A Prescription for Tackling the Opioid Overdose Crisis
“You cannot recover if you are not alive.”
Death rates from opioid overdose climbed during COVID-19 putting the spotlight back on an epidemic that has claimed an estimated 600,000 lives. Yet an old problem has taken a new direction. In recent years, deaths have been connected in ever greater number with illicit synthetic opioids, particularly fentanyl. Today, over 80% of opioid overdose deaths are linked to these very potent drugs, 50 x more powerful than heroin. What is especially frightening is that this new phase of the opioid epidemic affects the millions of American’s living in recovery, as well as those, especially the young, who may be experimenting with drugs for the first time.
So what now? Confronted with an epidemic and a poisoned illicit drug supply, what can we do to save lives? One area is legislation — enacting laws that enable education and access to approved and evidenced based treatment for OUD and for accidental overdose.
In May, we assembled four leading voices and proponents of co-prescribing laws.
● Dr. Stephen Loyd, MD, FACP, Former Tennessee Drug Czar and Current National Medical Director of JourneyPure Addiction Clinic
● Assemblyman John Armato, (D-NJ-2), Primary Sponsor of A. 3969, New Jersey’s Naloxone Co-Prescription Legislation
● Dr. Kevin Zacharoff, MD, Clinical Professor of Preventative Medicine at Stonybrook University
● Courtney Hunter, Vice President, State Policy, Shatterproof, who moderated the conversation
Co-prescribing laws require certain medical professionals to prescribe or offer a prescription for an opioid overdose rescue medicine in certain situations where the patient meets criterion for being at increased risk of overdose.
Yet as our panel stress, co-prescribing can play a role in protecting lives in our home and in the communities where we live, and where all too frequently opioids are available, legally and otherwise.
You can watch a full recording of the conversation on You Tube.
As our panel highlighted about America’s opioid epidemic:
“The disease of addiction is prominent and it’s in every corner of the United States, it’s every corner of every small town that we can think of.”
“Co-prescribing is going to help if we can pass that in more States, if we can get people to fill prescriptions, if we can increase education, if we can do more community outreach.”
“An opioid overdose rescue medicine is like a fire extinguisher, if opioids are in the home or community, you need the appropriate tools to combat an emergency”.
“When we view risk, we cannot only look at individual patient level risk. We must evaluate household and community risk. If opioids are in the home or community, we need to view the risk holistically.”
Co-prescribing is supported by a broad range of stakeholders, including the World Health Organization, U.S. health agencies (CDC, SAMHSA), state departments of health, and many patient, consumer, and advocacy groups.
A study of five states that required co-prescribing, including Virginia, found the distribution of rescue medicine naloxone grew by 255 percent in the 90 days following implementation of the mandate compared with the 90 days prior. Twelve states have now enacted a law or regulation requiring co-prescribing, most recently New Jersey, Arkansas, and South Carolina, with New York’s bill awaiting a signature from the governor.
Yet co-prescribing is one half of the puzzle, the other half is to ensure the prescription is full filled in the pharmacy. To this end, the panel flagged two major considerations:
- Address the stigma. Too often, patients are scared that if they get their prescription for an overdose rescue medicine filled that somebody will think they’re misusing.
- Holistic education. Co-prescribing is part of the solution, however advancing and improving the education of physicians, pharmacists and the public is what will ultimately close the gap.
Assemblyman Armato spoke of his State’s unique initiative to flag risk on every prescribed opioid:
“Any prescription of an opiate given out in the state of New Jersey now has a secondary label on it. It says ‘may cause addiction,’ ‘may cause overdose,’ and it’s in red. Now, a parent, a loved one, who’s filling that prescription is going to take a look at that and hopefully the light will come on.”
As the nature of the opioid crisis shifts towards more potent synthetic opioids, like fentanyl — encouraging new thinking and supporting evidence-based ideas — and therapeutics — will be essential to save lives.
At Opiant, we are committed to developing new medicines to treat addictions and drug overdose.
Before you go: Please hold down the clap button if you liked what you read! It will help this post gain exposure. Thank you!