CHARLESTON – Attorney General Patrick Morrisey has unveiled a draft best practices initiative aimed at eradicating prescription drug abuse by better equipping the state’s prescribers and pharmacists.
Morrisey released the plan on May 17 during a press conference at the State Capitol in Charleston. His initiatives draw support from medical professionals and members of the law enforcement community.
The attorney general said West Virginia must dramatically reduce the prescription of opioids as a first-line therapy option.
Morrisey said he hopes to reduce opioid use by at least 25 percent with this initiative and other practices.
“Prescribers and dispensers have crucial roles in the pharmaceutical supply chain,” Morrisey said. “Eradicating substance abuse demands a holistic and multi-faceted approach, which attacks the problem from a supply, demand, and educational perspective.”
Morrisey said that this means, among many other things, developing, refining and implementing best practices involving all segments of the pharmaceutical supply channel.
The draft initiative offers recommendations for prescribers and pharmacists who prescribe or dispense opioid prescriptions across West Virginia. It is designed to reduce misuse, while preserving legitimate patient access to necessary treatment.
Robert C. Knittle, executive director of the state Board of Medicine, praised the initiative and its promise for West Virginia.
"What Attorney General Morrisey is proposing are best practices which are closely aligned with the training that is now available to licensed prescribers throughout our state and adheres to the recently published CDC guidelines,” Knittle said. “The more opportunities we have to get this type of information out to physicians and other practitioners, the greater our chances will be to bring about substantial change.”
Del. Chris Stansbury, vice chairman of House Select Committee on Prevention and Treatment of Substance Abuse, commended the best practices announcement as part of rethinking the way people use opioid pain medication.
“Attorney General Morrisey has the public’s best interest at heart,” Stansbury said. “I think he wants this opioid pain pill crisis to go in the right direction. I think he has done his due diligence. He has talked to experts on all sides of the issue to make sure that when he comes out with this initiative that they are well-founded and principled arguments to rethink this pain pill epidemic.”
The guidelines urge pharmacists to verify the legitimacy of each patient, prescriber and prescription, in addition to ensuring the medication, dose, quantity and any mix thereof is safe and appropriate.
Dr. Janet Wolcott, a clinical pharmacy specialist at Cabell Huntington Hospital, praised efforts to gather input from a broad array of stakeholders.
"We're really excited with Attorney General Morrisey coming out with these best practices,” Wolcott said. “I think it represents one more group that has stood up and come up with a plan for assisting and combating the drug issue in West Virginia. They have reached out to broad and wide disciplines to review these best practices. That’s helped get more groups involved and behind the initiative before it is released. It also shows they’re actually listening. They called the disciplines and asked, ‘Is this feasible?’”
Likewise, prescribers are 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.
Dr. Timothy Deer, president of the West Virginia Society of Interventional Pain Physicians, also applauded the initiative.
“The Physicians of West Virginia are encouraged by the collaborative efforts of Attorney General Morrisey and Medical Societies to improve the health of our society,” said Deer, so is also a clinical professor of anesthesiology and pain medicine for the West Virginia University School of Medicine. “Best Practices are needed to create an algorithm of pain care where opioids are not used until other reasonable treatments have been used to improve function and suffering. Today's announcement is very encouraging and a great step forward.”
The best practices project underscores the importance of both professions utilizing the state’s controlled substance monitoring database; educating patients about safe use, storage and disposal of opioid drugs; and incorporating naloxone into opioid treatment discussions.
The proposal does not impact patients suffering pain as active cancer treatments or palliative and end-of-life care.
“We continue to support this vitally important work and look forward to working with the Attorney General’s Office in the future,” said Lanette L. Anderson, executive director of the state’s Board of Examiners for Licensed Practical Nurses.
Many experts agree oxycodone, hydrocodone and other prescription opioids can lead to addiction and heroin abuse, a progression that has killed far too many in West Virginia.
Morrisey also unveiled plans to purchase drug incinerators to assist in the disposal of unwanted and expired medication, in addition to a public service campaign to empower patients to question their need for opioid therapy.
In 2015, West Virginia recorded approximately 686 drug overdose deaths, including 598 opiate-related fatal overdoses.
The previous year, West Virginia led the nation in drug overdose deaths at a rate of 35.5 per 100,000 people.
Reversing the trend has been a top priority for Morrisey. He has fought the epidemic on multiple fronts with criminal prosecutions, increased funding, education, civil litigation, multi-state initiatives and the faith-based community.