The Role of the Pharmacist in Combating the Opioid Crisis: An Update

Abstract

The opioid overdose crisis has claimed hundreds of thousands of lives in the United States in the last decade, with overdose numbers continuing to climb. At the same time, the role of the pharmacist in combating the opioid crisis continues to evolve. Methods: A literature search was conducted in Ovid MEDLINE that incorporated both MeSH terms and keywords to describe two concepts: the opioid epidemic and pharmacists/pharmacies. The search was limited to articles published after 2010 through the end of 2021 and returned 196 articles that were analyzed thematically. Results: Thematic analysis revealed the following themes: prevention, interventions, public health role of the pharmacist, pharmacists in multiple roles, barriers, pharmacist and healthcare provider attitudes, educational initiatives for pharmacists and student pharmacists, and future research. Discussion: While a great deal of progress has been made in the role of the pharmacist in supporting individuals with opioid use disorder (OUD) in the last two decades, pharmacists must seek to invest time and resources into practices with a strong evidence base to better mitigate the growing, devastating impact of the opioid crisis. Pharmacists must be willing to embrace new and non-traditional roles in patient care, service and research, and seek to advance evidence-based knowledge and practice. Conclusion: Pharmacy practice has expanded greatly in the past decade with pharmacists taking on new and creative approaches to addressing the opioid crisis. Collaborative and interdisciplinary approaches to addressing the root causes of opioid misuse and opioid overdose are still desperately needed. These include attention to the critical roles of social determinants of health, stigma elimination, legislative advocacy for patients with OUD, and focused education for providers, pharmacists, and the community. Recognition and support of the value of collaboration to both improve public health and individual patient care, continued investments in pharmacy practice advancement in OUD treatment and harm reduction, and the creation of workflows and prescribing algorithms to assist in dosing medications to prevent withdrawal symptoms and achieve improved pain control are desperately needed.

Role of Board‐Certified Psychiatric Pharmacists in child and adolescent psychiatry

“…38,39 Pediatric guidelines provide recommendations for the frequency of metabolic monitoring among youth prescribed atypical antipsychotics. 39 According to the NCQA, only 35.6% (Commercial HMO), 34.6% (Commercial PPO), and 36.6% (Medicaid HMO) of children and adolescents prescribed antipsychotics received the recommended annual metabolic monitoring in 2021, with national averages between 30% and 38% since 2015. 35 In collaboration with child psychiatrists and pediatricians, BCPPs can play an essential role in optimizing metabolic monitoring through participation in CMM, psychotropic stewardship, and primary care education via collaborative education models (e.g., Extension for Community Health Outcomes [ECHO], The REsource for Advancing Children's Mental Health [REACH] Institute).…”

“…Routine metabolic monitoring is crucial because children and adolescents are more susceptible to the metabolic effects of atypical antipsychotics than adults, including a threefold risk of developing type 2 diabetes, weight gain, and dyslipidemia 38,39 . Pediatric guidelines provide recommendations for the frequency of metabolic monitoring among youth prescribed atypical antipsychotics 39 .…”

“…Routine metabolic monitoring is crucial because children and adolescents are more susceptible to the metabolic effects of atypical antipsychotics than adults, including a threefold risk of developing type 2 diabetes, weight gain, and dyslipidemia 38,39 . Pediatric guidelines provide recommendations for the frequency of metabolic monitoring among youth prescribed atypical antipsychotics 39 . According to the NCQA, only 35.6% (Commercial HMO), 34.6% (Commercial PPO), and 36.6% (Medicaid HMO) of children and adolescents prescribed antipsychotics received the recommended annual metabolic monitoring in 2021, with national averages between 30% and 38% since 2015 35 …”

IPEx: A gamification tool for learner application of pharmacologic principles of opioid use, misuse, and addiction

“…Despite lack of evidence or proven efficacy, opioids are often prescribed to treat chronic pain 1 . Moreover, abuse of opioids continues to surge 2 .…”

“…Despite lack of evidence or proven efficacy, opioids are often prescribed to treat chronic pain. 1 Moreover, abuse of opioids continues to surge. 2 Overdose deaths involving opioids increased by 56% from 2019 to 2020.…”