The Gravity of the Opioid Epidemic
Part 1: A Pharmacist’s Perspective
Control…it’s something we should all have, right? It’s something we seek and hope to keep. We want control in our own lives, and sometimes in other people’s lives as well. We obsess over it so much that we even try to apply it to things that are simply out of our realm. But…what happens when you don’t have control? You might live your life day-to-day feeling pretty confident in the metaphorical driver’s seat, and then one day something snaps. Life doesn’t add up the way it used to, and you lose your grip… Nothing seems the same, and the feelings of isolation and confusion become unbearable. You try to fix the problem, but your methods are flawed, and soon the only control in your life is the evil that has overtaken everything you love and live for. For addicts, the feeling of life spinning out of control is an uphill battle they try to fight every day, with every breath they take. Some will win, but many others won’t be so lucky. The opioid epidemic is becoming a greater problem in our region and in the United States with every passing day. It is not clear cut, and there are many spokes to the wheel. But, one thing is for certain…it has gotten completely out of control.
I challenge you to watch your local news, or read your local newspaper without seeing or hearing something related to the opioid epidemic. Vague, nondescript obituaries for people who seem far too young to have met life’s end, arrests and drug busts, thefts and robberies, the controversial Narcan debate…all stemming from the monster that is addiction. It’s all around us, whether we choose to notice it or not. It’s a problem that’s never been worse, and even neighborhoods and towns that were once quiet and safe are now feeling the devastating effects and lasting damage. When is enough really enough? What can we do to stop it, and how can we help others? The first step is understanding.
For this blog series, I am traveling down a road that may seem uncomfortable to some, but what I hope will be eye-opening and honest for many. As previously stated, there are many spokes to the wheel of the opioid epidemic, and what the pharmacist sees and experiences each day is just one of them. This is one pharmacist’s perspective…
With the opioid epidemic, healthcare professionals oftentimes have a front seat to the devastating journey, and also play a significant role in picking up the pieces from this epidemic. For Valerie Markley, PharmD, her experiences with the epidemic are raw, yet provide solutions and hope. As an inpatient staff pharmacist in a level 1 trauma center, opioid overdoses have become a routine part of the job. “Usually the cases we see are multimodal substance users,” Valerie explains, “meaning they are not just overdosing on one medication, but rather multiple opioids, heroin, or other street drugs at the same time.” This makes a serious and devastating situation all the more complicated and critical.
In many cases, the user’s addiction has stemmed from the use and then the abuse of perfectly legal, prescribed pain medications like Oxycontin®, Vicodin®, and Demerol®. What’s most devastating is that before the addiction was born, the addict was just an ordinary person living an ordinary life. The journey could begin with a surgery as simple as a wisdom tooth extraction, and slowly work its way through recommended doses of prescribed painkillers, to taking just a little more than recommended, to then purchasing the medication on the street when no refills are left. When these pills become too expensive, the next and most heartbreaking step is heroin. This road is commonly traveled, and it can happen very quickly…to anyone.
If heroin itself wasn’t serious enough, the “extras” it often comes with are what have made the overdose rates rise so dramatically. “Oftentimes patients do not necessarily know what they are taking when they get drugs off the streets,” Valerie states, “It is becoming more popular for street medications to be laced with other synthetic drugs without the buyers knowing.” This is one of the biggest causes of overdoses and overdose related deaths.
With so many devastating cases of addiction to and overdoses from prescription opioids, it doesn’t take much to notice the elephant in the room—is the pharmaceutical industry at fault? There are many opinions and theories behind where the blame should lie. You could point fingers at the insurance companies, physicians, or pharmaceutical industry until your hands are numb. You could debate and argue until you’re blue in the face, but the bottom line is, this epidemic didn’t stem from just one of these sources, but rather a very misguided and vicious cycle born from ignorance and devastating professional error. “The opioid epidemic is a multifactorial problem,” Valerie explains. “As health care professionals, we now have a greater awareness of the situation at hand and how to handle it with the help of federal and state laws, regulations, and tools.”
With use of prescription drug monitoring programs, physicians and pharmacists are now able to better regulate the prescribing and dispensing of opioids. This, in turn, improves patient safety and prevents abuse. Additionally, insurance companies are now limiting the quantities permissible for prescription refills, and often will require prior authorizations.
Valerie does not deny the role that her predecessors have played in this epidemic, but she does offer solutions and hope for how they are making strides to combat it. “Pharmacists, as well as physicians have the capability of recognizing drug-seeking behavior and fraudulent prescriptions,” she explains. “With pharmacist monitoring, we are able to manage appropriate doses for patients, and we’re also able to counsel patients regarding availability of treatment programs that can help patients who suffer from addiction.”
There are also many Prescription Take-Back initiatives and events hosted by the Drug Enforcement Administration (DEA), and many local governments, retail pharmacies, and hospitals. This allows anyone to dispose of leftover prescription medications in a safe and controlled manner, so that they do not fall into the wrong hands. Addiction does not discriminate, and many addicts started their painful journey with prescription opioids that were within arm’s reach in their own homes, sometimes at a very young age. For this reason alone, we cannot stress the proper disposal of leftover opioid medications enough! If you have leftover prescription medications in your home right now, please take the steps to dispose of them properly and safely!
To find prescription take back events near you, click here. For safe disposal of needles, syringes, infectious waste, or personal care products, please contact your local health department or call 1-800-RECYCLE (1-800-732-9253).
Ultimately, to fight this opioid epidemic, we first need to have three things—knowledge, understanding, and compassion. While the devastating behavior that addicts display can be confusing, abhorrent, and dangerous to others, we need to remember that underneath it all they are human beings suffering through one of the most terrifying and gripping diseases imaginable. Every addict is someone’s mother, father, daughter, son, sister, brother, or friend…and every life is worth saving.
If you, or someone you know needs help in finding a treatment facility for drug or alcohol addiction, call this helpline for 24/7 access to specialists who are on call to answer your questions and provide nonjudgmental guidance – (888) 610-5623
To be continued…
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Author: Michelle Adams