‘Our job is to educate’: East Tennessee pharmacist talks state opioid prescription patterns

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KNOXVILLE, Tenn. (WATE) — State doctors, nurses, dentists, and other licensed practitioners are monitored for prescribing patterns, annually.

For one local pharmacist, recognizing their role in preventing opioid abuse, it is an important part of the system in place.

Dr. Samantha Boldin, a pharmacist at Belew Drug in Knox County, says monitoring prescription patterns is only part of the solution.

“Our responsibility as pharmacists is to make sure that medicines that your doctor or nurse practitioner prescribes for you are safe and effective for you,” said Boldin.

The Tennessee Comptroller of the Treasury has identified 62 opioid prescribers with what it calls “abnormal prescribing patterns” in a study released Wednesday.

According to the state, Comptroller researchers with its Office of Research and Education Accountability (OREA) worked to identify prescribers whose patterns were “significantly statistically abnormal,” and to investigate what disciplinary responses, if any, were taken by the licensing boards in response.

The report identifies those 62 prescribers based on their 2017 prescribing patterns. The identification is for further investigation a does not alone indicate inappropriate prescribing.

Of those 62 identified there are 24 dentists, 21 doctors and physicians, 9 APRNs, and 5 physician assistants who were identified based on their prescribing of opioids for pain, and three doctors who were identified based on their prescribing of opioids for MAT.

What do the numbers look like for practitioners?

For Boldin, the report tells only part of the story she sees while working at Belew Drugs everyday. She agrees that there has been a decrease in “doctor shopping,” or when patients look for opioids from multiple prescribers.

The report shows that between 2013 and 2018, there was a nearly a 70% decrease in patients who “doctor shop.”

During the time of reform, the OREA report shows that the rate of opioid prescribing decreased from 2 million prescriptions in the fourth quarter of 2013-2014 to 1.4 million in the fourth quarter of 2018.

Boldin says she credits education for the decrease and overall understanding for the risks of prescription opioid use. She says, more often than a decade ago, patients are opting for other options that don’t include medication. Those options include physical therapy or massage therapy to treat pain.

But still, Boldin recognizes there is still a problem with prescription opioid abuse.

“I’ve had situations in the past month where I’ve had to say I’m sorry I can’t fill this for you…” said Boldin.

In those moments, Boldin says she looks at the patient and their needs, rather than just accepting a prescription that may come with red flags.

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