Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders

Abstract

The global rise in opioid-related harms has impacted the United States severely. Current efforts to manage the opioid crisis have prompted a re-evaluation of many of the existing roles in the healthcare system, in order to maximize their individual effects on reducing opioid-associated morbidity and preventing overdose deaths. As one of the most accessible healthcare professionals in the US, pharmacists are well-positioned to participate in such activities. Historically, US pharmacists have had a limited role in the surveillance and treatment of substance use disorders. This narrative review explores the literature describing novel programs designed to capitalize on the role of the community pharmacist in helping to reduce opioid-related harms, as well as evaluations of existing practices already in place in the US and elsewhere around the world. Specific approaches examined include strategies to facilitate pharmacist monitoring for problematic opioid use, to increase pharmacy-based harm reduction efforts (including naloxone distribution and needle exchange programs), and to involve community pharmacists in the dispensation of opioid agonist therapy (OAT). Each of these activities present a potential means to further engage pharmacists in the identification and treatment of opioid use disorders (OUDs). Through a careful examination of these approaches, we hope that new strategies can be adopted to leverage the unique role of the community pharmacist to help reduce opioid-related harms in the US.

Meeting people where they're at: A focus on pharmacist harm reduction roles in the opioid crisis

“…As written in the American Pharmacists Association 2019 policy, “Patient‐Centered Care of People Who Inject Non‐Medically Sanctioned Psychotropic or Psychotropic Substances,” pharmacists can and should sell nonprescription syringes, offer syringe disposal, distribute fentanyl test strips, administer immunizations, recommend, and prescribe pre‐ and post‐exposure prophylaxis medications for human immunodeficiency virus (HIV), offer point‐of‐care testing for HIV and hepatitis C virus (HCV), besides dispensing opioid overdose reversal and OUD medications . Pharmacists can learn more about harm reduction roles through the recorded webinar, “Opioid Harm Reduction,” available in the ACCP Ambulatory Care Self‐Assessment Program (ACSAP) Book 3, Neurologic Care and Management , and several other publications . Table summarizes some of these harm reduction interventions, solutions, and implementation strategies.…”

Pharmacy stakeholder reports on ethical and logistical considerations in anti-opioid vaccine development

“…While there are multiple stakeholders who likely have differing positions on these ethical and logistical concerns, front-line practitioners represent an intriguing initial population to survey, as they are in a relatively central position of influence in regard to eventual treatment implementation. Traditionally, the opinions of front-line practitioners and other relevant stakeholders, such as patients, have been delayed until later stages of medication development [ 22 – 25 ]. The near-exclusive reliance on scientific expertise during early phases runs the risk of overweighting this groups’ collective opinion in ethical and logistical areas, where their technical expertise may be irrelevant.…”

Community Pharmacists' Roles in Optimising Opioids Therapy for Chronic Non-malignant Pain Patients: a Qualitative Study.

“…Studies in the USA and the UK suggest community pharmacists have constructive attitudes toward pharmacy-based screening and intervention to reduce substance use disorder [13,14]. However, little is known about community pharmacists' experiences as the literature that focuses on their role in relation to optimisation of prescribed opioids and addresses the pharmacists' perspective in the UK is sparse.…”