The opioid epidemic in America can largely be traced back to millions of patients being over-prescribed powerful painkillers like OxyContin® and hydrocodone, among many others. As we learned more about the way these medications worked while coming to terms with the alarmingly high rate of addiction among users who began taking these medications after surgery or for acute pain, the effect of opioid use disorder scaled nationwide. Nearly two decades later, new prescription guidelines were put in place to help reduce addiction and overdose rates by making sure doctors, pharmacists, and patients are all playing a role in the prevention of opioid addiction. While illicit and prescription opioids are still a significant issue, these steps have created awareness and changed prescribing practices.
Healthcare professionals are in a unique position when it comes to preventing opioid use disorder because they can identify a patient’s behavior when their perceived need and request for opioid medication has escalated, potentially into recreational drug use. There are now prescription drug monitoring programs (PDMP) that give all doctors access to a database tracking a patient’s prescriptions of controlled substances. The new prescribing guidelines established in 2015 have helped doctors curtail the number of opioids prescribed to patients as well. These systems help identify individuals who are engaged in “doctor shopping,” attempting to obtain perceptions for opioids from one source, as well as monitoring refills.
With new tracking databases and prescribing guidelines, pharmacists are also able to do their part in helping prevent opioid addiction in patients using them. Besides providing them with instructions on how to take the medication properly, they are also able to monitor false, altered or stolen prescriptions and communicate with prescribers about patient dispensing patterns. Flagging certain patients who may be at risk is another useful tool for pharmacists. There has been a push towards safer medication formulation and regulation on the part of drug makers to make their products more abuse-deterrent (ADF), so pills are not effective when crushed down or altered physically. Pharmacists can help educate the public on these topics.
Opioid pain killers are still a medical necessity to treat acute and even chronic pain. That means that patients also must play their role in understanding how quickly opioid use disorder can occur and the long term effects of opiates on the brain. Any misuse of the drug, such as taking a stronger dose than prescribed, can set the course of receptors in the reward center of the brain rewiring, eventually causing cravings and the need for even higher doses due to building tolerance. Those who take their opioid medications precisely as prescribed while educating themselves about the dangers and life-long consequences of opioid use disorder should be less likely to misuse their prescriptions.
We tend to think that anything legal and prescribed by a doctor is patently safe and shouldn’t cause harm. The reality is, when not used as specified, even the most common prescription painkiller like hydrocodone can set someone off on the path towards addiction. With many new precautions in place, patients and medical professionals can work together to prevent the need for recovery services for opioid use disorder in patients prescribed these powerful medications for pain management.