Guest blog from Valerie Prince, President of APhA
The numbers on opioid use disorder (OUD) alone paint a grim picture. Opioids are tied to over three-quarters of drug overdose deaths. More than a million people have died in the United States from fatal opioid overdoses in the last two decades. We lost 80,000 lives to opioid overdoses in 2021 alone.
Behind every statistic, every number, lies a human story—individuals and their families ravaged by this epidemic. Opioid addiction affects people from all walks of life: children, parents, family, neighbors, and friends. Far from being figures on a chart, these numbers are a resounding call for action.
We have seen a decrease in the number of prescriptions written for opioids as well as the number of units of opioids dispensed. And treatment options do exist for OUD—three FDA-approved medications are on the market that can be used to treat OUD. Yet we still observe high rates of OUD with only 36% of those suffering receiving any treatment for it. Buprenorphine, the first-line drug for the treatment of OUD, is not used by most patients.
Why are we still seeing a lack of access to these medications?
There are many reasons. Unfortunately, one of the most fundamental causes is that many pharmacies refuse to stock buprenorphine because they simply do not want to deal with the paperwork associated with controlled substances. A second reason is that DEA and the United States Department of Justice (DOJ), in their consent decrees with wholesalers and pharmacies, treat buprenorphine just as if it were hydrocodone—subjecting pharmacies to quantity limits and ratios that further limit availability of this lifesaving medicine. APhA is working with the Substance Abuse and Mental Health Services Administration (SAMHSA), DEA, and DOJ to address this latter issue.
It is imperative for pharmacists to be a part of ending this epidemic. We practice in a wide variety of settings, and each of our practice sites has its own set of limitations and opportunities. Some sites may lack the resources or education and training on treating OUDs. APhA provides training resources, available at www.pharmacist.com, to bring pharmacy team members up to speed, including DEA-compliant training for buprenorphine prescribers in states where pharmacists have such authority. We can’t all be part of the solution in the same way, but even a pharmacist who provides access to buprenorphine for a patient with OUD by simply dispensing the drug is performing a lifesaving act.
Our role as pharmacists is to be accessible and compassionate health care leaders. We must foster an environment in our practice settings that embraces those affected by addiction, offering a lifeline rather than judgment. Stigma is a problem, and we fight it with everything we’ve got through loving care that embraces everyone. This means we must be willing to advocate for our patients to expand access to medication-assisted treatment. We need to work with our employers to have buprenorphine readily available. And we need to be open to learning more about OUD treatment and its critical role in combating this epidemic. When we dismantle the stigma associated with opioid addiction, we create spaces for individuals to seek help.
In my acute care practice, I frequently see patients who are hospitalized because of their substance use disorders (SUDs). Many more of our patients die from complications of SUD and never make it to, or past, the emergency department. It’s heartbreaking to know that many of those lives could have been saved by accessing treatment that should have been available to them.
People are dying and we can help them.
Valerie Prince, PharmD, BCPS, FAPhA
President, American Pharmacists Association