Pharmacy industry takes action to boost training, access to treatment

WASHINGTON — The pharmacy industry is doing its part to help stem the tide of prescription drug abuse and heroin use as part of wide-ranging, public- and private-sector efforts announced this week by President Barack Obama.

At a community forum in Charleston, W.Va., Obama and administration officials highlighted the need to change prescribing practices for opioid medications, channel more resources for addiction treatment and facilitate access to naloxone, a drug that helps prevent overdose deaths.

“More Americans now die every year from drug overdoses than they do from motor vehicle crashes. The majority of those overdoses involve legal prescription drugs. In 2013 alone, overdoses from prescription pain medications killed more than 16,000 Americans. I don’t have to tell you, this is a terrible toll. The numbers are big, but behind those numbers are incredible pain for families. And West Virginia understands this better than anybody because this state is home to the highest rate of overdose deaths in the nation,” Obama said at the forum, held at the East End Family Resource Center in Charleston.

Since 1999, sales of prescription pain medications have surged 300%, and in 2012 259 million prescriptions were written for these drugs, “which is more than enough to give every American adult their own bottle of pills,” the president noted.

“And as their use has increased, so has the misuse. Some folks are prescribed these medications for good reason but they become addicted because they’re so powerful. At the same time, we’ve seen a dramatic rise in the use of heroin, which belongs to the same class of drugs as painkillers, known as opioids. In fact, four in five heroin users started out by misusing prescription drugs, then they switched to heroin,” Obama said. “So this really is a gateway drug — prescription drugs become a gateway to heroin. As a consequence, between 2002 and 2013, the number of heroin-related deaths in America nearly quadrupled, although the number of heroin-related overdoses is still far exceeded by the number of legal prescription drug overdoses. So this crisis is taking lives. It’s destroying families. It’s shattering communities all across the country.”

To address this crisis, Obama announced federal, state, local and private efforts aimed at reducing the prescription drug abuse and heroin usage. A linchpin of the initiative involves commitments by more than 40 provider groups — representing doctors, dentists, advanced practice nurses, physician assistants, physical therapists and educators — to have more than 540,000 health care providers complete opioid prescriber training over the next two years.

On the pharmacy side, the National Association of Chain Drug Stores said it will continue to educate its 125 chain member companies — representing 40,000 pharmacies with 175,000 pharmacists — about opioid overdose and naloxone. The National Community Pharmacists Association, representing 23,000 pharmacies with over 62,000 pharmacists, plans to distribute inserts to pharmacists that highlight safe drug disposal and naloxone. And the American Pharmacists Association will educate pharmacists, student pharmacists and other stakeholders through a new resource center on opioid use, misuse and abuse.

CVS Health plans to allow CVS/pharmacy drug stores to dispense naloxone without patients needing to present an individual prescription, pursuant to a standing order from a physician or collaborative practice agreement in an additional 20 states in 2016. CVS also is slated to launch a new drug abuse prevention program called Pharmacists Teach, in which its pharmacists will make 2,500 presentations in high-school health classes. Meanwhile, over the next 12 months, Rite Aid Corp. plans to train 6,000 pharmacists on naloxone use and expand the drug chain’s naloxone dispensing program to additional states.

Also, the American Society of Health-System Pharmacists will provide training and resources to 40,000 pharmacists, student pharmacists and pharmacy technicians. And next year, the National Association of Boards of Pharmacy plans to enhance access to prescription drug monitoring program (PDMP) data to thousands more doctors and pharmacists in Arizona, Delaware, Kentucky and North Dakota.

Obama also said that CBS, ABC, the New York Times, Google, the National Basketball Association, Major League Baseball and other companies plan to donate millions of dollars in media space for public service announcements, produced by the Partnership for Drug-Free Kids, on the risks of prescription drug misuse.

“We’ve all got a role to play,” the president said at the community forum, which was also attended by Sylvia Burwell, secretary of the U.S. Department of Health and Human Services; Michael Botticelli, director of National Drug Control Policy; Chuck Rosenberg, acting administrator of the Drug Enforcement Administration; West Virginia Sens. Joseph Manchin (D.) and Shelley Moore Capito (R.); West Virginia Gov. Earl Ray Tomblin; and Charleston Mayor Danny Jones.

“The goal today is to shine a spotlight on this and then make sure that we walk out of here committed to doing something about it,” Obama added. “We want to make sure the whole country understands how urgent this problem is.”

The president has issued a memorandum to federal departments and agencies to help ensure that health care professionals who prescribe opioids are properly trained and improve access to treatment for prescription drug abuse and heroin use. The memo calls on departments and agencies that provide, reimburse for or facilitate access to health benefits to conduct a review to identify barriers to medication-assisted treatment for opioid use disorders and develop action plans.

Other state, local and private-sector actions include efforts to double the number of doctors certified to prescribe buprenorphine for opioid use disorder treatment, from 30,000 to 60,000 over the next three years; double the number of providers that prescribe naloxone; double the number of health care providers registered with their state PDMPs in the next two years; and, in the next two years, reach over 4 million health providers with awareness messaging on opioid abuse, proper prescribing practices, and actions they can take to help address drug abuse and misuse.