Rx Automation: Fighting America’s Opioid Epidemic

When viewed through a specific lens, every American generation over the past 50 years can be associated with substance and drug abuse. The era of heightened political tension and rise of hippie culture in the 1960’s gave rise to psychedelic substances such as Lysergic Acid Diethylamide (LSD), commonly referred to as acid. President Nixon’s “Public Enemy Number One” campaign aimed at hindering LSD and amphetamine use in the 1970’s drastically increased the popularity of other drugs like cocaine. The mid 1980’s – 1990’s experienced an unprecedented and far-reaching distribution of drugs including heroin and crack-cocaine, turning inner city neighborhoods across America into warzones. What came next, what the American public struggles to grapple with to this day, is perhaps the worst drug epidemic this nation has ever faced; Opioid abuse.

Opioids are a class of drugs that include both illegal substances such as heroin and legal substances such as oxycodone, hydrocodone, codeine, morphine, and many others; these substances not only relieve pain but produce extreme euphoria. Although typically safe when administered by a prescriber over a short period of time, the euphoric affect leaves some individuals highly susceptible to dependence long after their prescription has expired. According to the National Institute on Drug Abuse,

“the rate of death from overdoses of prescription opioids in the United states more than quadrupled between 1999 and 2010, far exceeding the combined death toll from cocaine and heroin overdoses” (Volkow, Frieden, Hyde, Cha).

Since 2010, the death rate has increased another 35% and shows no signs of slowing down. With tens of thousands of Americans dying each year from opioid abuse, the U.S. government has taken initiatives to curb this epidemic.

Among these initiatives is the utilization and expansion of healthcare information technology and automation software. Ohio Governor John Kasich, for example, has allocated $20 million towards new technology and tools to thwart the dramatic increase in opiate abuse. In the “New Strategies to Fight Opiate and Fentanyl Crisis in Ohio (2016 -17)”, government policies include expanding automation processes such as Electronic Pharmacy Management systems. Indeed, new strategies include:

  • Expanding integration of the Ohio Automated Rx Reporting system (OARSS) into the electronic medical records and pharmacy dispensing systems.
  • Develop an OARSS training website for higher education and residency programs to simulate use of system for future prescribers and pharmacists.
  • Use algorithms to develop proactive alerts for prescribers in the Ohio Automated Rx Reporting System.
  • Develop a report in the OARSS to allow prescribers to view their prescribing habits comparted with their peers.
  • State of Ohio Board of Pharmacy will explore providing access to the OARSS for certified drug courts in Ohio.

Pharmacy Management Systems are an essential tool in countering opioid abuse. Pharmacy automation systems track the distribution of prescribed opioids including dosage and advanced clinical tools such as e-prescribing enable direct communication between prescribers and pharmacists. In turn, pharmacists can more easily detect signs of abuse while eliminating fraudulent prescriptions.

Lt. Governor Brian Calley is tackling Michigan’s opioid abuse crisis head on; a state recording 95 opioid related deaths in 1999 to over 1,000 in 2016. Michigan lawmakers have advocated replacing an

“old and outdated antiquated system that did not have the level of width or the functionality in today’s practices to be effective” for years (Skubick).

Enter the Michigan Automated Prescription System (MAPS), a pharmacy automation system and preventative tool “that allows doctors, law enforcement, pharmacies and rehab centers to track who is giving and getting prescriptions. They look up a patient record in the system and look at what they’ve been dispensed by way of controlled substances within the systems” (Skubick).  Although Michigan and Ohio have long campaigns ahead, the expansion and modernization of pharmacy automation systems is a significant step in the right direction.

Congress is also making significant steps by introducing bills such as the Heroin and Opioid Abuse Prevention and Treatment Act of 2017 and allocating funds to curb opioid abuse and provide treatment to those who suffer with dependence. In reality, the opioid abuse epidemic is unlike previous drug crises; primarily due to the fact opioids are, in most cases, legally prescribed. Whether it is a construction worker suffering from back pain or a high school student having a wisdom tooth removed, the need for opiates are typically legitimate. Thus, it is essential prescribers take the utmost responsibility and precaution when administering these powerful substances. In an age dominated by technology, prescriber responsibility, precaution, and medication safety starts with sophisticated pharmaceutical automation processes. Adopting and implementing this technology across the nation is the first step in combating this arduous crisis.

Check out the Wall Street Journal’s captivating documentary below to learn more.

 

References:

Golston, Hilary. “Kasich Focuses on Opioids, Automation, Political unity; Avoids Political Landmines.” WKYC April 04, 2017

National Institute on Drug Abuse. U.S. Department of Health & Human Services

National Institute on Drug Abuse. “Prescription Opioids and Heroin Report 2015.” U.S. Department of Health & Human Services. 

Nora D. Volkow, Thomas R. Frieden, Pamela S. Hyde, and Stephen S. Cha; “Medication-Assisted Therapies – Tackling the Opioid-Overdose Epidemic.” New England Journal of Medicine, May 29th, 2014.

Skubick, Tim. “Community Crisis: How State Lawmakers are Fighting Opioid Abuse.” WLNS.com, May 22, 2017.

Wall Street Journal. “American Epidemic: The Nation’s Struggle With Opioid Addictions, Jan 3, 2017

2 replies
  1. Sandra Edwards says:

    As a nurse I have to tell you, that at the root of the problem of pain medication abuse is the idea that pain is what the patient says it is. This is a ridiculous concept that all health care organizations must abide by. We have taught over many years that everyone should be pain free, that is unrealistic, pain in joints etc. are a natural part of the aging process that people need to understand is normal. I cannot tell you how many people I have asked what their pain level is, and they rate it 10 out of 10 while taking a brief break from texting on the phone, guess what they are given, an opioid!! We have receptor sites for opioids and those should never be tickled unless post surgery or post trauma i.e. vehicle accident etc. We have raised 2 generations of spoiled people who believe that the slightest ache is unacceptable. I also believe tax payers should not pay for recovery, not one dime, the drug companies need to pay and people who need recovery need to pay-it is the only way to teach everyone that their dependence on opioids has consequences. When you have to fight and work for something you value the outcome.

    • John Cosenza says:

      Sandra

      Thanks for your comment and insight! What do you think is the first step to reversing the prescribing process which has enabled this drug epidemic? Should healthcare organizations change their policies in regards to pain management? is this a realistic approach? Or should healthcare organizations better educate patients on pain, the tolerance of pain, and safer ways to manage pain? Thanks!

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