In September 2017, the pharmacy chain CVS announced that, in response to the growing opioid epidemic, it would limit opioid prescriptions to seven days for certain conditions. This applied to patients who were new to the medications. CVS also decided to limit the daily dosage of pain pills according to their strength, and a new policy will require use of immediate-release formulations before extended-release opioids, which are intended for severe, long-term pain treatment. Experts say that longer prescription durations as well as higher dosages increase the chances of dependence.
Another effort CVS will employ in an attempt to curb opioid abuse is training their pharmacists to counsel patients on the risks of dependence and addiction. They also plan to expand their Medication Disposal for Safer Communities Program, which is a program in conjunction with The Partnership at Drugfree.org that provides local police departments with a drug collection unit to help communities safely dispose of unwanted medications, including controlled substances.
According to the U.S. Centers for Disease Control and Prevention, between 1999 and 2014 sales of prescription opioids in the US almost quadrupled. With over 9,600 stores in the United States, CVS is one of the largest providers.
Some worry that these new regulations will interfere with the relationship between patients and doctors, as well as impairing pain relief for patients who use opioid medications properly. By requiring prior authorization, they argue, patients will be left suffering while the pharmacy and insurance companies sort things out. CVS counters that its guidelines are flexible and doctors will be able to ask for exceptions.
CVS isn’t the only pharmacy chain to tighten control over opioid prescriptions. Walmart announced in May 2018 that it and Sam’s Club pharmacies would limit customers’ opioid prescriptions for acute (short term) pain to a seven-day supply, with up to a 50 morphine milligram equivalent maximum per day. Walmart also intends that by January 2020, its pharmacies will require e-prescriptions for controlled substances. According to Walmart, electronic prescriptions have proven to be less prone to errors than their paper counterparts, and they cannot be altered or copied. They are also electronically trackable.
In January 2018, Walmart also rolled out a new initiative to help people properly dispose of opioid medications that are no longer needed. Anyone filling a prescription for a class II opioid – which includes hydromorphone (Dilaudid), methadone (Dolophine), meperidine (Demerol), oxycodone (OxyContin, Percocet), fentanyl (Sublimaze, Duragesic), morphine, codeine, and hydrocodone – now receives a free packet of a powder called DisposeRx. You simply add warm water and the DisposeRx powder to the pill bottle, and it forms a biodegradable gel around the pills.
These changes are in line with CDC guidelines that state that “three days or less will often be sufficient” for those prescribed the painkillers, and “more than seven days will rarely be needed.”
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