NCPA Executive Update

NCPA Executive Update delivers insights on legislative, regulatory, policy, and industry developments from NCPA CEO B. Douglas Hoey, Pharmacist, MBA, to NCPA members and pharmacy leaders every other Friday.

Community pharmacists on the front lines of the opioid epidemic | NCPA Executive Update | June 8, 2018

by NCPA | Jun 08, 2018

Dear Colleague,

Doug Hoey

There was a day when the occasional conversation about opioids at pharmacist cocktail parties eventually led to mu, kappa, and delta receptors, 222 forms, constipation stories, and the occasional story about thwarting a forged or altered prescription (Dear Drug Seeker, did you really think I wouldn't catch your forged out-of-state prescription for Tylenol No. 4 from Dr. Longnecker?) Not exactly scintillating conversation but, frankly, a breath of fresh air compared to what's in the current headlines about opioids.

The number of opioid prescriptions declined 10.2 percent last year. That's the good news. The bad news is that more than 42,000 people died from opioid-related overdoses in 2016, according to the Centers for Disease Control and Prevention. Medicinal opioid prescriptions have gone down, but use of, and deaths from, fentanyl-laced heroin have increased. Congress has taken action, and in this election year, political candidates want to make sure that they can campaign that they are doing something. This has resulted in the introduction of an eye-popping 50 pieces of legislation. With so much legislation trying to solve a complex problem, there are bound to be some unintended consequences. NCPA has tracked all of these bills to make sure they are helpful to community pharmacists and the patients they serve or, at a minimum, are neutral or do no harm.

So far, so good. Two bills endorsed by NCPA, H.R. 3528, the Every Prescription Conveyed Securely Act, which maintained provisions sought by NCPA to exempt long-term care patients and to ensure that patients' choice of pharmacy is respected, and H.R. 4275, the Empowering Pharmacists in the Fight Against Opioid Abuse Act, are among those making their way through the legislative process.

Legislation can only do so much, of course. One of the things making the biggest difference in communities is the work community pharmacists are doing to educate patients about the appropriate use of opioids to treat pain while safeguarding against addiction. Proper disposal of prescription opioids also makes a difference. NCPA members can buy discounted, DEA-compliant disposal systems and mail back envelopes through the NCPA Foundation's Dispose My Meds program. Contact the NCPA Foundation to request information, list your pharmacy on the locator tool, or, while supplies last, request a package of mail-back envelopes to send home with patients, made possible by a donation from Cardinal Health.

An example of pharmacists helping their communities came across my desk this week. Georgia pharmacy owner and NCPA member Ira Katz used naloxone to save a life – again. Katz is a fixture in the Little Five Points area of Atlanta, having owned Little Five Points Pharmacy for nearly 40 years. Some of you may have heard Ira speaking about one of his successful business niches, natural supplements, at NCPA's Annual Convention. Recently he became the subject of a social media spotlight and a bit of a local hero for his part in saving a 21-year-old man's life.

When a customer noticed the man, motionless behind of the wheel of his Mercedes SUV about 8:30 a.m. just outside Katz's pharmacy, she first thought he was sleeping. Quickly, she realized he was passed out, and she burst into the store, calling for help. Katz ran out, opened the car door and felt for a pulse. It was faint, he said, and the man was not breathing. Katz recognized the problem and instructed his technician to bring naloxone and yelled for someone to call 911.

He administered the naloxone and did CPR for more than five minutes. Finally, the man breathed on his own and eventually was able to walk to the ambulance. It was a close call.

It was the second time in eight days that he'd administered Narcan. The world has changed in the 40 years he's been a pharmacist, Katz says, and sadly, this scene happens every day in every community. "The point I want to get across is that every pharmacy needs to have Narcan or naloxone available. The drugs are out there. We're not seeing as many prescription opioids and now they're getting junk on the street, and they don't know what's in it."

Katz doesn't think he's a hero. He's just taking care of people, as he has done for 40 years. "They need help," he says. "They need counseling. It's not out there."

Luckily for this 21-year old man, his community's pharmacist, Ira Katz, was there making a difference in changing the conversation about the opioid epidemic.

Doug Hoey