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Pharmacists touted as last line of defense against addiction

It might seem unlikely that the federal Drug Enforcement Administration, in its fight against ruthless heroin networks that stretch from Afghanistan and Mexico to Uniontown and New Castle, would seek help from the likes of Adam Dashner, an earnest sixth-year student at Duquesne University in Pittsburgh.

Earlier this month, though, at twin Prescription Drug Awareness Conferences held here, the DEA’s top man in Pennsylvania implored 225 pharmacists —and impending pharmacy school graduates like Dashner — to tighten controls over the prescription opioids that are blamed for heroin addiction and overdoses.

“We need you guys,” Gary Tuggle, the DEA special agent in charge, said to 115 pharmacists who attended the session. “You are often going to be the last line of defense for us.”

Faced with pill-seeking addicts toting prescriptions they forged or cadged from doctors, pharmacists must resist the temptation to look the other way and make the sale, Tuggle said.

“If you ever find yourself second-guessing whether you should dispense or not, you are probably right,” he continued.

Some pharmacists at the conference noted that their corporate bosses urge them to move more meds. They are encouraged to call customers promptly at refill time, and always ask if they need anything else.

But Dashner said the DEA’s message resonated.

“The profession of pharmacy, yeah, it’s a business,” he said. “But above that, it’s a health care business.”

Sometimes in refusing to fill a prescription, he said, “the health service you’re providing to the individual and the community is much greater than the money lost.”

“We have always heard that we’re the last line (of defense against abuse), and we always have the option to say no,” said Vince Politi, a pharmacist for a long-term care pharmacy who attended the conference. “I’ve had to turn people away. … It’s very difficult when you have a patient who’s there with a legitimate prescription and condition.”

Pharmacists can “have that conversation” with a customer “saying, you might have a dangerous problem here,” Gary Tennis, the Pennsylvania secretary of drug and alcohol programs, said in a phone interview. “I think they have a role of making sure (doctors) aren’t hurting people.”

Overdose deaths reach new high

Fatal drug overdoses reached a new high in 2014, killing nearly 50,000 Americans, according to the Centers for Disease Control and Prevention. Twice as many Americans died from drug overdoses in 2014 as in 2000.

Most of the deaths involved heroin or painkillers like OxyContin. These drugs accounted for 28,647 deaths in 2014, or 61 percent of the overdose deaths. Deaths from heroin and narcotic painkillers increased 14 percent last year, to 9 per 100,000 from 7.9.

The national numbers were affected mainly by increases in deaths in 14 states: Alabama, Georgia, Illinois, Indiana, Maine, Maryland, Massachusetts, Michigan, New Hampshire, New Mexico, North Dakota, Ohio, Pennsylvania and Virginia. The other states had no significant increases compared with 2013.

Among the states with the highest overdose death rates — West Virginia, New Mexico, New Hampshire, Kentucky and Ohio — two, Kentucky and West Virginia, had no significant increases from 2013.

— THE NEW YORK TIMES

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