Best practices to reduce painkiller abuse


By Patrick Morrissey - Contributing Columnist



Fighting the drug epidemic and reversing its deadly consequences are some of the most important challenges we face in the Mountain State. That is why I’m pushing a best practices initiative that will help West Virginia reduce its use of opioid painkillers by at least 25 percent.

The statistics are ominous and demand an aggressive response.

West Virginia tallied the nation’s highest drug overdose death rate in 2014 at 35.5 deaths per 100,000 people. That’s more than double the national average and depicts a trend that continued into 2015, when the state recorded an estimated 686 drug overdose deaths, including 598 opiate-related fatal overdoses.

But beyond those staggering numbers are the human faces of substance abuse.

Every West Virginian knows a face of substance abuse. Whether that person is a family member, friend, neighbor or colleague, his or her battle should drive each of us to action.

My office is committed to winning this fight. However, we need a different approach than what the State has seen in the past – quite frankly, we have to tackle this epidemic holistically from a supply, demand and educational perspective.

A multi-disciplined approach is crucial to eradicating both the demand and supply of opioid prescription drugs. It is my hope that our recently unveiled best practices initiative and other aggressive actions can reduce West Virginia’s use of opioid painkillers by at least 25 percent.

Our goal is simple – help patients experience the relief they need without the risk of becoming addicted to a drug that shares many characteristics with heroin.

Through emphasis of best practices, we seek to dramatically reduce the use of opioids as a first-line therapy in pain treatment. This means we must significantly increase use of non-opioid alternatives and empower patients to question the necessity of any opioid prescription they receive.

The draft initiative offers recommendations for prescribers and pharmacists to reduce misuse, while preserving legitimate patient access to necessary treatment. The guidelines urge pharmacists to verify the legitimacy of each patient, prescriber and prescription, in addition to ensuring the medication, dose and quantity of a product used is safe and appropriate.

Prescribers are also encouraged to regularly monitor their patient’s use of opioid drugs; utilize physical exams and urine tests to spot evidence of misuse; and educate each patient about the risks of opioid treatment, only then approving such a prescription after a screening and consideration of non-opioid alternatives.

The draft best practices initiative further urges both professions to expand the use of the West Virginia Controlled Substance Monitoring Program; educate patients about safe use, storage and disposal of opioid drugs; and incorporate naloxone into opioid treatment discussions.

When opioids prove appropriate and necessary, the initiative seeks to ensure these highly addictive painkillers are prescribed and dispensed at the lowest effective dosage rate, consistent with expert medical advice. The proposal applies exclusively to adult patients and does not impact those suffering pain associated with active cancer treatments or palliative and end-of-life care.

I believe these prescribing and dispensing guidelines balance the need for safe and effective pain management treatment for West Virginians, while addressing our state’s serious opioid epidemic.

Our initiative is gaining steam every day. Currently, we have received support from a broad coalition of experts, including the state’s Boards of Medicine and Osteopathic Medicine, the Professional Registered Nurses Board, law enforcement groups and many health care societies and professionals. Everyone will need to work together if we truly want to take back our communities.

My office remains committed to that mission.

Together with the best practices initiative, I recently unveiled plans to purchase four drug incinerators to assist in the disposal of unwanted and expired medication. I’ve also teamed with the state’s Boards of Medicine and Osteopathic Medicine for a series of public service announcements to empower patients to question their need for opioid therapy.

In May, I partnered with Ohio Attorney General Mike DeWine for a large conference in Williamstown to engage the faith-based community. I hope success from that event will result in similar faith-based conferences across West Virginia.

All of that follows efforts to transfer $10 million from my office’s Consumer Protection Fund in hopes the Governor’s Office and state Legislature could use the money to spur drug abuse treatment and reduce the backlog of drug tests at the West Virginia State Police crime lab.

On other fronts, a partnership with the U.S. Attorney’s Office recently netted its fourth criminal drug conviction in northern West Virginia. This partnership, along with our aggressive enforcement actions against entities within the supply chain and through the state’s efforts to attack this problem holistically, will help rid West Virginia of this terrible epidemic.

Our state’s people are dying at an alarming rate.

The time is now for all of us – government officials, medical professionals, law enforcement, faith-based leaders and the community at large — to do everything possible to put an end to these senseless deaths.

Generations of West Virginians are at risk if we don’t do everything imaginable to make progress now.

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By Patrick Morrissey

Contributing Columnist

Patrick Morrissey is attorney general for West Virginia.

Patrick Morrissey is attorney general for West Virginia.

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