New laws, policies will help fight the opioid epidemic
Although the number of opioid prescriptions in Tennessee has decreased, the number of drug overdose deaths involving opioids statewide has increased to more 19 deaths per 100,000 people.
Shelby County overdose deaths also are rising, as a 2017 report reveals drug overdose deaths of 22 per 100,000 -- 17 per 100,000 involving opioids.
This epidemic increasingly plagues our communities, classrooms, streets, and homes. To reduce drug overdose deaths in Tennessee, not only is the number of opioid prescriptions written a concern, but so are other factors.
Thirty five percent of all individuals dying from opioid overdoses were also taking benzodiazepines -- drugs known to produce central nervous system depression and sedation and commonly used to treat conditions such as anxiety and insomnia.
As Tennesseans, we have dedicated support from our state government and others to work together to help combat the tragedy resulting from the opioid crisis.
Among the major initiatives put forth by the state to help prevent and reduce the misuse of opioids is TN Together (tn.gov/opioids), which provides comprehensive resources to address the statewide opioid epidemic.
Beginning in January, a new state law mandates partial fills of opioid prescriptions and imposes limitations on days’ supply and dosage strength.
An additional approach to addressing the opioid crisis is the use of abusedeterrent opioid agents.
For example, BlueCross BlueShield of Tennessee, which covers about 70 percent of insured Tennesseans, will stop covering OxyContin (except for those who are exempt, such as cancer patients) in January, Instead, they will encourage the use of other medications including opioid medications that are engineered to be “abuse-deterrent.”
Abuse-deterrent formulations are tamper resistant, and while this does not mean these products are impossible to abuse or that they prevent addiction or overdose, these agents make abuse more difficult and less rewarding.
Prevention and treatment of opioid addiction, whether illicit or non-illicit, requires a comprehensive approach.
In addition to limiting opioid prescriptions and using abuse-deterrent opioid formulations, strategies include:
❚ appropriate use of naloxone to reverse opioid overdose;
❚ appropriate education and warnings about the concomitant use of opioids with benzodiazepines;
❚ ensuring health care professionals receive education and training on appropriate pain management;
❚ prescribing and providing adequate support and rehabilitation to individuals who suffer from addiction.
We must be cautious that we do not compound the suffering of those who genuinely experience chronic pain, have documented indications for prescription opioid use, and need pain relief that is not resolved by non-opioid medications.
All of us must help to address the opioid crisis, including pharmacists who are the front line of dispensing medications, including both opioids and benzodiazepines. Don’t be shy about asking your pharmacists about your medication therapy.
With increased globalization, underground markets, and internet drug dispensing, we are surrounded, and none of us is immune to the epidemic.
A comprehensive approach to resolving the crisis requires us all -- patients, all health care providers, payers/insurers, government officials, caregivers, family, friends, and community members – to be part of the solution.
As Tennesseans, we can and must overcome this crisis together to ensure the vitality of our state and the well-being of all our citizens.
Marie Chisholm-Burns, PharmD, MPH, MBA, FCCP, FASHP, FAST, is the dean and a professor in the University of Tennessee Health Science Center’s College of Pharmacy in Memphis, Knoxville, and Nashville.