The Hypocrisy Of Modern Pharmacological Ethics

 During the COVID-19 pandemic, pharmacists claimed that certain drugs, like Hydroxychloroquine or Ivermectin, were "unsafe" for someone infected with COVID

• This despite the proven track record of both drugs seen from billions of doses over decades of use
• There has never been a publicly documented story of a pharmacist taking an ethical stand against filling an opioid prescription
• It is hard for individuals to take a stand by themselves

Effect of Pharmacist Email Alerts on Concurrent Prescribing

• Reducing risky prescription behavior by doctors who seem oblivious to the pharmacological risks of coprescribing opioids and benzodiazepines is a noble endeavor.

Email Alerts Failed to Detectably Reduce Coprescribing

• Combining randomization with quality improvement activities may help stakeholders seeking evidence-based interventions to encourage guideline-concordant care

Over the past 2 decades, opioid overdoses and deaths have increased substantially in what is widely described as a public health crisis

• There are several examples of successful opioid prescribing nudges including peer comparison feedback on pills per opioid prescription, reduced default duration or quantity for new opioid prescriptions, and letters to practitioners informing them that one of their patients overdosed.
• Nudgelike interventions have also successfully reduced benzodiazepine prescribing.

Solution: Opioids and benzodiazepines individually have FDA black-box warnings

• Prescribing these at the same time for a patient is officially discouraged because of the profound risks of toxic drug-on-drug interactions
• Solution: Pharmacists can simply refuse to fill concurrent prescriptions of opioids/benzos together
• Study was trying to see if pharmacists could be recruited to help remediate the pressing issue of reducing dangerous prescribing tendencies of doctors
• The design of the study seems at least somewhat troubling
• How can the study ethically allow pharmacists to knowingly fill coprescriptions for a pair of drugs that can cause profound harm if taken concurrently?

In Sum:

• Pharmacists will no longer be allowed to fill prescriptions for medications without checking to see if the patient is on a different drug that is contraindicated to be taken together with the new drug
• Fill prescriptions for highly addictive opioids with black-box warning, despite the acute risk of highly dangerous drug-drug interactions
• Lipitor and Ivermectin or HCQ, two of the safest drugs ever developed if prescribed for an indication of covid

https://brownstone.org/articles/the-hypocrisy-of-modern-pharmacological-ethics/