Pharmacists and the War on Opioid Addiction
By Laurie Pumper, MPhA
Leading up to and following President Trump’s declaration of a national public health emergency on opioids, Congress and several pharmacy associations are taking action. The president’s action came on Oct. 26; it does not release any additional funds to deal with a drug crisis that killed more than 59,000 Americans in 2016. It does allow for some grant money to be used to combat opioid abuse and expand the use of telemedicine services to treat people in rural areas — many of them ravaged by opioid abuse but lacking doctors.1
The U.S. House Energy and Commerce Committee held a hearing on Oct. 25 on federal efforts to combat the opioid crisis. The National Community Pharmacists Association (NCPA) joined the American Pharmacists Association (APhA), Academy of Managed Care Pharmacy (AMCP), American Society of Consultant Pharmacists (ASCP), American Society of Health-System Pharmacists (ASHP), College of Psychiatric and Neurologic Pharmacists (CPNP) and the National Alliance of State Pharmacy Associations (NASPA) in submitting a statement for the record at the hearing encouraging the committee to pass H.R. 3991, the Expanded Access to Opioid Abuse Treatment Act of 2017, a bill that would enable pharmacists to obtain a Drug Addiction Treatment Act (DATA) waiver in the same manner as physician assistants and nurse practitioners.
The committee heard from witnesses from the FDA, DEA, SAMHSA, CDC, and NIH on agency efforts to address the crisis and to implement the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act. Chairman Greg Walden (R-OR) detailed the committee’s ongoing bipartisan investigation into alleged pill dumping in West Virginia and chided the DEA for its lack of cooperation in providing documents and answers to the committee on shipments from distributers. Committee members focused on a range of problems contributing to and possible solutions for the crisis; of note, Rep. Buddy Carter (R-GA) raised the need for non-opioid alternatives to pain treatment and the incentive that PBMs have created through greater reimbursement for opioids over non-addictive alternatives.
On Nov. 8, the National Association of Chain Drug Stores (NACDS) reported on a study it funded on how to better utilize community pharmacy and improve public health. The study by the Johns Hopkins Center for Health Security found that chain and independent U.S. pharmacies are an untapped resource in the efforts to curb the opioid epidemic — as well as to halt the spread of antibiotic resistance and bolster pandemic and emergency preparedness and response. Pharmacists already play a critical role on the care team, but “more can be done to ensure pharmacy professionals practice at the ‘top of their license’ — the peak of what they are capable and licensed to do to support public health,” said Gigi Kwik Gronvall, PhD, the study’s corresponding author. The study found the most pressing need to adjust policy in favor of community pharmacy is the fight against the opioid crisis. Reform could also help reduce the onerous liability, payment, and legality issues in some states that continue to limit a pharmacy’s role in opioid abuse intervention and education. NACDS President and CEO Steven C. Anderson said, “We hope the recommendations in this report will foster new partnerships to address pressing needs, including the development of collaborative and comprehensive solutions for the opioid abuse epidemic.” 2
On Nov. 9, The Hill published an opinion piece by National Community Pharmacists Association CEO B. Douglas Hoey, “Here’s a Pharmacist’s Perspective on Addressing the Opioid Crisis.” Hoey wrote, “Independent community pharmacists, many of whom practice in rural communities that are feeling the brunt of the problem… are on the frontlines of this battle.”
Hoey went on to explain the work that NCPA is doing through testimony in Congress, at the Centers for Medicare and Medicaid Services and elsewhere. He noted, “NCPA strongly endorses further empowering pharmacists to help save lives. Naloxone rapidly reverses the effects of opioid overdoses. All 50 states have passed laws expanding access to this lifesaving drug, but only a few states give pharmacists the ability to act independently in dispensing naloxone.”
1 Source: Trump Declares Opioid Crisis a “Health Emergency” but Requests no Funds, New York Times, Oct. 26, 2017. https://www.nytimes.com/2017/10/26/us/politics/trump-opioid-crisis.html Accessed Nov. 14, 2017.
2 Source: National Association of Chain Drug Stores website, Nov. 8, 2017. https://www.nacds.org/news/study-highlights-opportunities-for-pharmacies-to-help-curb-u-s-opioid-epidemic-bolster-other-public-health-efforts/ Accessed Nov. 14, 2017.