West Virginia ruling has consequences for pharmacists

In May, the West Virginia Supreme Court of Appeals ruled that people with drug addictions can sue pharmacists, physicians, and other dispensers and prescribers of pain medications for contributing to their addiction and criminal activity.

I know a lot of very frustrated pharmacists who want to do the right thing, but feel like they are getting hammered from all sides! Regulators demand perfection or pharmacists risk severe penalties. While we have some good tools, these tools aren’t perfect. And, even before this ruling, just catching an abuser in the act is a little like a dog chasing a car. Once caught, it’s difficult to know what to do next.

The idea that pharmacists could be legally accountable for enabling drug abusers is both a red flag and an opportunity. Rightly or wrongly, the ruling places blame on pharmacists and health care prescribers. In addition, the decision might create an incentive for those who abuse drugs to pursue legal action, which could have a range of effects from increasing the cost of care to putting a community pharmacist out of business.

Conversely, the court ruling highlights the need for pharmacists to have access to electronic health records. This is an opportunity to promote much-needed collaboration among community pharmacists, hospital pharmacists, physicians, and other health care professionals. And I would add to the list state medical and pharmacy boards.

Last week, the National Association of Boards of Pharmacy convened the Controlled Substances Stakeholders in Chicago. Comprising pharmacy and medical associations/organizations, wholesalers, and pharmaceutical companies, this stakeholder group is focused on finding mechanisms for better coordination and collaboration among pharmacists and physicians to combat prescription drug abuse and on identifying tools and resources to foster better collaboration.  A significant portion of the meeting was spent discussing tools and resources that could assist physicians and pharmacists to address potential abuse problems. 

Patient care improves when pharmacists are on the health care team. Pharmacists are “tuned in” to a patient’s medication needs, but access to a patient’s provider by phone (very time consuming), e-mail, or best of all via the patient’s electronic health record can confirm or eliminate doubts. Prescribers and pharmacists must work together as partners to optimize care.

Pharmacists have the responsibility to question, monitor, and counsel patients and members of the care team regarding controlled substance use. Is there a relationship with the prescriber and the patient? Is there a valid medical condition and does the use of this particular medication make sense? Without better access to patient information, I am concerned that this court ruling will make it more difficult for legitimate patients to be properly treated.

The challenge of managing patients who take opioids isn’t new. In 2015, Mark T. Holdsworth and colleagues published a study in JAPhA that proposed a formalized risk-based community pharmacy practice strategy for agents such as opioids.

Visit pharmacist.com to read more about the lawsuit.


Updated July 28, 2015