Chapman expert says pharmacists can help stem the epidemic of prescription drug abuse

A box full of prescription drugs is seen as teens in the Laguna Prescription Drug Awareness club help police run a Prescription Take Back Day event in Laguna Beach in 2012.

Prescription drug abuse in the United States has become an epidemic, according to the Centers for Disease Control and Prevention, with prescribed painkillers killing more than 16,000 people in the United States in 2013.

And accidental deaths from prescription opioids in Orange County are on the rise.

Last month, Register columnist David Whiting pored over coroner reports to find that 175 people died this way in Orange County last year, compared with 155 four years ago.

Though Americans make up 5 percent of the world’s population, they consume 75 percent of the world’s prescription drugs and 99 percent of the world’s hydrocodone, according to a statement from the National Rx Drug Abuse Summit, making finding a solution to the national and local drug abuse problem a major priority.

Several presidential candidates have addressed the issue, and the Obama administration recently released a statement announcing several initiatives to combat prescription drug abuse and heroin use.

Pharmacists are among those expected to take action to help prevent opioid overdose and curb drug addiction in the future, according to the administration’s statment.

Opioids are a class of prescription pain medication that includes hydrocodone, oxycodone, morphine and methadone, the statement said. “Heroin belongs to the same class of drugs, and 4in 5 heroin users started out by misusing prescription opioid pain medications,” the administration said.

Not only do individuals suffer from prescription drug abuse; so do family and friends of the addict.

It was seeing so many people in pain that made Dr. Mary Gutierrez, a pharmacy professor for the past 24 years, realize how prevalent the problem of prescription drug addiction had become.

Gutierrez is an expert in pharmaceutical drug abuse and a faculty member of the new Chapman University School of Pharmacy. The school began accepting students last year and is the first pharmacy school in Orange County.

She has treated veterans who she said often have psychiatric and drug addiction problems after they start out taking opioids for physical injuries.

“They go to addiction to relieve the psychiatric pain,” Gutierrez said.

Often, these veterans don’t want help, she said.

“While they are in the addiction, they are in such pain that they’d rather keep using than seek treatment,” she said.

Gutierrez said that is just one reason why pharmacists aren’t the only ones who benefit from prescription drug abuse education.

We asked Gutierrez what role pharmacists play in pharmaceutical drug addiction and how they can prevent it.

Q. How are people who abuse opioids getting ahold of so many pharmaceutical drugs?

A. Patients who abuse prescription drugs can go doctor or pharmacy shopping to attain the drugs. Prescription drug abuse can be seen with patients or people in their household.

Prescription bottles are left unlocked and unmonitored in most households, and few people perceive real harm in taking medications that weren’t prescribed to them.

If you look at Orange County, a lot of teenagers are using their parents’ prescriptions.

Q. Do pharmacists have a responsibility to help curb drug addiction?

A. DEA regulations state that pharmacists have the same responsibility as prescribers to help prevent drug abuse and diversion. They must use their professional judgment to assess whether a prescription for a controlled substance is legitimate.

Most states have the prescription drug monitoring program.

A PDMP is a statewide electronic database that collects designated data on substances dispensed in the state.

The PDMP is housed by a specified statewide regulatory, administrative or law enforcement agency.

The housing agency distributes data from the database to individuals who are authorized under state law to receive the information for purposes of their profession.

Pharmacists can check with this national database for patients’ prescribers and prescriptions filled information. Pharmacists are responsible for the safety and legitimacy of the prescriptions.

Q. How can pharmacists tell if someone abuses pharmaceutical drugs?

A. Some red flags may involve having multiple prescribers and pharmacies for the same combination of drugs; requesting early refills frequently; paying cash with no trace of any credit cards payments; and filling their prescriptions at pharmacies far away from patients’ homes.

When pharmacists have a concern about a prescription, they have a right to contact the prescriber; contact other pharmacies that have filled prescriptions for the patient; counsel the patient or ask for further information; refer the patient for addiction treatment; and refuse to fill the prescription.

Utilizing the prescription drug monitoring program can help pharmacists with decisions of denying potential drug abuse prescriptions.

Q. What can pharmacists do to help curb drug addiction and prevent opioid overdose?

A. Providing drug information and treatment referrals can be helpful for patients who are abusing prescription drugs.

The California State Board of Pharmacy in April approved emergency regulations allowing pharmacists to furnish, without a prescription, an antidote called naloxone to reverse opioid overdose. Naloxone hydrochloride, an opioid overdose rescue drug, will be available by request or at the suggestion of a pharmacist in California pharmacies.

Pharmacists dispensing the potentially life-saving medication must successfully complete continuing education on the use of naloxone hydrochloride, screen for any hypersensitivity and must provide the recipient with training in opioid overdose prevention, recognition, response and on the administration of naloxone hydrochloride.

Q. What is Chapman’s School of Pharmacy doing to educate students about prescription drug use?

A. The School of Pharmacy has dedicated an extra unit in the Psychiatry/Neurology course to teach students about pain management and drug abuse. We may also add another elective course on helping patients with drug addictions in the near future.

Parents, families and teachers must also be educated and provided with resources so they will know how to help their loved ones and students with drug addictions. I encourage people to see the documentary“Behind the Orange Curtain” to understand teenagers’ drug addiction problems, and the need to reach out and help them.

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