By: A.J. Day & Maria Carvalho
Pain affects more Americans than diabetes, heart disease and cancer combined. It represents an important public health issue that is associated with a wide range of injury and disease.1 As a result, an estimated 20% of patients with chronic pain receive an opioid prescription when visiting physician offices, and rates of opioid prescribing have grown significantly, in particular for family practice, general practice and internal medicine.2
This has in turn contributed to further problems. Over two million people had an opioid-use disorder in 2016, translating to an economic burden of $504 million. On average, 116 Americans died every day from an opioid-related drug overdose.3 Today, the addictive properties and the potentially fatal risks of opioids have led to a nationwide public health emergency, as declared by the Acting Secretary of Health and Human Services on October 26, 2017.4
Prevention, assessment and treatment of pain can be challenging not only to patients and caregivers, but also to health care providers. The Centers for Disease Control and Prevention recommend nonopioid pharmacological treatments and nonpharmacological treatments as preferred for chronic pain (outside of active cancer, palliative, or end-of-life care).5
How Pharmacy Compounding Can Help
Local compounding pharmacies are an integral part of their communities and are readily accessible to patients and physicians. For decades, compounding pharmacists have been helping patients with chronic pain by dispensing customized transdermal pain medications. While avoiding the use of addictive drugs, these medications may be customized to include different types of drugs, in various dosage strengths, that are delivered simultaneously in one application.
However, there are still many patients and health care providers who are unaware of this nonopioid treatment. Compounding pharmacists are in a unique position to help combat the opioid epidemic by suggesting transdermal pain medications to their patients and physicians. PCCA members in particular have access to a wide array of pain formulas with plenty of supporting literature on our PCCA Science page under Journal Articles > Lipoderm. Furthermore, PCCA members have access to a broad range of in-person and web-based compounding training and specialized support in pain management.
More recently, we co-authored an article published in the Journal of Opioid Management, titled “The Role of Transdermal Compounding in Opioid Safety.” It discusses the current U.S. opioid epidemic and explains how transdermal compounding can be a safe and effective therapeutic option for specific patients who need help with pain management.6 This article may be a useful scientific resource for patients and health care providers who are not yet familiar with the benefits of transdermal pain medications.
A version of this article was originally published the Summer 2018 issue of the Apothagram, PCCA’s quarterly, members-only magazine.
A.J. Day, PharmD, RPh, is the Director of Clinical Services at PCCA
Maria Carvalho, PharmD, MRPharmS, PhD, is the Manager of PCCA Science
1. American Academy of Pain Medicine. (n.d.). AAPM facts and figures on pain. Retrieved from http://www.painmed.org/patientcenter/facts-on-pain/
2. Centers for Disease Control and Prevention. (2016). CDC guideline for prescribing opioids for chronic pain — United States, 2016. Morbidity and Mortality Weekly Report: Recommendations and Reports, 65(1). Retrieved from https://www.cdc.gov/mmwr/volumes/65/rr/pdfs/rr6501e1.pdf
3. U.S. Department of Health and Human Services. (2018). The opioid epidemic by the numbers in 2016 …. Retrieved from https://www.hhs.gov/opioids/sites/default/files/2018-01/opioids-infographic.pdf
4. Hargan, E. D. (2017). Determination that a public health emergency exists. Retrieved from https://www.hhs.gov/sites/default/files/opioid%20PHE%20Declaration-no-sig.pdf
5. Centers for Disease Control and Prevention. (n.d.). CDC guideline for prescribing opioids for chronic pain. Retrieved from https://www.cdc.gov/drugoverdose/pdf/guidelines_at-a-glance-a.pdf
6. Bucher, C. V., Day, A. J., & Carvalho, M. (2018). The role of transdermal compounding in opioid safety. Journal of Opioid Management, 14(1), 17-22. http://dx.doi.org/10.5055/jom.2018.0425
These statements are provided for educational purposes only. They have not been evaluated by the Food and Drug Administration, and are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment.