Pharmacists Provide, Monitor Opiates

by Seth Cleveland
Delta Digital News Service

Opioid Crisis

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JONESBORO — For the local medical community, the opioid crisis continues to be an uphill battle.

Recently highlighted by President Trump’s combative statements against the epidemic, awareness continues to grow.

A Growing Epidemic

According to the Department of Health and Human Services, Arkansas has one of the worst dependency rates and treatment capacities in the nation. With this crisis comes a new motivation for the medical community to combat the issue.

Natalie Hinton, a fourth-year pharmacy student at A-State, was not optimistic about medical advancements or research being done to decrease the severity of the issue. She said the way the body works, opioids are really the only current advancement that can sufficiently block pain receptors. Searcy pharmacist Nancy Showalter said she agreed.

There are other treatments, however. “NSAIDs, something like ibuprofen — there are other drugs in that class that works a little better than ibuprofen and they provide a longer time frame for their pain relief — I think drugs like that could be used, but in some situations, patients can’t use those drugs,” she said.

Who’s to Blame?

Sen. John Boozman highlighted steps the state is taking to provide some relief to the opioid epidemic: DEA policy reform, proposed legislation, increased area spending and pharmaceutical sanctions. Yet some local pharmacists seem to think that cracking down on the amount of pills they’re allowed to give out is antithetical to the treatment of the issue at hand.

“I think that pharmacies are already trying to fight it. I think that physicians really need to be held accountable. I think they write way too many opioid prescriptions,” Hinton said. “If the doctors were not writing so many prescriptions, it would not be nearly as big of an issue.”

Hinton said she does not place all the blame on physicians, but she was not alone in her discomfort.

“I hate that (opiates) would not be there for those that really need them,” Showalter said. “But I also understand that this is a crisis and something has got to be done.”

Several procedures in place allow Arkansas’ pharmacies to monitor the activities of prescription purchasers.

“You can look up a person by their name and it shows where they’ve gotten controlled substances, the date they got them,” Showalter said.

Arkansas is one of six states that have “refusal clauses.” These effectively allow a pharmacy to completely refuse service to a suspicious customer without fear of being sued.

“We would just simply refuse their prescription,” Showalter said.

As pharmacies already closely monitor the amount of drugs they administer, perhaps the solution lies in the hands of the doctors prescribing them. Thomas Day, an orthopedic surgeon, said he actually agreed with Hinton and Showalter.

“I blame physicians for the free prescribing of addictive medications,” he said.

Day said he could see the progression of over-prescribing from the mid-’90s to the early 2000s.

“More and more practitioners for whatever reason became more comfortable prescribing pain medication just because (patients) said they hurt,” Day said. “We created a whole generation of Americans that if they have any kind of pain, they think they need a pill for it.”

As a result of this, Day said there has been an uptick in “pain contracts.”

“I see anywhere between 70 to 80 patients a week and in that time, I see as few as five or as many as 10 patients that are on a pain contract,” he said.

Pain clinics are clinics that specialize in treating pain. They deal in a lot of opiates. When on contract at a pain clinic, a patient is supposed to be highly monitored through random urine tests. But in a lot of cases, Day sees something different.

“What happens is these pain clinics become a place where people go once a month, pay their money, and get their prescription and keep going back,” he said.

Future Hope

While there do seem to be many sides to this complex crisis, things can seem a bit forlorn. Hinton, Showalter and Day all expressed feelings of what appeared to be a hopeless desperation, i.e. desperate to discover a solution and hopeless to the discovery of the solution.

But with more understanding and more awareness, there comes progress. Software is being designed, legislation is being enacted and awareness is being raised, all in the name of this cause.