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Let me tell you something about being a pharmacist. It’s hard. And let me tell you something about the “war on opioids” or the “opioid epidemic” as it’s referred to in the press. It’s real, and it’s a tough battle on all sides of the fence. I’ll start off by saying that I take my job very seriously. I care about every person that walks through my door; whether or not you’re filling a prescription or asking what bug spray to use, I want to provide you with the best care I can. Why? Because the health and safety of you and all our community is important to me. Safety—keep that in mind. So why do I preface with this and what does it have to do with the “war on opioids?” Well, this war has many battles in it. And battles in this war are happening every minute of every day in every community. Let me begin…
Some days are tougher than others. One particular day started off with one of my long term patients in tears at my counter wondering why I didn’t “trust her enough” to fill her pain meds two week early. I’ll be honest. My first internal response was irritation. We go through this with this patient every. single. month. Without fail. And she isn’t alone. There isn’t a single day that goes by without someone requesting the same thing. “I need my pain pills early.” “I just need a few pills to get me through.” I have heard every excuse in the book, been lied to more times than I can count, and have had some very unpleasant confrontations—all surrounding people and their pain medications. It’s sad. It’s hard. And it places me—and all pharmacy personnel–in the middle of a situation that I’d rather not be placed in.
Back to my patient in tears. I listen patiently to her story as to why she needs her pills early. I calmly explain to her—again—why we cannot fill her prescriptions until she is due for them. More honesty–after all these years of being her pharmacist it hurts that she places the blame on me. I tell her that it is nothing about “trust” but about keeping her safe and ensuring that her medications are being used properly and as they are prescribed. My role as a pharmacist has a lot to do with keeping patients safe. Safe from medication errors. Safe from medication interactions. And sometimes safe from yourself. What if you take too much? What if one extra dose overwhelms an already overwhelmed body? Let me help keep you safe. Don’t look at me as the bad guy. Sometimes “No” is in your best interest whether you can see it or not.
I think about this patient interaction and all the interactions similar to this, and it makes me sad…and it terrifies me. It terrifies me that drugs can grab people so tightly that it consumes them. That life can turn into a cycle that revolves around doctor’s appointments and prescription refills. (And can quickly spiral downwards into much darker places.) That people will skip vacations, weddings, and even funerals if it interferes with the day they can pick up their medication.
I read a study recently that showed a large percentage of people will get addicted to opioid pain medications in as little as five days worth of medication. Five days. And I believe it. I cringe when I see prescriptions brought in for 20, 50, or even more narcotic tablets. That’s how it begins. Many states are trying to crack down and limit the number of tablets that can be prescribed on a narcotic prescription and also limit treatment for acute pain to a maximum of two to three days. Is that the answer? I wish I knew.
So where am I going with this? I want you to be aware of the risks of opioid addiction. It’s here, it’s there, it’s everywhere. Addiction spans all age groups and it does not discriminate. It can start with a single tablet. My advice? Know your medications. Don’t take (or give your child) an opioid medication. Opioids are often the stepping stone to much worse. Don’t take that first step. Talk to your doctor. Talk to your pharmacist. Ask for alternative pain management options. What’s the slogan on TV? “Not all oops need opioids.” It’s true. You have choices. And please don’t be afraid or embarrassed to seek help if you are struggling with addiction. Addiction is a disease, not a weakness.
Back to my patient from earlier. She doesn’t see anything wrong with her actions or repeated requests; she does not believe she has a problem. Addiction is funny like that. Her physician is put in the tough spot of providing pain relief that has transgressed to more. Should he deny her care? And her pharmacist—like most pharmacists—is doing her best to provide medication management and safety in a world consumed by drugs. Like I said earlier, it’s a tough battle on all sides of the fence.
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