August 9, 2018
Inside: Millions of Americans still misuse opioids. But your independent community pharmacy can help. Learn how to help protect your patients through conversation, education, and a keen eye.
The opioid epidemic remains in full force.
The alarming problem has prompted action from both private and political parties. But it still isn’t enough. Fatal overdose rates continue to rise across the country.
Pharmacists uniquely stand in the gap between the dangerous drugs and patients. No one is better positioned to help curb rising opioid misuse.
And, independent pharmacists, in particular, know their patients and their drug patterns better than anyone else.
Which makes you one of the most important figures in the fight against opioid abuse. The Centers for Disease Control and Prevention (CDC) said, “On the front lines of dispensing opioid pain medications and providing medication-related services, pharmacists can serve as a first line of defense by engaging in prevention and treatment efforts of opioid use disorder and overdose.”
But do you know how to address the opioid misuse with patients? Do you know how to spot red flags?
Opioid misuse is a sensitive issue.
One wrong statement to patients could offend them and turn them away. One word left unsaid could be a missed opportunity to prevent misuse.
We have some tips you can follow to skillfully and effectively navigate opioid abuse issues with your patients. Compiled from a CDC brochure, these recommendations can bolster your relationships with patients and potentially save lives.
When dealing with sensitive issues, questions work better than statements.
Sometimes it takes a few strategic questions to coax important information from patients.
Questions also serve as an easy way to get the conversation started.
The CDC recommends asking your patients these questions:
The way you ask a question makes a big difference in how patients will respond.
People are naturally skilled at noting tone of voice and body language, especially when discussing personal and sensitive topics.
Accusatory and judgmental tones will cause patients to wall up. Compassionate and kind tones make them more receptive.
Approach your questions in these ways:
Trust primarily grows over the long-term. Everything you do leading up to your conversation lays the groundwork for how trusting the patient will be.
“Effective strategies for working with patients with chronic pain are not learned in a single session,” the CDC said in a training module on applying the CDC’s Guideline for Prescribing Opioids. “They must be practiced, reviewed, and applied consistently over time.”
Learn how to build trust with patients for the long haul.
But you can also build trust in a single conversation. Consultants and salesmen learn how to do this proficiently to win over customers.
“It turns out that human beings are hard-wired to have conversations impact them in such profound and significant ways that it can actually turn genes on and off,” Judith Glaser, author of Conversational Intelligence, told Psychology Today.
The most effective way to earn trust quickly is to make your patient feel valued. “Anything that has some sense of, ‘You have value.’ That hits a person in their heart as feeling important and valuable. You can almost say anything once you’ve done that,” Glaser said.
Ways to make a person feel valued and to build trust:
After you’ve asked the right questions in the right way and established trust, it’s time to educate your patients.
The right questions allow you to tailor your education to their particular context. Their trust prepares them to listen to your recommendations.
The CDC recommends pharmacists discuss these five topics to educate patients:
1. How to store and dispose of unused medications
2. Why patients shouldn’t save unused medication
3. Why it’s important to fill all medications at a single pharmacy
4. The common side effects and the importance of reporting them
5. How to take medication as prescribed and the risks of inappropriate medication use
Preventing opioid misuse doesn’t rest solely on your patients’ shoulders, even after you’ve properly educated them.
As their medication consultant and provider, you can take proactive steps to help prevent misuse.
But the CDC recommends you don’t do it alone. You’ll be more effective in collaboration with prescribers.
“Pharmacists and prescribers should apply the guideline and work collaboratively to optimize pain management while preventing opioid use disorder and overdose,” the CDC said. “Establishing and maintaining collaborative working relationships improves patient outcomes.”
Collaborations include working together on treatment plans, monitoring drug use, and using Prescription Drug Monitoring Programs (PDMP).
Pharmacists should develop a skilled eye for signs of opioid misuse. Of all the healthcare providers, pharmacists have the best viewpoint for spotting suspicious signs in patient behavior.
The CDC recommends keeping an eye out for these red flags:
Forged prescriptions take many forms. If you don’t know what to look for, they might sneak past you.
Look for these signs of forgery from the DEA’s Pharmacist’s Guide to Prescription Fraud:
Other strategies to spot red flags include consulting the PDMP and verifying and communicating with the patient’s prescriber.
Forgeries are one type of illegitimate prescription. Patients can produce illegitimate scripts in other ways, too.
For example, if you notice that a single prescriber tends to write considerably more prescriptions than other prescribers, may indicate a fake prescription.
Another common sign is a patient taking depressants and stimulants simultaneously.
Other examples of suspicious patient behavior to look for:
Your pharmacy plays a huge role in preventing opioid misuse. Talk to your patients about opioids and keep your eye out for suspicious signs.
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