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Dsuvia is NOT OTC!

November 7, 2018
Posted by: Gerald “Pharmacist Jerry” Finken, RPh, MS

Photo credit: Craig Sherod Photography via AcelRx Pharmaceuticals

What do OTC, prescription, and Schedule II opioid narcotics have in common?

When not used properly they all may cause death.

For instance, it continues to be reported that more than 16,000 people die each year from taking OTC aspirin or related NSAID products for their pain.

In addition, it is reported that 72,000 people, allegedly seeking pain relief, die from an overdose of opioids.

As a pharmacist, I know both numbers are misleading, albeit they drive the point home that deaths occur from FDA approved medications.

Next question: what’s the difference between an OTC, a prescription drug and a Schedule II opioid narcotic?

It is the FDA’s classification for misuse or abuse and the controls required for the medication to find its way to the patient.

Again, as a pharmacist, I can tell you that providing a patient with an OTC medication is much different than the dispensing of a prescription medication, which again is much different than dispensing a Schedule II narcotic.  The narcotic, as any pharmacist will attest, has always been very tightly controlled and requires much more documentation and accounting for every pill dispensed.

All this considered,  for some reason the press and our politicians have forgotten that the US already has many safeguards in place to protect the public from harm.

Such is the case with the recent article published by the NY Times titled F.D.A. Approves Powerful New Opioid Despite Warnings of Likely Abuse.  The powerful new opioid they are talking about is Dsuvia.

This article makes it sound like Dsuvia is being approved as an OTC rather than a Schedule II narcotic.  I think the positioning is incorrect and criticism is misdirected.

If the politicians and the press want to blame someone for the current or any future opioid epidemic, they should be looking at the four fingers pointed at themselves as they point the one finger at the pharmaceutical industry.

What everyone needs to know is that every Schedule II prescription medication can be tracked for how much is manufactured, how much is sent to distributors and how much is sent to pharmacies, hospitals, clinics, etc.

Moreover, each state is able to track exactly which physician wrote the prescription, which pharmacy filled the prescription and which patient received the prescription.

The federal government via the DEA as well as each state gets this information such that every tablet, capsule and milliliter dispensed is accounted for at every step of its life cycle.

So, when it comes to opioids, the real question the press and the politicians should be asking is: Why did the federal and state governments allow the opioid crisis to happen?  

Where was the Federal DEA and West Virginia state drug enforcement agencies when 21,000,000 pain pills were shipped into a small West Virginia town in the past decade! (Click here to see the story.)

If the press and the politicians really want to have a bigger impact on social ills they should go after the deaths and all the misery caused by alcohol misuse and abuse.  It has been reported that alcohol related deaths are equal to the sum of the NSAID and opioid deaths together at 88,0000 annually. And, let’s not forget the 480,000 tobacco related deaths in the US per year. (CDC)

As a pharmacist who only wants what is best for people and patients, I urge all of us to remember that not everyone in pain or who has a glass of wine is a drug abuser nor will they become drug abusers, as the press and politicians want you to believe, especially when regulations are enforced and when people have easy and free access to their healthcare providers such as their pharmacist.

Of course, the healthcare provider must also be given the time and support to follow their oaths rather than optimizing financial benefits.

Abuse will always be a problem and as a healthcare provider I hope through technology and education we can find better ways to help people before they find themselves addicted.

What do you think?

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