context into what’s going on with the patient.
If they come in to drop off an opioid prescription, check for forgeries. If anything about the prescription raises a concern, contact the doctor immediately.
How Your Pharmacy Software System Comes Into Play
As mentioned earlier, your pharmacy software system can give you context behind your patient’s behavior. Furthermore, it can give you a detailed road map of their health journey.
Examine your patient’s fill frequency. Opioid prescriptions are a 30-day supply at the most. Depending on the state, doctors may write them for a longer dose. Your pharmacy software system should raise a red flag if they request a fill too soon after the previous one.
The general rule of thumb is to fill another month-long prescription 27 days after the previous one. Do the math and go on from there.
Your pharmacy software system should have direct access to prescription monitoring programs (PMP), especially for prescription opioids.
PMPs will give you an overlook of your patient’s fill history beyond your independent pharmacy. It is an extremely invaluable tool to detect patterns of prescription opioid misuse.
In this case, your pharmacy software system should give you all the information you need to ethically fill — or refuse — a prescription. Now it’s time to go back to the pharmacy floor.
Provide Naloxone
The AMA attributes a portion of opioid overdoses or deaths due to an apparent lack of access to naloxone. Luckily, greater availability might not be too far off.
The FDA voted unanimously to make Narcan available without a prescription. It is a safe, easy-to-use medication that works within the first few minutes of an overdose. It also has no potential for abuse.
Order more quantities of Narcan through your pharmacy software system. Always offer Narcan to patients who regularly take opioids.
Refer your patients to the Narcan website to learn more about how the medication works.
Offer Them Recovery Resources
A well-informed patient inevitably becomes a healthier one. Just like how viewing your patient’s profile gives you a plan of action, you can create one for your patients.
The CDC’s “Overdose Prevention” page provides several resources to help your patients manage opioid abuse.
The page includes local health center locators, an opioid treatment program directory, and more. Sometimes providing these resources is as essential as filling a prescription. After all, an independent pharmacy does more than put pills in a bottle.
Help End the Opioid Crisis
Though we have made strides in ending the opioid crisis, there’s still a way to go. As an independent pharmacist, your job is to help on an essential, micro level: one patient at a time.
It doesn’t sound like much, but the potential impact is immense. Use all the tools at your disposal, whether that’s your pharmacy software system, online resources, or even your pharmacy staff. It takes a village after all.
