With pharmacists left out of medication-assisted treatment, loved ones die. It happened to my family.
Every day, more than 100 families suffer the loss of a loved one to an opioid overdose. On November 1, 2018, ours became one of them when my great-niece Chloe Archer lost her battle with opioid use disorder (OUD) at age 24.
Her story is familiar to many of us. Chloe sustained a serious leg injury during a softball game in high school and had to undergo surgery to install a plate and 14 screws in her lower leg; she was prescribed opioids for the pain. Like so many Americans, the medicine intended to help ease her suffering had grueling, unintended consequences that ended in her death 6 years—and multiple agonizing attempts at recovery—later.
She tried medication-assisted treatment (MAT) in her efforts to recover. First, she had to find a practitioner who had a DATA waiver and was willing to prescribe her buprenorphine for OUD treatment (e.g., Subutex, Suboxone)—no easy feat. Then, she had to go to a pharmacy to get her prescriptions filled and back to her prescriber to maintain the appropriate monitoring consistent with her treatment plan. She had to prioritize these trips every week over other commitments, challenges, and interests, and none of it was covered by insurance. Others, like patients prescribed naltrexone, have the extra step of going back to the prescriber to get the drug administered. The process combined with the everyday challenges faced in overcoming OUD were so onerous that Chloe turned to heroin, which was readily available and inexpensive. As her father told me, it was just too hard to follow the rules.
We can do better!
I envision a world where pharmacists carry out certain key aspects of MAT in one trip. Our members caring for patients suffering from OUD constantly seek reforms that would allow pharmacists—the most accessible health care provider—to play a greater role in expanding patient access to MAT and improving care. Chloe’s story is a heartbreaking example of how expanded inclusion of pharmacists on the health care team could save lives by lowering barriers and improving access but didn’t! These services can embody the 3-C’s identified by APhA for meeting the needs of whatever “neighborhood” you are serving—Collaboration, Coordination, and Communication focused on meeting the needs of the patient.
APhA fought hard last year to pass federal legislation that would have provided coverage for additional care from pharmacists in providing opioid-related services, but with Congress reluctant to provide the necessary funding, we were unsuccessful. We’re not giving up, and neither should you.
We need to put a face on this issue for policymakers—the face of a patient, a family member, and a loved one. Tell the stories of our patients, people like Chloe, to make the case that pharmacists are key to minimizing treatment barriers and best armed with medication-related expertise that can help solve the opioid crisis and prevent senseless deaths. We need to make this real to the policymakers keeping pharmacists out of the equation.
Chloe was bright and athletic. Her opportunity to make a difference in the world was cut short. We can’t afford to keep losing people like her—not when pharmacists are accessible and knowledgeable health care providers who could play such an important role in saving their lives. Please share your stories, with us, and with Congress! We’re all in this together.