Medication Treatment for Opioid use Disorder and Community Pharmacy: Expanding Care during a National Epidemic and Global Pandemic

Abstract

Medications for opioid use disorder (MOUD), such as methadone and buprenorphine, are effective strategies for treatment of opioid use disorder (OUD) and reducing overdose risk. MOUD treatment rates continue to be low across the US, and currently, some evidence suggests access to evidence-based treatment is becoming increasingly difficult for those with OUD as a result of the 2019 novel corona virus (COVID-19). A major underutilized source to address these serious challenges in the US is community pharmacy given the specialized training of pharmacists, high levels of consumer trust, and general availability for accessing these service settings. Canadian, Australian, and European pharmacists have made important contributions to the treatment and care of those with OUD over the past decades. Unfortunately, US pharmacists are not permitted to prescribe MOUD and are only currently allowed to dispense methadone for the treatment of pain, not OUD. US policymakers, regulators, and practitioners must work to facilitate this advancement of community pharmacy-based through research, education, practice, and industry. Advancing community pharmacy-based MOUD for leading clinical management of OUD and dispensation of treatment medications will afford the US a critical innovation for addressing the opioid epidemic, fallout from COVID-19, and getting individuals the care they need.

Clinician perspectives on methadone service delivery and the use of telemedicine during the COVID-19 pandemic: A qualitative study

“…For example, research in other countries has shown that methadone dispensing through pharmacies can be safe, effective ( Calcaterra et al, 2019 ), and increase access ( Joudrey et al, 2020 ; Kleinman, 2020 ), especially during a public health emergency when OTPs may not be adequately prepared to make alterations in care delivery. Experts in the field suggest that while the easements in policies to increase the number of take-homes is recommended in the case of emergencies, the use of alternative forms of treatment delivery are also needed ( Cochran et al, 2020 ; Green et al, 2020 ).…”

U.S. student pharmacist perceptions of the pharmacist’s role in methadone for opioid use disorder: A qualitative study

“…37 Participants in this study noted a need for collaboration with MOUD prescribers, potentially under a collaborative practice agreement, to allow patients better access to MOUD treatment. 38 Along with collaboration with prescribers, students noted that further exposure to MOUD treatment within the U.S. Doctor of Pharmacy curriculum is necessary—noting that immersion in the lived experiences of these patients would be preferential.…”

Recommendations and Guidance for Steroid Injection Therapy and COVID-19 Vaccine Administration from the American Society of Pain and Neuroscience (ASPN)

“…The opioid epidemic, in particular, has grown in magnitude in part due to restricting access to critical pain management care 35 as well as barriers to access to substance use disorder treatment. 36 As discussed above, the literature on the impact of spinal procedures on COVID-19 vaccination is supportive of concomitant virus prophylaxis and interventional pain management, although as is often the case in medicine, 100% safety has not as yet been empirically established. Undoubtedly, patients requiring spinal procedures for pain control should be provided with sufficient education that allows them to provide informed consent should they choose to pursue concomitant COVID-19 vaccination and interventional spine procedures.…”