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The Other “O”-pidemic

Harold E. Cohen, RPh
Editor-in-Chief

12/18/2013

US Pharm. 2013;38(12):1.

Lately, there has been a great deal of attention paid to the obesity epidemic, and rightly so. Obesity is spreading (pun intended) worldwide, with tragic effects on human life. Americans, as well as citizens in many countries around the world, are fighting the obesity epidemic. And while health professionals in other countries struggle to bring obesity under control, they don’t seem to be paying as much attention to the other epidemic—opioid addiction.

In the United States, as in many other countries, the use of highly addictive opioids has become a standard drug regimen against severe pain and a substantial benefit in general pain-management therapy. The extent of this practice was underscored in a recent study conducted by researchers at Boston’s Beth Israel Deaconess Medical Center and recently published in the Journal of Hospital Medicine. The study examined approximately 1.14 million nonsurgical adult admissions to 286 U.S. hospitals. Among this group, the study revealed that opioids were used in more than half of the cases. Opioid-prescribing rates ranged from 5% in the lowest-prescribing hospital to 72% in the highest. As you would expect, hospitals with higher opioid-prescribing rates had a higher relative risk of severe opioid-related adverse events per patient. I think it is fair to say that data from this study can be extrapolated to represent what is happening in thousands of other hospitals, critical care centers, and physicians’ offices nationwide. While opioid use doesn’t necessarily link to opioid addiction, the more extensive the usage, the more likely a greater number of people will experience some degree of opioid addiction or dependence in their lifetime. This is especially true of healthcare professionals, whose job stress and easier access to opioids make them prime targets for addictive disease (AD).

Last month, U.S. Pharmacist featured a continuing education (CE) lesson devoted to “Issues and Data Associated With Addictive Disease in Pharmacists” ( http://uspharmacist.com/continuing_education/ceviewtest/lessonid/109516/). The CE lesson pointed out the fact that pharmacists are not immune to AD. The authors estimated that one in nine pharmacists “will potentially suffer from AD at some point in his or her career,” particularly in the first 15 years of practice, primarily because “pharmacists have far greater exposure to addictive medications” than other healthcare professionals. But close proximity to addictive drugs and stress on the job are only two factors to consider. Other risk factors include, but are not limited to, a genetic predisposition to AD, inadequate education and training, feelings of invincibility, and peer pressure.

As difficult as it may seem, if you suspect a colleague of practicing pharmacy while impaired, it is imperative that you notify someone who can get that individual immediate help before a patient’s safety is compromised. The authors of the CE article revealed promising results for chemically dependent pharmacists who were treated in a program specifically tailored to the pharmacy profession. The 2-year recovery success rate for addicted pharmacists is 87.1%. Interestingly, the researchers found that while oral opioids were the drug of choice for nearly 71% of pharmacists in the study, this did not significantly increase the risk of relapse.

It is important that all pharmacists remain keenly aware of the mental stability of their colleagues; such vigilance could save lives and help stamp out the other “O”-pidemic.

To comment on this article, contact editor@uspharmacist.com.
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