Experts believe the opioid epidemic, fueled by a combination of prescription pain relievers and illegal opioids like fentanyl and heroin, is one of the worst public health crises in this country's history. Nearly 2 million Americans abused or were dependent on prescription opioids in 20141-more than any year on record-and six out of 10 drug overdose deaths that year involved an opioid. 2
Across the country, community pharmacists are engaging in the fight against the prescription opioid epidemic. Using resources from the Generation Rx initiative-a partnership between the Cardinal Health Foundation and The Ohio State University College of Pharmacy-they are educating their patients and communities about safe medication practices and the dangers of prescription drug misuse among people of all ages.
As part of Medication Abuse Awareness Month, Betsy Walker, director of Community Relations at Cardinal Health and co-director of Generation Rx, spoke with independent pharmacist Ed Christofano, R.Ph., owner of Hayden's Pharmacy in western Pennsylvania, about how he's fighting prescription drug abuse and misuse. His tireless work in educating his community has earned him a string of honors, including the 2015 Commonwealth of Pennsylvania Pharmacist of the Year Award, the 2016 Ken Wurster Community Leadership Award from Cardinal Health, and The Ohio State University's College of Pharmacy Distinguished Alumni Award for 2016.
Walker: You've focused so much of your community work on fighting prescription medication misuse. What inspires that work?
Christofano: The opioid epidemic is a particularly big problem in Westmoreland County. We have the highest rate of opioid overdoses in the entire Commonwealth of Pennsylvania. Already this year, there have been 71 overdose-related deaths here, according to Overdose Free PA. It's pretty disheartening.
As in most other parts of the country, the epidemic affects people of all ages, from grade school students to the elderly. There are so many people who don't know how dangerous some of the drugs they have in their medicine cabinets are. There's a lot of need for education.
At the OSU College of Pharmacy, we learned that knowledge is power. Providing knowledge to the public about prescription drug medications and their abuse potential gives everyone in a community the power to fight this epidemic.
Walker: Can you share some of the highlights of the education you do around prescription drug misuse?
Christofano: My focus is simple: America's biggest drug abuse problem is not on the streets: It's in our medicine cabinets. According to leading national studies, about 15 percent of teens report abusing prescription medicines. I quote that statistic all the time, and it still astonishes me. For the most part, these teens are getting the drugs from medicine cabinets of family and friends.
Even now, with the opioid epidemic in the news so frequently, a lot of people don't realize how dangerous some of the drugs in their medicine cabinets can be.
Walker: Through Generation Rx, we often quote the National Survey on Drug Use and Health, which tells us that nearly 70 percent of those who misuse prescription drugs get them from family members or friends, and often from the medicine cabinet.
Christofano: Prescription medications in the home are so tempting. Anybody who wants to begin abusing prescription drugs knows that medicine cabinets are the best place to get them. So let's get rid of the temptation. Go through medicine cabinets and pull out every unused or expired prescription and get rid of it. The medications that are residual from a previous procedure, surgery, or prior medication therapy need to be removed from temptation. It's also important to dispose of these unused or expired medications properly.
National Prescription Drug Take-Back Day is on Saturday, Oct. 22 this year. That's an event that makes it easy to dispose of medications. You don't even have to get out of your car. A lot of communities also have a permanent drug drop box where you can get rid of medications any time of year. If you live in Western Pennsylvania, you can drop off your medications to any of the Hayden's Pharmacy locations, anytime.
All current medications you use should be kept in a locked cabinet or in a drug lock box. Whenever we dispense a narcotic, we give the patient a small, virtually indestructible lock box to keep it in. In fact, we give a lock box to anyone who asks for it.
Walker: Generation Rx was born within the pharmacy community; we see pharmacists all around the country engaging in educating their patients and others in the community about prescription drug misuse. For those just getting started, can you talk about the work you've done to find and build your audiences?
Christofano: It makes sense that a program intended to educate people about the dangers of prescription drug misuse came from the pharmacy community: A community-based pharmacist is the most accessible healthcare provider in a community. I believe the position comes with responsibility to reach beyond the pharmacy counter.
As pharmacists, we have so many opportunities to engage with and join forces with other community leaders-from law enforcement to school superintendents to faith-based leaders-to improve the health of a community.
That said, building an audience willing to hear about the problem of prescription drug abuse took a good bit of groundwork. I started with high schools: I reached out to school boards, to school superintendents, to school teachers, to school nurses. I just wanted to have the conversation about the epidemic. And once these school leaders learned some of the statistics, they wanted to engage.
After I made my first presentation to a school board, I posted some highlights on our pharmacy's Facebook page. Suddenly, I started getting lots of invitations to talk to other school groups.
I'm also a member of the Westmoreland County Drug and Alcohol Commission and a board member of the Council for Substance Abuse and Youth. Both these organizations are doing great work in fighting prescription drug abuse, and I'm really proud to partner with them. They also help connect me with lots of new audiences.
Before this year is over, I hope to have presented in 17 school districts in Western Pennsylvania. And I find I'm no longer just talking with school groups: I have been invited to speak with folks in community centers, churches, local clubs and organizations-just about any place people will have me.
Walker: Pennsylvania now has a standing order that serves as a prescription for all Pennsylvanians for naloxone, the medication that blocks the effects of an opioid overdose. Have you incorporated naloxone education into your presentations?
Christofano: I talk about naloxone in every one of my presentations: Many people are not aware of what it is. Some are afraid to use it, and some people think that distributing naloxone might encourage more drug use. But there isn't evidence to support that fear.
About 28,000 people in the US died from opioid overdose in 2014; about 2,500 of them were Pennsylvanians. Many overdose deaths could have been avoided with immediate access to naloxone.
I've been working with the Westmoreland Drug and Alcohol Commission and the Council for Substance Abuse and Youth to get naloxone rescue kits into area high schools. I'm helping to write policy and procedures for the administration and storage of the kits, and my staff and I train first responders, teachers and parents to administer naloxone.
We can save lives with naloxone, and then we can help get people into treatment. That's got to be a big part of the fight to end the opioid epidemic.
Please visit our Generation Rx site to access our free, ready-to-download resources to help you educate people of all ages in your community about safe medication practices. Watch the video below to learn more about the initiative.