‘Not one pill more’: Taming the opioid epidemic one medicine cabinet at a time | Perspective
When you have zero opioids left at home, you're preventing the deadly chain of events from starting.
Our son Adam died in September 2015. He overdosed on fentanyl, but the start of his addiction began with opioid prescription painkillers from past surgeries that were in the kitchen cabinet of our New Hampshire home, innocently next to vitamins, Tylenol, and cake sprinkles. Ordinary stuff. Now, we have extraordinary grief.
We've spent every day since then thinking about what we could have done differently. If you've lost a child to an opioid overdose, you find that for every answer you come up with, there are many more questions to face. We didn't even consider locking our prescription opioids – why would Adam or our three other children be interested? We never thought there was a chance that our unguarded opioids would tempt them or worse, lead to addiction.
The more we thought about it, the more we knew that the core issue was that we were never educated about the risks associated with the medication and never threw the unused opioids away. It's a simple idea now, but we never considered it then.
That is why we founded the Zero Left campaign and program, to stop this killer epidemic. The availability of opioids leads to overuse. Overuse leads to addiction. Addiction leads to death. But when you have zero opioids left behind in your house, you're doing something to prevent the deadly chain of events from starting at all.
Others have taken similar steps. For example, the pharmacy benefit manager Express Scripts has a comprehensive opioid management program that is based on a simple intuition: If we can just make sure people get the medicine they need, and not one pill more, we can change the course of addiction and save more lives. By keeping new opioid prescriptions to a seven-day limit, among other important actions, the problem is being addressed at its root.
In addition to smaller supplies for new prescriptions, Express Scripts is taking proactive measures to better educate people with new opioid prescriptions on safe use of the medications and the importance of properly discarding any unused medication — two actions that speak to the heart of our mission at Zero Left. They even provide Deterra disposal bags to members with an opioid prescription, which greatly simplifies the safe disposal of unused medications.
Compounding the problem is the fact that studies show nearly 60 percent of patients undergoing opioid therapy have been prescribed other drugs that could interact dangerously. Of those patients, two-thirds were using drugs prescribed by at least two physicians, with just under half filling prescriptions at multiple pharmacies. Every additional pharmacy, every additional physician, and every additional route through which a patient acquires health care creates an added layer of confusion.
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It's no secret that all of us are paying a huge price for this mismanaged pain therapy. All members of the health-care sector need to get serious about working together to find a way to mitigate the growing scourge of opioid dependence.
By doubling down on scrutiny of the legal pharmaceutical opioid supply, from production to prescription and consumption, we would be well on our way to defeating the addiction epidemic.
Naloxone, for instance, marketed as Narcan, has been instrumental and is beginning to gain a foothold against the opioid epidemic. But addicts are actively searching for new highs, making naloxone less and less effective against new synthetic opioids, some of them related to the fentanyl dose that killed Adam. Adequately addressing the opioid epidemic requires a renewed, systemic approach that will monitor and mitigate the routes through which patients most commonly become addicted.
While emergency treatments such as naloxone have been instrumental in saving tens of thousands of lives across the country, it's merely a Band-Aid solution — and one that will do little to effect long-term change. The answer lies in more careful oversight at the junction where drugs are prescribed and prescriptions are filled, and it's clear to us that health-care companies, like Express Scripts, are well-positioned to help close the pathway to addiction.
Our best chance at ending rampant opioid abuse is for prescription-drug use to be monitored at all touch points in the patient-care continuum, including the parent or the friend who needs to speak up when something doesn't seem right.
We left opioids unguarded. Now we know that Zero Left is the only way to go. We're proud that others are rallying around a common cause: Stop addiction before it starts.
Jim and Jeanne Moser live in New Hampshire, where they have created the Zero Left campaign.