The Role of Pharmacists in Fighting Substance Abuse
Every year, the month of September is designated by the Substance Abuse and Mental Health Services Administration as National Recovery Month. This year marks the 30th year of Recovery Month recognition with the theme “Join the Voices for Recovery: Together We Are Stronger."
A supportive community is key to the foundation of a substance-free society. In my personal experience, I have seen strong communities and locally available resources help reduce the risk of substance abuse. In cases when substance abuse does occur, local support can help drive a faster and smoother path to recovery. Different members of the community play different roles in recovery and prevention of substance abuse; one role that is not always considered, but can act as a first line of defense, is that of the pharmacist.
According to the Centers for Disease Control and Prevention (CDC), between July 2016 and September 2017, emergency department visits related to opioid overdoses increased a whopping 30 percent. Pharmacists are most often the first healthcare professional or person in general to identify potential or chronic substance abuse cases. For this reason, they’re well-positioned to play a crucial role in fighting substance abuse through prevention, education, and awareness of assistance programs.
Here are a few ways the community pharmacist can be an agent of change in the fight against substance abuse:
Prevention with Awareness: The first step towards change starts with awareness. As a pharmacist, it’s critical to keep up to date on the latest federal and state rules and regulations as well as treatment guidelines around both prescription and non-prescription drugs of abuse. Pharmacists should also recognize a patient’s total opioid daily dose and calculate the morphine milligram equivalent (MME) to track when high dose opioids are being utilized. The opioid dose and how long a patient takes it highly correlates to risk of opioid use disorder, a type of substance abuse. Some helpful resources that can be reviewed and accessed online include:
- ASHP’s Guidelines on Perioperative Pharmacy Services
- CDC Guideline for Prescribing Opioids for Chronic Pain
- Opioid Use and Misuse Resource Center
Identification: Another powerful tool for controlling substance abuse starts with recognizing the patient and understanding their needs. This can be done by asking open-ended questions, verifying the prescription and identity/address of the patient. Some potential red flags for abuse are: early drug refill requests, prescriptions from different prescribers, lying on lost prescriptions, pre-existing psychiatric conditions, and cash payment. Also, examine the patient’s pharmacy and medical claims history to identify risk factors for abuse. You can find more information about identifying substance abuse here.
Education and Assistance: Pharmacists can also play the role of moderator and facilitator to the potential or chronic substance patient. Talking, educating and cautioning patients about the risk of substance abuse and opioid overuse disorder and holding patients accountable for their course of treatment can help prevent substance abuse before it starts. Speak to patients openly and encourage them to ask questions about their medications and about the risk of addiction and abuse. Provide them with reputable online resources for additional information: Medication Assisted Treatment, Substance Abuse and Mental Health Services Administration, National Institute on Drug Abuse.
A pharmacist is only one of many people in the lives of individuals who might find themselves vulnerable to substance use and abuse, but they also have opportunities for intervention that others may not have. Thoughtful attention and discussion are powerful tools in the right hands. Recovery Month is a great time to think about the impact pharmacists can have as members of the community.