The Need for Pharmacy Health Literacy in the Opioid Crisis

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April 19, 2018
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Opioids have become the new supervillain. With the rising number of drug overdose deaths in the United States, prescription opioid misuse has resulted in a public health crisis. The opioid epidemic is having a profound impact on our nation’s health – touching every facet of our society including education, business, health care, housing, family/social support, sports, law enforcement and culture.

What we know:
  • An estimated 2.4 million Americans have an opioid use disorder, according to federal estimates.
  • More than 90 Americans die from opioid overdose every day (that’s three people every hour).
  • Drug overdoses are now the leading cause of death among Americans under 50, more than deaths due to guns or car crashes.
  • Soaring opioid drug deaths have caused U.S. life expectancy to decline for two years in a row.
  • Opioid overdose death rates are highest among whites and males.
  • Increasing numbers of American children are ending up in intensive care units after poisoning or overdosing on prescription painkillers or other opioids.
  • Governors in Alaska, Arizona, Florida, Maryland, Massachusetts and Virginia have all declared states of emergencies due to the opioid crisis.
  • The economic burden of prescription opioid misuse in the United States is $78.5 billion a year, including the costs of health care, lost productivity and addiction treatment.

With greater awareness of how addictive and dangerous opioids can be, U.S. doctors now are prescribing fewer opioids less frequently – although still three times more than U.S. doctors prescribed in 1999 and much greater when compared to doctors in Europe. However, there are many people who need pain relief because they live with chronic pain. Along with the alarming number of overdoses, there also is the high number of people who misuse pain relievers prescribed to them for pain management.

Chronic pain and pain-related disability disproportionately affect low-income populations. Moreover, low-income populations tend to have lower health literacy. Educating patients about the risk of opioid addiction, and helping them become aware of the signs and symptoms of addiction, can help patients and doctors work together to optimize pain management while minimizing the risk of addiction. In particular, there is an urgent need to raise pharmacy health literacy.

Why pharmacy health literacy?

Pharmacy health literacy is how well individuals can obtain, process and understand basic health, medication information and pharmacy services needed to make appropriate health decisions. Numerous studies over the last 20 years have shown that many adults have difficulty understanding common instructions for taking their medications, which can lead to improper usage and poor health outcomes. This direct correlation reveals why increasing pharmacy health literacy regarding opioid use, abuse and misuse is a critical step in the opioid battle.

The time to act is now.

Given the highly addictive nature of opioids and their availability, it’s important to encourage consumers to ask questions to expand their knowledge and understanding about this health crisis and how it can affect them personally if they are prescribed opioids. Provider education, combined with public education and awareness, are essential in the fight. To help address this urgent need, it is paramount that distributors, pharmacies, providers, insurers and advocates work together on the following approach:

  1. Use verbal, written and visual communication strategies to empower patients with limited health literacy to manage complex medication regimens.
  2. Provide clear guidance written at a sixth- to eighth-grade reading level.
  3. Improve poorly written instructions on how to take opioid medications (e.g., single-step vs. multi-step instructions).
  4. Include consumers in the development and testing of materials to determine whether consumers can read, understand and use them.
  5. Take into consideration the cultural differences with regard to language or beliefs about health care. 
  6. Use “Teach-Back” methods as an effective strategy for confirming that health care providers have explained what patients need to know in a way that patients can understand.

Implementing these six steps for using a patient-centered approach to raise pharmacy health literacy can help ensure that patients understand medications prescribed to them, reduce the number of opioid overdoses and prevent opioid abuse. There is no single “silver bullet” solution to the opioid epidemic, but consistent education of all parties – from prescribers to patients and their caregivers – is a vital part of the solution.