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Disruptive Healthcare

October 3, 2019

In a recent op-ed in the Dayton Daily News, Marc Sweeney, R.Ph., Pharm.D., Dean of the Cedarville University School of Pharmacy, offered a look at how personal responsibility fits into the opioid crisis.

The recent announcement that Purdue Pharma will file for bankruptcy as part of the settlement with myriad opioid litigations raises interest as to the methods and rationale for addressing the opioid crisis. As the ongoing investigation of the cause of this crisis continues, it appears that large corporations are taking the hit for actions of individuals who have chosen to abuse opioids, as well as those who have prescribed them. I suppose it is because of the potential for financial gain of deep pocket manufacturers and distributors.

Placing Blame

As a former pain management pharmacist, I practiced in the 1990s and early 2000s managing patients in hospitals, homecare, outpatient clinics, and hospices. I fully recognized the dangers and risks associated with use of opioids, including Oxycontin® (made by Purdue Pharma). I have always been diligent to consult with patients about appropriate use and potential risks, while watching for any indications of patient abuse and addiction. I have always understood how this class of drugs worked and the potential risks associated with their use. I am fairly certain that other health care providers have been aware of these, as well. As a responsible practitioner, I know I did not always recognize risk factors as I should have. However, I would never “blame” the pharmaceutical company for mismanaging a patient or missing the signs of addiction. This has been my responsibility in my role as a pharmacist. Collectively, a large group of health care providers failed to identify at-risk patients, those abusing and those who had become addicted to opioids. How is it that we have decided that this opioid epidemic is the fault of the companies that manufacture and sell the products?

I hope that we never get to a place where anything less than excellent care is blamed on the companies that manufacture the drugs.

Provider Responsibility

As the Food and Drug Administration’s (FDA) approval of new drugs continues, it is vital that prescribers and health care providers take responsibility for managing drug therapy appropriately. All drugs have side effects, risks, and contraindications that need to be appropriately evaluated when they are prescribed and dispensed to patients. I hope that we never get to a place where anything less than excellent care is blamed on the companies that manufacture the drugs. I am not discounting the concerns of misleading marketing campaigns or initiatives that are inconsistent with appropriate patient care; however, diligent and responsible practitioners are responsible for knowing the research, FDA labeling, and risks associated with all drugs, regardless of how they are marketed. I am not sure I have ever recommended therapy based upon a “marketing campaign.” Pharmaceutical company marketing campaigns need to be held accountable for reliability of data and research, but I question whether they should shoulder the blame of poor clinical decisions.

Community Support

We have come together as a community, including health care professionals, public health organizations, and technology companies, to address this crisis. We have seen a significant improvement in decreasing the deaths in Montgomery County, Ohio. The answer appears to be rooted in community efforts more than anything else. I believe that focusing on personal responsibility, collectively applied across health care communities and our families and communities at large, will likely have a greater impact on preventing opioid abuse – as well as bringing a solution to the growing influx and use of illicit opioids, which now are responsible for the majority of overdose deaths. Will action against drug manufacturing and distribution companies solve this next phase of the opioid crisis?

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