APhA2017: Opioids and the complex problem of addiction

Pain physician Krane delivers keynote at Opening General Session

Keynote speaker Elliot J. Krane, MD, punctured myths about opioids and addiction in an electric, riveting presentation to attendees at the Opening General Session of the 2017 APhA Annual Meeting & Exposition in San Francisco today.

“Our reliance on opioids has been said to lead to the opioid ‘epidemic,’” Krane said. “There’s a lot of inflammatory talk, [but] complex problems are usually not going to be solved by simple answers.” He added, “We have people whose lives depend on opioids.”

Exposure to opioids alone does not cause addiction, said Krane, a practicing physician and professor of anesthesiology, perioperative, and pain medicine at Stanford University Medical Center. Factors such as genetics and psychiatric illnesses create a predisposition to addiction.

Opioid addiction is inexorably linked to depression, despair, hopelessness, and loss of self-esteem, and the states with the highest addiction rates are not coincidentally the states left behind by economic growth, he said.

“Opioid use goes up with economic despair,” Krane said.

“Strict limits on opioid prescribing are not going to work,” he added, referring to the CDC opioid prescribing guideline. “It’s going to result in inhumane treatment for patients with chronic pain.”

Pharmacists need to be sensitive to recognizing people with addiction when they come in, he said. Every pharmacy should have a take-back program, though that isn’t easy, he added. Krane advocated for increased access to naloxone and a national prescription drug monitoring program.

Rep. Earl L. “Buddy” Carter (R-GA), BSPharm, brought tidings and Capitol Hill humor from Washington, DC, where he serves on the House Energy & Commerce Subcommittee on Health. “If you’re not at the table, you’re on the menu. Finally, we’re at the table,” he said.

Carter, the only pharmacist in Congress, spoke of the pharmacist provider status legislation making its way through Congress. “We’ve been doing this [pharmacists’ patient care services] for years,” he said. “You need to be recognized and compensated for it.”

He noted that his office was meeting with FDA next week about the possibility of a pharmacist-only class of medications.

APhA President Jean-Venable “Kelly” R. Goode, PharmD, BCPS, FAPhA, FCCP, said, “I challenge each of you to have the courage to seek the new.” About the quest for federal provider status, Goode told attendees, “We will win this battle.”

She said, “My love for this profession runs as deep as my Virginia roots.” She is the 161st APhA President and the fourth APhA President from the state of Virginia.

Goode concluded that the light at the end of the tunnel wasn’t an oncoming train, but the profession’s bright future. “That’s our power—the power of patient care,” she said.

The Opening General Session began with a color guard from Travis Air Force Base presenting the colors and the singing of the national anthem by U.S. Public Health Service pharmacist LCDR Juliet Jordan-Joseph.

Mark Walberg, the host of “Antiques Roadshow,” was back for his eighth year as emcee for the APhA General Sessions, striding onto the stage with the words, “Far out, everybody!” and passing out flowers in the audience. Goode joined Walberg, and then introduced the APhA Board of Trustees to the stage, where they flashed peace signs. They led the audience in reciting the Oath of the Pharmacist.

APhA Award recipients were recognized. Goode presented the Remington Honor Medal to Daniel A. Hussar, BSPharm, MS, PhD.

Echoing others, Hussar encouraged attendees to become involved: “We have a lot of work to do in convincing our brothers and sisters in the profession that they need to get involved.”

For the APhA Academies, the Linwood F. Tice Friend of the APhA Academy of Student Pharmacists Award went to Michel B. Disco, MBA, RPh. The Daniel B. Smith Practice Excellence Award, administered by the APhA Academy of Pharmacy Practice & Management, went to Mary Ann Kliethermes, BS, PharmD. The APhA Academy of Pharmaceutical Research & Science’s Tyler Prize for Stimulation of Research went to William Douglas Figg Sr., PharmD, MBA. The 2017 APhA Fellows for the practice and science academies were also introduced.

The Hugo H. Schaefer Award was presented to Clark H. Gustafson, BSPharm. Thomas P. Reinders, PharmD, received the Gloria Niemeyer Francke Leadership Mentor Award. The H.A.B. Dunning Award went to Pfizer Inc.