For the last two days, I attended number of presentation at the Indiana Pharmacists Alliance’s annual convention.. This particular presentation, like many others were presented by PharmD’s who are in or completed 1-2 (yrs) different residences. So these are the academically the brightest of the brightest.
This particular presentation was on the new auto injector EVZIO (Naloxone)… this little single use (2 separate injection) has a audio function to walk anyone thru its proper use… This little jewel only cost abt $600.00
Of course, the presentation started out with 44,000 people dying of drug overdoses in this country.. never mind that nearly 50% are by non-prescription drugs… which EVZIO probably has no use to reverse the overdose.
In Indiana, there was 999 drug deaths… with about 20% being from legal opiates… doesn’t mean that the person dying from the opiate had been legally prescribed to them.
In Indiana, the medical examiner and/or toxicology report abt 70% were either not identified or not tracked..
I asked the presenter of the 16 K opiate deaths.. how many were accidental or suicides… ANSWER – DON’T KNOW
I asked the presenter of the 16 k opiate deaths .. how many involved a single drug or involved a multiple drug cocktail .. ANSWER – DON’T KNOW
A couple of the older Pharmacists, officers of the Association made commented that the “profession was in good hands” if these young PharmD presenter were representative of the future of pharmacy…
I’m sorry.. but if the brightest of the brightest only believe and regurgitate stats by entities that may have other agenda(s) when presenting data results without questioning the breakdown – or lack of break down of the results
I have seen the 44 K number of drug overdose deaths… but.. this is the first time that I have seen the fact that nearly 50% are from OTC MEDS..
Is Indiana trying to “warp” the number? how come nearly 50% nationally are OTC meds and in Indiana abt 70% are not identified ?
How many pts died of a overdose that was actually prescribed to them ? How many are suicides ? How many died from a drug “cocktail ” ?
Could those pts that had opiates prescribed to themselves died from a accidental overdose or actually committed suicide. Could that number be in the low single digits ? Of those that are suicides, was that because they were not getting adequate pain management ?
So many numbers… and so little detail… why does no one questions these ?
Filed under: General Problems
I wonder, do “unspecified drugs” include alcohol? Perhaps alcohol isn’t defined as a drug in Indiana.
Do “drug overdoses” include poison? Drugs are chemicals, so do these statistics include deaths due to chemical poisoning from lead, arsenic, or coal? What about deaths from drugs like those used in chemotherapy? Drug overdoses from medical mistakes?
Looks like the abuse of “unspecified drugs” is at epidemic proportions, especially when compared to opioids and heroin. I don’t know how the DEA is going to fight “unspecified drugs” without a little more information.
I’m reasonably sure that others are asking the questions. I’m convinced that the people who are in a position to discover and provide the answers are forwarding an agenda that considers the answers to the questions a distraction or downright dealer of death to their genuine agenda.
Most people are interested in what the truth is, especially when the elucidation of the facts would serve to mitigate or eliminate suffering of this magnitude. That these questions have not been addressed is an indication, at least to me, of obfuscation by pretending that the questions don’t exist because there is no recognition of them being asked in the first place.
As to the up and coming hope for the profession, I wouldn’t judge them too harshly or consign them to the box of establishment mouthpieces just yet. Keep in mind that these young PharmDs that were trotted out to present at this conference have very little real world experience in actual practice. By the time that a PharmD completes their PGY1and PGY2 rotations, they have essentially been under the direction of Pharmacy educators to some degree for up to six years. Even when completing the clinical rotations before completing their degree and accruing the hours needed to sit for the state board licensing exam for the state that they intend to practice in, they have really no autonomous experience. A one or two year residency does allow for more autonomous experience, but they’re still under some degree of instruction and supervision. It’s only when practicing without the academic safety net does the real learning begin. My point in spelling this out is that the methods with which academia imparts education in certain areas and attitudes regarding certain situations tends to be to approach risk with making the decision call that will best protect the individuals license. At least that was my education in the PharmD program that I graduated from. I recall it being practically jackhammered into my head that any one who suggested that they would be best treated by a controlled substance, especially opioids, was exhibiting drug seeking behavior and were addicts and possibly criminals who hadn’t been arrested yet. So after hearing this on a regular basis for eight semesters, it took a few years in the trenches to realize that this philosophy was only true sometimes. In that same period of time I developed the chops that allowed me to be pretty good at telling the difference. My point is that these young pharmacists presenting at the conference are pretty green and at that point are presenting what they were instructed to at a fairly important conference. It was probably the largest crowd to whom they had presented to date, so the presentations were, by design, conservative. Because of the indoctrination imparted to them by the profession’s “party line” view of opioids and the people who utilize them, they very well may have not considered these questions. In the case of if the questions were considered, I would not have been surprised if they were told that the questions were too off-topic and were not suitable for the overall agenda of the presentation to even be posited rhetorically. These best and brightest will only realize their potential when they are working in day to day, real world situations that expose them to the dilemma of deciding if the person standing in front of them has genuine, debilitating pain issues or if this person is looking to get loaded or looking to score inventory for their next “business day” activities. I realize that I’m a series of guesses, but please understand that they’re educated guesses that I believe offer a fair degree of accuracy because I have a fair amount of real world experience with many of these scenarios. Any pharmacist with at least five years post graduation experience should be able to corroborate, to some degree, what I have said here.
I would say “Unspecified drugs’ include the ‘bath salt’ class…I have read in our paper articles where they have linked some drug related deaths to ‘spice’ products. The problem is there is no definitive tests for many of the chemicals used in these ‘bath salts’ like they have for opiates, cocaine etc. They probably would only know to test for it based on evidence at the scene of spice packets. Our state has outlawed ‘Spice” but an article not long ago pointed out how confusing our own state law is when it comes to enforcement and such. The product ingredients also change constantly as I understand it. I would agree medication errors are also a big contributor to the ‘unspecified’ section. They are not required to be reported to our BOP, if they are caught, everything is internal where the error occurred (eg hospital, retail, LTC). IMO they should have been prepared for such questions,