Steps Pharmacists Can Take to Help Address the Opioid Epidemic in the Pharmacy

Pharmacy Times interviewed Jeffrey B. Simon, JD, co-chair of the National Opioid Litigation Conference and a lead negotiator for the many local districts participating in the historic settlement in a multi-district opioid lawsuit in Texas.

Alana Hippensteele: What are some steps that pharmacists could take to help address the opioid epidemic in the pharmacy?

Jeffrey B. Simon: Well, let me start with the fact that most pharmacists who over-dispense opioids are acting in good faith—just like most doctors who overprescribed opioids are acting in good faith. The oversupply of opioids in America was largely not caused by pill mill doctors with a criminal motive. Certainly, there are such physicians who engage in criminal behavior and got criminally prosecuted and that still happens; there are pharmacies and pharmacists who did that too. But in general, most overprescribing is done based on the misperception, based on long standing misinformation, that prescribing and dispensing opioids for perpetual use is safe and effective, when in fact it's not.

So now, pharmacists have all manner of regulatory responsibilities, both at the federal and state level, but most of them manage very well. But they do need to be asking themselves the question, if they are dispensing high-dose opioids on a perpetual basis, is that something they ought to be doing? Should they be looking into whether there is a diversionary motive behind the prescribing? As I say, there are procedures in place for how to do that, we don't want pharmacists to ignore also.

Pharmacists should be permitted and promoted to offer Narcan, or naloxone, the generic form of the drug that reverses opioid overdoses when administered in time, when they’re dispensing high-dose opioids. Obviously, they must receive authorization for this. I'm not talking about them just making their own decision that this is something they're going to do, but they should want to do that.

Just yesterday, on our podcast Outside Counsel, I interviewed a woman, a mother of 2, who was once a mother of 3, but who lost her oldest son to an opioid overdose, who herself experienced an opioid overdose 5 years ago. Narcan was administered in time and saved her life.

She got into rehab, she got into recovery. She has stayed clean for the last 5 years. Were it not for Narcan, she would not be doing the work that she's doing today, which is telling her story and working in treatment clinics and in the opioid harm reduction community. Narcan is literally a lifesaving drug that when administered in time, can get people into rehab, and completely turn their lives and the lives of their loved ones around.

Alana Hippensteele: On that note, any closing thoughts?

Jeffrey B. Simon: Just this, that I thank you, and I thank your readers and your listening audience for your interest in this topic. The opioid epidemic is the largest drug-related epidemic in American history. Apart from COVID-19, it is the largest public health crisis that we have experienced in the last century in the United States. The awareness of the epidemic—what it is and what it isn't—and getting good information is so crucially important. Any time that I have a platform to talk about it, I am grateful to have it and I'm grateful to you.