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Apothecary as an Administrator’s Option to Opioid Abuse

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Ygnacio “Nash” Flores and Michael Ochoa
July 25, 2017

The abuse of opioids is receiving growing public scrutiny. For example, The Economist mentioned the complex issues behind the factors and environments that facilitate the dependency on opioids in their weekly newspaper from April to May 2017. Likewise, in shutterstock_3711256882016, President Obama signed into law The Comprehensive Addition and Recovery Act (CARA) to address the epidemic of dependency on opioids. National Public Radio has aired at least ten stories on the various causes and dangers of opioid abuse. Equally concerning was a 2016 Wall Street Journal article titled “5 Things About Veterans and Opioid Addiction” which highlighted the growing epidemic among veterans.

In the midst of the debate on solutions for countering the opioid AT Option1epidemic, there is a critical section of the pharmacological environment that has been largely ignored as an intervention in not only remedying the current factors leading to addiction, but also to the prevention of opioid dependency in the use of opioid based pain medicine during the acute phase of treatment for pain management. Ignoring compounded medicinal options in treating pain takes away an alternative that can drastically reduce the likelihood of addiction.

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The practice of pharmacology predates written history as cultural folklore is replete with the heroic stories of shamans, wizards, witchdoctors and curanderos who compounded poultices and concoctions to cure people in their respective communities. The idea of apothecary as a medical option is linked to anachronistic visions of wizards like Merlin rather than the option that can solve contemporary issues. As modern medicine replaced the traditions of the shamans, the compounding side of pharmacology has been relegated to a position in medical practice that has been shunned at best and totally ignored at worst. Regrettably, supporting the distrust of compounding companies are stories of unethical practices within the industry.

In the case of opioid addiction from prescriptions, the current issues in abuse and addiction have shown that the traditional use of pills needs to be reconsidered. Using prescriptions with less potency is not much better as an alternative since the opioid, including synthetic opioids, is being introduced into the body in the same manner and with the same hazards of ingesting medications. Use of compounded medical options is a way to treat pain through the localized use of opioids that reduces drug to drug interactions as well as providing a more economical model for pain treatment and management. Ingestion of opioids has a global effect on the body whereas a patch using compounded opioids does not affect the entire body. Further, compounded medicines allows for personalized medications designed for specific individuals.

Even though many physicians do not often consider the use of prescribing compounding solutions for severe pain, they need to be better informed of compounded opioids as an option for managing pain. Currently, it is possible to have compounded opioid-based medication delivered through the use of patches placed on the body. This allows the opioid-based medicine to work as a pain suppressor by concentrating the medicinal impact directly to the areas of pain without the requirement to ingest the opioid; a practice that has already proven to carry a great risk for addiction.

Public administrators and leaders need to ask the right questions when exploring options for pain management related to the abuse and addiction of opioid-based medications. Public leaders also need to be aware of the compounding options when creating legislation and developing programs to prevent and mitigate the abuse and addiction of opioids. Interestingly, a review of recent legislation addressing opioid addiction, there is no mention of compounding prescriptions as an option to address this social problem.

Public and medical leaders need to appreciate the value of compounded medicines in addressing the current social issue of opioid abuse and addiction as well as preventing the future use of addiction while still managing the pain patients experience. Using compounded medicines in the future will move the medical industry from volume-based care to value-based care.


Authors: Ygnacio “Nash” Flores, EdD, teaches Homeland Security, Criminal Justice and Corrections at Rio Hondo College. [email protected] | Michael Ochoa is the Co-Founder and CEO of Advanced Therapeutics, a multi-specialty health care company. [email protected]

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The American Society for Public Administration is the largest and most prominent professional association for public administration. It is dedicated to advancing the art, science, teaching and practice of public and non-profit administration.

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