Education is key to reducing the current opioid epidemic, and no other strategies can substitute for it, according to Dr. Adam Kaye, a professor of pharmacy at the University of the Pacific in the latest issue of the journal Current Pain and Headache Reports.
In an article titled “Current State of Opioid Therapy and Abuse,” Kaye writes that the newer medical technologies that make it harder for people to abuse opioids — such as the development of pills that produce unpleasant side effects if broken, crushed, or injected — will likely have limited results in curbing the current epidemic of opioid abuse.
“Education is the foremost strategy,” Kaye said. “We must educate primary care providers, surgeons, pharmacists, and other health professionals, as well as patients. That education must take place prior to the starting point of opioid therapy — and it needs to be independent of the pharmaceutical industry.”
The facts surrounding this drug epidemic are grim: Opioid misuse increased by an astounding 4,680 percent between 1996 and 2011, according to the article. These drugs were associated with 28,647 deaths in 2014, triple the number in 2000, and represented 61 percent of all drug overdose deaths.
More than 90 percent of patients who survive a prescription opioid overdose continue to be prescribed opioids, most often by the same prescriber. Prescription opioids are a gateway drug for heroin in that up to 80 percent of heroin users first took prescription opioids.
Kaye and his co-authors lay out and discuss three types of strategies that have been developed to discourage opioid abuse:
- physical barriers, such as polyethylene oxide, prevent accidental crushing, or chewing;
- sequestered aversive agents, such as niacin, cause adverse events in patients who chew or crush tablets;
- sequestered opioid antagonists, such as naloxone, render the opioid ineffective.
The authors write that the first two strategies may help protect patients with no intent of abusing opioids from inadvertent overdose, but neither is likely to deter the intentional abuser. The third strategy carries a risk of sudden and harrowing withdrawal for addicted patients.
“Pharmacists have a big responsibility for cutting down opioid abuse and deaths, whether it’s Prince or other celebrities or the guy down the street,” Kaye said. “We have to be part of primary education efforts.”
The FDA’s Anesthetic and Analgesic Drug Products Advisory Committee and the Drug Safety and Risk Management Advisory Committee recently mandated that prescribers of opiates and their health care teams, including pharmacists, be required to obtain opioid education and broader pain management training.
Source: University of the Pacific