#1 Many pharmacies failing to dispense Naloxone kits
Two new studies find that pharmacies are failing to provide naloxone kits to customers without a doctor’s prescription. Naloxone or Narcan the brand name for the nasal spray version is the lifesaving opioid antidote for overdose reversals.
The first study in California found that less than 25 percent of pharmacies in the state would dispense naloxone without a prescription. This is despite the state passing a law requiring the drug to be available over the counter
The second study in Texas found that less than 7 out of 10 pharmacies had naloxone in stock though 80 percent were willing to dispense it without a prescription.
The key factors contributing to this were:
- Lack of training
- Lack of motivation to add the drug to their store inventory
- Moral objections to dispensing an agent that might encourage further drug abuse
California is one of the states that are currently requires co-prescribing of naloxone with certain opioid painkillers while Texas is also considering implementing this measure. The FDA is looking at mandating co-prescribing at the federal level as well following the US Surgeon General’s public position requesting individuals taking opioids and their caregivers and friends to keep a naloxone kit on hand.
#2 AMA rules against current CDC pain management guidelines related to opioid prescribing
The American Medical Association’s House of Delegates at their interim meeting in Maryland ruled on a series of resolutions giving back freedom to physicians in opioid prescribing. Recent physician actions in this regard have been severely influenced by the 2016 CDC pain management guidelines as related to opioid prescribing for chronic pain management. Recent horror stories of patients with chronic pain finding their medications cut down or eliminated completely and finding themselves having to cope with debilitating pain and side effects, were key to the AMA deciding to take a stance now.
Patients themselves had started to organize protests and start grassroots movements to have their voice heard such as the Don’t Punish Pain movement. This initiative held over 75 rallies across the US in September raising the alarm for federal agencies to urgently revisit policies on opioid prescribing for chronic pain management that wouldn’t leave patients in the lurch with limited or no access to needed meds.
In particular, the AMA Delegates ruled:
RESOLVED that our AMA affirms that some patients with acute or chronic pain can benefit from taking opioids at greater dosages than recommended by the CDC Guidelines for Prescribing Opioids for chronic pain and that such care may be medically necessary and appropriate.
RESOLVED that our AMA advocate against the misapplication of the CDC Guidelines for Prescribing Opioids by pharmacists, health insurers, pharmacy benefit managers, legislatures, and governmental and private regulatory bodies in ways that prevent or limit access to opioid analgesia.
RESOLVED that our AMA advocate that no entity should use MME thresholds as anything more than guidance, and physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing opioids at a quantitative level above the MME thresholds found in the CDC Guidelines for Prescribing Opioids.
Lynn Webster, MD, a pain management expert and past president of the American Academy of Pain Medicine commented, “Great to see the AMA is finally stepping up to help bring common sense to the ill-conceived and frankly very harmful CDC guideline. Unfortunately too many people have already been a victim of CDC’s misguided attempt to address the opioid problem.”
Earlier this year, the FDA promised to revisit the CDC guidelines and have hired an external organization to help come up with an appropriate set of prescribing guidelines for all patients.
#3 Facebook, Twitter, Google create new anti-opioid initiative
The Center for Safe Internet Pharmacies (CSIP) announced this week that they have teamed up with Facebook, Twitter, and Google to form a coalition to fight the opioid epidemic. The initiative dubbed as, Tech Together to Fight the Opioid Crisis, had its first meeting on November 13, 2018 in Washington D.C. The goals of the initiative are to Increase awareness and support for those struggling with addiction
The Center for Safe Internet Pharmacies is a nonprofit organization that was founded in 2011 by the Obama White House. It represents the technology sector and commerce intermediaries including Google, Microsoft, Facebook, Oath, UPS, Paypal, MasterCard, Discover, Amex and .Health with a mission to promote industry best practices to mitigate illegal online pharmacies while educating consumers about safe purchasing of their prescription drugs.
At the coalition’s first meeting, representatives from the individual organizations and public health experts held a day of learning and discussion featuring a fireside chat led by Dopesick author Beth Macy.
Simultaneously, Facebook’s VP of US Public Policy Kevin Martin shared a newsroom post titled, “Supporting Our Community in the Face of the Opioid Epidemic” on November 13, 2018. While Twitter and Google are still to outline their plans, Martin took the opportunity to lay out Facebook’s efforts across three areas—partnering with experts like SAMHSA and Partnership for Drug-Free Kids, using technology to make finding help easier and remove bad content faster, and to foster positive online communities.
#4 Massachusetts state suffered $14.7 billion opioid epidemic cost in 2017
The Massachusetts Taxpayers Foundation issued a report this week with macro-level and detailed analysis of the state’s line item costs in relation to the opioid epidemic. The aggregate cost to the state is upwards of $14.7 billion.
· $9.7 billion in lost productivity
· $4.5 billion in healthcare costs
· $500-550 million in criminal justice and public safety costs
The report notes that costs are underestimated. For example, the healthcare costs don’t include follow up healthcare costs for infants and children with Neonatal Abstinence Syndrome. Neither are other costs such as foster care included.
More worrying, the report warns that the trends show the situation worsening.
#5 Opioid defendants claim plaintiffs stonewalling on crucial evidence with hundreds of lawsuits at stake
An upcoming showdown over evidence that has been requested multiple times by the defense but not provided by the plaintiffs, could factor into the the future of the more than 1,000 opioid lawsuits now concentrated in federal court in Ohio.
As of early November, the plaintiffs had not provided the required minimum 500 suspect prescriptions and 300 patients who developed addiction along with detailed medical records to understand why the prescriptions were written in the first place. The Judge in the case then gave the plaintiffs another option of withholding the information, but only if they agreed to not present evidence of individual opioid patients at trial.