Research Priorities for Expansion of Opioid Use Disorder Treatment in the Community Pharmacy

Abstract

In the last decade, the U.S. opioid overdose crisis has magnified, particularly since the introduction of synthetic opioids, including fentanyl. Despite the benefits of medications for opioid use disorder (MOUD), only about a fifth of people with opioid use disorder (OUD) in the U.S. receive MOUD. The ubiquity of pharmacists, along with their extensive education and training, represents great potential for expansion of MOUD services, particularly in community pharmacies. The National Institute on Drug Abuse’s National Drug Abuse Treatment Clinical Trials Network (NIDA CTN) convened a working group to develop a research agenda to expand OUD treatment in the community pharmacy sector to support improved access to MOUD and patient outcomes. Identified settings for research include independent and chain pharmacies and co-located pharmacies within primary care settings. Specific topics for research included adaptation of pharmacy infrastructure for clinical service provision, strategies for interprofessional collaboration including health service models, drug policy and regulation, pharmacist education about OUD and OUD treatment, including didactic, experiential, and interprofessional curricula, and educational interventions to reduce stigma towards this patient population. Together, expanding these research areas can bring effective MOUD to where it is most needed.

Perspectives on Admissions and Care for Residents With Opioid Use Disorder in Skilled Nursing Facilities

“…28 The proposed federal Modernizing Opioid Treatment Access (MOTA) Act of 2023, which would allow methadone to be prescribed and dispensed outside certified opioid treatment programs, could enhance MOUD access in SNFs by allowing pharmacy-based methadone for OUD. 29,30 Therefore, SNF residents stand to benefit from permanent methadone reforms that eliminate regulatory barriers to accessing treatment. 31 Second, interviews identified concerns about the age of residents with OUD; these concerns were based on past experience and overlapped with stigma-driven concerns in many interviews, revealing a convoluted amalgam of attitudes.…”

“…Specifically, the delivery of predosed methadone to SNFs by CODAC (the largest provider of behavioral health care in Rhode Island) and telehealth through the state’s 24/7 buprenorphine hotline were noted as resources . The proposed federal Modernizing Opioid Treatment Access (MOTA) Act of 2023, which would allow methadone to be prescribed and dispensed outside certified opioid treatment programs, could enhance MOUD access in SNFs by allowing pharmacy-based methadone for OUD . Therefore, SNF residents stand to benefit from permanent methadone reforms that eliminate regulatory barriers to accessing treatment …”

“… 28 The proposed federal Modernizing Opioid Treatment Access (MOTA) Act of 2023, which would allow methadone to be prescribed and dispensed outside certified opioid treatment programs, could enhance MOUD access in SNFs by allowing pharmacy-based methadone for OUD. 29 , 30 Therefore, SNF residents stand to benefit from permanent methadone reforms that eliminate regulatory barriers to accessing treatment. 31 …”