ASA Advises Walmart on Appropriate Opioid Treatment for Pain and Pharmacists’ Role in Safe Dispensing

On March 1, ASA engaged leaders from Walmart’s Health and Wellness Practice Compliance Division at a meeting with other medical societies in Bentonville, Arkansas. The meeting was convened through the American Medical Association (AMA) Opioid Task Force, which ASA has been a member of since 2014. David Walega, M.D., ASA’s representative to the Opioid Task Force and Vice Chair for Research and Chief of Pain Medicine in the Department of Anesthesiology at Northwestern University Feinberg School of Medicine, represented ASA. Other participants included the AMA, American Academy of Pain Medicine, American Academy of Family Physicians and the Arkansas Medical Society.

Walmart’s representatives sought feedback on how pharmacists and physicians can best work together in exercising corresponding responsibility, serve patients most effectively and mitigate diversion. The medical societies advised on red flags at the point of sale and how pharmacists can best communicate with physicians when red flags arise. There was also robust conversation about recommendations around morphine milligram equivalency (MME), high doses and prescribing patterns. ASA representative, Dr. Walega, cautioned against arbitrary prescription limits and a one-size fits all plan for patients. Instead, they explained the variability in individual patient diagnoses and treatment, recommending ways pharmacists might interpret individual patient data and how to work with other health care professionals when concerns arise.

Walmart explained how the company is taking steps to ensure patients understand how to safely use opioids, the risks associated with them and proper disposal methods. With every opioid prescription, patients receive an educational brochure, as well as the option of DisposeRx, a powder-form disposal method that sequesters opioids from abuse and pollution.

ASA is pleased Walmart, one of the largest retail pharmacy chains in the nation, was proactive in organizing this meeting to seek physician input. The Society looks forward to future collaboration around policies that put patients first and promote best practices for pain management and responsible dispensing.