How Compounding Pharmacies Can Help in the Fight Against Opioid Addiction Rates in the U.S.
It’s easy to forget that not all drugs that lead to overdoses, ruined lives, and death are acquired in parking lot deals or on street corners. Many drugs that ruin lives, families and communities came with an official prescription after visits to a doctor and a pharmacist. In the United States, 15,000 people die annually from overdoses of prescription painkillers. Of people 12 or older, 1 in 20 reported using prescription opioids for nonmedical reasons within the last twelve months. Stunningly, enough prescription painkillers were prescribed in the year 2010 to medicate every American adult for 24 hours a day, seven days a week, for an entire month.
On the surface, this may seem like a simple issue of over-prescribing painkillers, but as with any public health issue, the causes—and solutions—are many. Compounding pharmacies are in a unique position to contribute to the eradication of this issue. They are able to change the medication itself and alter addictive properties through the act of compounding, and hold a vital role in the fight against opioid addiction. 1
Compounding Can Be a Vital Tool in Addiction Prevention and Treatment
Tackling the nation’s painkiller addiction epidemic requires a multi-faceted approach from all areas of health care, including primary, secondary and tertiary care methods; clinical care approaches; and insurers working with providers to reduce barriers to addiction treatment and secure prescription avenues to prevent over-prescribing. For compounding pharmacies, more stringent measures to ensure provenance of prescriptions and education for staff to recognize warning signs of addiction, such as filling prescriptions from multiple sources, can be vital in preventing the spread of addiction as well.
The primary way compounding pharmacies can assist at a patient-level in the fight against addiction, however, is by using the tenets of compounding as preventative measures. Compounding, at its root, is meant to provide a better care experience for patients—providing alternative, less-systemic, and easier delivery methods tailored to individual patient needs. These measures inherently reduce the risk of addiction for all patients and can particularly benefit patients with a history of or predisposition to opioid painkiller addiction.2
Most of the opiates being abused by addicted patients are in pill form. These are easy to open up, transport, and also provide the brain toxicology-altering high that addicts seek. One of the easiest ways to combat addiction is to remove the reward from the situation entirely. By compounding oral painkillers into topical creams and gels when possible, compounding pharmacies lower the risk of addiction considerably. Not only do topical compounds deliver more localized pain relief and cause fewer complications due to lower absorption rates, a topical compound does not alter brain state the way oral opioids do when delivering the sought-after high.
Compounding pharmacies can also provide alternative options for traditional painkillers. Typically reserved for patients who have allergies to certain medications and, therefore, need compounded alternatives, using a painkiller alternative for Vicodin or Oxycontin can lower prescriptions for the highly addictive and readily available painkillers. Patients or doctors with patients who are working on overcoming drug addiction can also work with a compounding pharmacy to help with “tapering,” or the act of slowly reducing ingested levels of opioids to safely treat the body’s addiction without abruptly cutting off supply.3
As more Americans receive health coverage through the Patient Protection and Affordable Care Act, visits to physicians and all health care providers will increase. The rise in health care visits and prescriptions could give rise to another jump in potential abuse of painkillers unless all involved in the health care system work together to increase prevention and treatment efforts. Compounding pharmacists, in particular, are in a unique position to impact ongoing and future work against opioid addiction and other public health crises.
The Role of Compounding Pharmacies in Public Health
Pharmacists’ stature in health care continues to expand rapidly. Pharmacist already play a key role in patient-centered medical systems and accountable care organizations, expanding beyond product-oriented services like merely dispensing medication or acting as order-takers. Today’s pharmacist works with patients and patient care teams much more proactively on pharmacotherapy and overall health and wellness, including lifestyle changes.4
While compounding pharmacists’ ability to contribute to public health debates often hinges on the current regulatory framework, compounding pharmacies are on the front lines of the fight against opioid and painkiller addiction. They often work with physicians who are seeking alternatives for patients who’ve exhausted conventional options and interact directly with patients when filling prescriptions.5
The pharmacist can see crucial warning signs firsthand, such as filling prescriptions from multiple sources or for multiple painkillers for the same condition. Staff at compounding pharmacies are the best-positioned providers to educate patients on the proper use of medications and the dangers of overuse at the time of filling the prescription.
Compounding pharmacies also have access to a trove of pharmaceutical data. Although pharmacies typically use this data to review and improve their own quality control, systems and supply chains, it could also be used with patient consent for broader research purposes. Data could reveal information about the client population that could be utilized to improve delivery methods and for new interventions for public health causes.
Pharmacists, perhaps of all health care providers beyond doctors, have the most direct access to and communication with patients. They can see key factors that help researchers in studying epidemiology and drafting public health policy, such as which vulnerable populations may not be able to pick up or afford medications. The impact of including pharmacists in a broader public health discussion could be highly beneficial for a number of public health crises, including the opioid painkiller addiction epidemic.6
Compounding pharmacies can contribute to the fight against opioid addiction on both fronts—at the macro level by working with researchers and other health care professionals to understand the broader development of these public health issues; and at the micro level by working with patients and physicians to use compounding to reduce the addictive properties of medications. It’s time for compounding pharmacies to be recognized as far more than just order-takers. The patient-first values underpinning the entire compounding pharmacy industry make compounding pharmacists the right people for the front lines of the fight against opioid addiction.
Pharmaceutica North America is a leading provider of high-quality active pharmaceutical ingredients and compounding kits. We support compounding pharmacists in their mission to improve patients’ quality of life. Contact us to learn more about our quality products and the ways compounding pharmacies can impact public health.
- “Prescription Painkiller Overdoses in the U.S.,” Nov. 1, 2011, http://www.cdc.gov/vitalsigns/PainkillerOverdoses/index.html ↩
- “Compounding pharmacists battle for solution to painkiller overuse,” July 11, 2014, http://www.modernhealthcare.com/article/20140711/NEWS/307119958 ↩
- “Compound pharmacies possible alternative to addictive medications,” Jan. 5, 2015, http://www.digitaljournal.com/life/health/compound-pharmacies-may-provide-alternative-to-addictive-meds/article/422660 ↩
- “The Role of the Pharmacist in Public Health,” Nov. 8, 2006, http://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/07/13/05/the-role-of-the-pharmacist-in-public-health ↩
- “Pharmacists’ impact on public health,” August 15, 2013, http://drugtopics.modernmedicine.com/drug-topics/content/tags/chronic-disease/pharmacists-impact-public-health ↩
- “Pharmacy and public health: A pathway forward,” March 2013, http://japha.org/article.aspx?articleid=1839978 ↩