Law: Confronting the Prescription Opioid Crisis: The Pendulum Swings

Drug overdose deaths have been rising for three decades and reached a new record in 2020, fueled principally by opioids. Lethality due to prescription
opioid drugs dominated the early part of the epidemic and still account for a significant number of deaths. This period was characterized by a desire to
treat pain adequately and resulted in rampant prescribing. Later, clinical guidelines and regulatory efforts sought to reduce the use of opioids and successfully
discouraged opioid use. This continuing education activity traces the role of prescription drugs in the development of the opioid epidemic and the regulatory response. It also examines health care professionals’ responsibility to reduce diversion and how the application of the regulatory changes have adversely affected patients being treated for pain.

Pharmacist and Technician Post-test Questions

1. Approximately how many people died from a drug overdose in 2020?
A. 71,000
B. 93,000
C. 38,000

2. When did the opioid prescribing rate peak?
A. 1999
B. 2010
C. 2019

3. Approximately what percentage of opioid overdose deaths were associated with prescription drugs at the peak period of prescribing?
A. 70%
B. 50%
C. 33%

4. Currently, which drug is the main driver of drug overdose deaths in the United States?
A. Prescription opioids
B. Heroin
C. Fentanyl

5. What helped propel the rapid growth in the use of oxycodone?
A. The clinical superiority of long-acting opioid dosage forms for pain
B. Misleading claims about the risk of opioid addiction
C. Ease of prescribing oxycodone as it was a C-III drug

6. What did Congress intend in declaring 2000-2010 the “Decade of Pain”?
A. To recognize and emphasize pain management and palliative care
B. To encourage the widespread use of non-opioid analgesics
C. To increase funding for substance use disorder facilities

7. What did the 2016 CDC guidelines do?
A. Reinforced various recommendations made in the 1990s
B. Recommended avoiding opioid doses above 90 MME/day
C. Made exceptions for those patients with cancer only

8. Which of the following is the most common state limit on first-time opioid prescriptions?
A. 3 days
B. 7 days
C. 14 days

9. When the DEA brought an action against a pharmacy in 2009 for failure to acknowledge red flags when dispensing opioids, what defense did the pharmacist mount?
A. He was not aware of the concept of red flags for opioids
B. There was no reported opioid overdose problem in his community
C. It was not his job to question a physician’s judgment

10. A pharmacist charged by the DEA of dispensing illegitimate prescriptions raised the defense that there was no statute in the state where the pharmacy is located that required documentation of a “red flag.” Which of the following is correct?
A. The DEA accepted the defense, dismissed the action, and directed the state to handle any future cases
B. The DEA relied on documentation of a red flag being the prevailing professional standard and ignored the defense
C. The DEA relied on wording in the Controlled Substances Act and denied the defense

11. What did the DEA criticize in a recent action against a chain?
A. Working conditions prevented pharmacists from evaluating prescriptions’ legitimacy
B. The chain did not comply with state and federal opioid prescription limits
C. Pharmacists gave technicians too much authority in dispensing opioids

12. Which of the following statements about treating pain is correct?
A. Patients with chronic pain have a higher risk of suicide even when controlling for other factors such as socioeconomic status.
B. Physicians are becoming more likely to accept and treat patients with pain
C. Dispensing policies in most pharmacies are consistent with the CDC guidelines

13. What percentage of cancer patients reported being unable to get opioid medications because a pharmacist refused to fill the prescription according to research from the Cancer Action Network?
A. 1%
B. 12%
C. 27%

14. Recently, lawsuits have been filed against three of the largest U.S. pharmacy chains by patients. What did these lawsuits allege?
A. Short filling of opioid prescriptions
B. Discrimination against patients with pain
C. Refusal to fill opioids prescriptions that do not comply with CDC guidelines

15. Which of the following is CORRECT with respect to a recent lawsuit filed by a physician against a chain pharmacy that refused to fill his prescriptions?
A. He claimed that the pharmacy had defamed him and cast him in a bad light
B. He claimed that the pharmacy improperly sought information about his prescribing patterns
C. The judge in the case ruled that the pharmacy acted properly in refusing to fill his prescriptions

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Law: Confronting the Prescription Opioid Crisis: The Pendulum Swings

Pharmacist & Technician Learning Objectives

Abstract

Accreditation Statements

Faculty

Faculty Disclosure

Disclosure of Discussions of Off-label and Investigational Drug Use

Content

Post Test for Pharmacist & Pharmacy Technician

Pharmacist and Technician Post-test Questions

References

Full List of References