American College of Clinical Pharmacy
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ACCP Report - September 2019

Washington Report

ACCP’s Efforts to Address Opioid Abuse Highlighted in Washington Post

Written by John McGlew
Director of Government Affairs



Capitol

According to the Washington Post, from 2006 to 2012, 76 billion prescription pain pills were manufactured and shipped to pharmacies all over the country, fueling a public health epidemic that killed 100,000 Americans.

Central to ACCP’s vision for the clinical pharmacy profession is its belief that pharmacists must be accountable for engineering and overseeing a fail-safe medication use system. In response to an ongoing investigative series into this national public health crisis, ACCP President Suzanne Amato Nesbit, Pharm.D., FCCP, BCPS, CPE, submitted a letter to the Washington Post editor calling on cities like Baltimore to ensure that pharmacists are part of the solution to the opioid and addiction crisis. Click here to read Nesbit’s letter in full.

Of note, this letter simply highlights some of the work ACCP is currently engaged in relevant to the opioid and addiction crisis. The College is actively partnering with key allies to highlight areas where clinical pharmacists can uniquely support efforts to address this public health crisis nationwide.

NAM Forum on Mental Health and Substance Use Disorders

ACCP is proud to be the only national pharmacy organization represented at the prestigious National Academies of Medicine (NAM) Forum on Mental Health and Substance Use Disorders. In this capacity, ACCP is leading an effort to support the integration of services for mental health and substance use disorders into the broader health care delivery and financing system. Working with key interprofessional stakeholders, ACCP is focusing on positioning clinical pharmacists within the definition of what constitutes minimally adequate care for mental health and substance use disorders and highlighting innovative practices to facilitate and optimize data collection, integration, and use.

American Society of Addiction Medicine (ASAM)

ACCP continues to partner with ASAM to identify potential areas for collaboration and member engagement, particularly focused on collaborative educational sessions at ACCP and ASAM meetings, development of public policy statements, exploration of clinical guidelines, and a potential advocacy partnership.

Coalition to Stop Opioid Overdose (CSOO)

ACCP is also helping position clinical pharmacists within CSOO, a diverse range of mental health, substance use disorder, and health care professional organizations united around common policy goals to reduce opioid overdose deaths. Specifically, CSOO focuses on strengthening the substance use disorder workforce and removing barriers to evidence-based prevention, treatment, harm reduction, and recovery support services for all people with (or at risk of) a substance use disorder who need those services.

Alliance for Addiction Payment Reform

ACCP has also been active in the Alliance for Addiction Payment Reform, a national multisector alliance of health care industry leaders dedicated to developing the Addiction Recovery Medical Home (ARMH) model, an alternative payment model (APM) engineered to provide patients with a long-term, comprehensive, and integrated pathway to treatment and recovery. Of importance, this effort is closely aligned with ACCP’s prioritization of the “what” (the defined clinical service) rather than the “who” (the clinician) and as well as with the value-based approach to care and payment that ACCP supports.

Recognition of CDTM in Sen. Warren/Rep. Cummings Language

On Capitol Hill, two leading Democrats cowrote an extensive piece of legislation known as the Comprehensive Addiction Resources Emergency (CARE) Act. The CARE Act is modeled directly on the Ryan White Act, which released funding to combat the AIDS crisis, and would provide state and local governments with $100 billion in federal funding over 10 years to combat opioid addiction. Of importance, the CARE Act specifically recognizes clinical pharmacists delivering care under formal collaborative practice agreements. Because of the price tag and perceived political partisanship, it is unlikely that this bill will pass in its current form, but ACCP hopes to preserve the collaborative drug therapy management provision in future legislative initiatives.

Advocacy Strategy and Outlook

ACCP’s top advocacy priority focuses on helping achieve medication optimization in the treatment of chronic diseases through comprehensive medication management (CMM). Of importance, ACCP fully recognizes that the scale of America’s addiction problem goes well beyond simply “getting the medications right.” Addressing the opioid crisis that has developed in the 21st century will require meaningful and comprehensive system-wide policy changes that support evidence-based prevention, treatment, harm reduction, and recovery support services.

Thus, although ACCP does not believe it appropriate to seek opportunities to advance its CMM effort through legislation specifically targeting opioid abuse, the College asserts that clinical pharmacists are essential team members in the multidisciplinary approach to chronic pain that focuses on the patient’s medical condition, comorbidities, and medication management services, including medication-assisted treatment services for those with a dual diagnosis of chronic pain and opioid use disorder. In keeping with ACCP’s organizational vision that the College will drive positive changes in health care as the professional organization most influential in advancing clinical pharmacist roles and responsibilities to optimize pharmacotherapy in preventing and treating disease, ACCP’s Board of Regents continues to support committing staff time and resources to help ensure the profession demonstrates appropriate leadership amid a recognized public health crisis.