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Pharmacist, prescriber perceptions of Rx drug abuse problem differ

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JOHNSON CITY (May 29, 2013) – Pharmacists who dispense prescription medications and health care providers who prescribe them have dramatically different perceptions regarding the prevalence of prescription drug abuse, according to a study by three researchers at East Tennessee State University.

Dr. Nick Hagemeier, an assistant professor of Pharmacy Practice at ETSU’s Bill Gatton College of Pharmacy, is the lead author of a paper that details the findings. He collaborated with Dr. Jeff Gray, a colleague in the ETSU Department of Pharmacy Practice, and Dr. Robert Pack, associate dean for the ETSU College of Public Health. Their paper was published in the academic journal “Substance Use and Misuse.”

The three ETSU faculty members are part of a large interprofessional team of researchers at the university who meet regularly to collaborate on prescription drug abuse research that could lead to prospective solutions. The U.S. Centers for Disease Control and Prevention has described the prescription drug abuse problem as epidemic in nature, as the numbers of associated deaths from abuse quadrupled from 1999-2008.

“There has been a significant focus in the literature on prescribing and dispensing behaviors, from pain management, abuse deterrence and addiction treatment perspectives,” Hagemeier said. “Speaking from a community pharmacist perspective, there’s still a lot we don’t know. I know we can do a better job of helping patients through improved prescription drug abuse-related communication and education. Our team’s goal is to inform this research area and help pharmacists, prescribers and patients battle this epidemic.”

The researchers surveyed prescribers and pharmacists to measure their perceptions of drug abuse prevalence and their perceived abilities to discuss prescription drug abuse with patients and colleagues.

Pharmacists in the study were much more likely to suspect that patients receiving potentially addictive opioid pain relievers were abusing them. While pharmacists estimated that 41 percent of individuals who were prescribed those drugs abused them, only 17 percent of prescribers estimated the same. Also, prescribers estimated that 85 percent of patients had a legitimate medical reason for opioid pain relievers, while pharmacists thought 64 percent had a legitimate medical reason.

Hagemeier said it’s important to note that patients can have a real need for prescription pain medications, and still be abusing the medication or diverting the medications to others for nonmedical use.

The problem of prescription drug abuse is so pervasive that it will require multiple solutions, Hagemeier said, with improved communication between prescribers, pharmacists and patients being one component. He left a nine-year career in pharmacy practice to pursue a career in research and pharmacy education in an effort to do more.

“I can remember the times when I was dispensing pain medication to patients where I suspected abuse, but I came to feel that I didn’t have all the tools I needed to help a patient with a prescription drug abuse problem,” Hagemeier said. “We are working to establish ETSU as a hub for prescription drug abuse research. It’s undoubtedly a devastating, complex problem. Through our Academic Health Sciences Center and the faculty, staff and students in our prescription drug abuse working group, we have several pieces of the puzzle here at ETSU that will be necessary to prevent prescription drug abuse and help patients who find themselves in the throes of it. ”