Prevention better than cure: expanding on pharmacists’ role in prescription opioid overdose and addiction management

Abstract

As prescription opioid misuse and abuse increases in prevalence, pharmacists continue to be in frontlines of prevention and therapeutic management. Pharmacists as public health practitioners should be aware of new and relevant paradigms of substance abuse research and prevention and how they can further contribute to mitigation of opioid and other substance use disorders (SUDs). Screening, brief intervention, and referral to treatment (SBIRT) is a prevention tool that has been used to identify, reduce and misuse, abuse, and dependence on substances, including drugs and alcohol. The screening and brief intervention aspects of SBIRT have been shown to be adaptable across multiple health-care settings. Techniques to conduct applicable stages of SBIRT can be learned and used by pharmacists across multiple practice areas as they engage with the public. SBIRT can be used in conjunction or as a supplementary tool to other prevention and management strategies such as the use of prescription drug monitoring programs and naloxone prescription and distribution. We make a case that pharmacists, particularly those in the community setting, who act as the entry points for many patient engagement encounters, can incorporate SBIRT into their counseling and medication therapy management workflows. As pharmacists continue the move toward codifying provider status, their expertise along with expansion of services, such as the application of SBIRT called for in this article, should be continually leveraged to increase access to treatment and services for at-risk patients with SUDs.

The Role of Pharmacists in Opioid Addiction Management

“…28,29,30 With the help of Prescription Drug Monitoring Programs (PDMPs), pharmacists are better positioned to control prescriptions and identify patients who have a higher risk of opioid addiction. 31 The PDMP enables pharmacists to screen for opioid misuse and discuss opioid-related treatment with patients. 32 In addition to PDMP, pharmacists have access to naloxone which is instrumental in reversing opioid overdose.…”

“…Prevention is recognized as instrumental in dealing with substance use disorder and addiction management and can be used as an early intervention measure to deal with opioid addiction. 31 Prevention is recognized as instrumental in delaying both the onset and progression of substance use disorders which makes it instrumental in addiction management. Successful prevention of opioid addiction and abuse can involve a number of measures including addressing risk factors, screening, education, and discouraging use among other measures.…”

“…Using models such as the Screening, Brief Intervention and Referral to Treatment (SBIRT) model as a guide to prevention can enable pharmacists to achieve optimal outcomes. 31 The model provides a comprehensive approach that allows healthcare providers to carry out screening, prevention, and timely referral to patients who have SUD. 34 The model is vital in the management of people with SUD including identifying those at risk of developing the problem.…”

“…The main aim of the brief intervention is to explore an individual's motivation to change by increasing their insight and awareness about risks associated with substance abuse. 31 Pharmacists can play this role effectively considering they are knowledgeable about the risks associated with opioid abuse. They are also better positioned to give advice to patients on the negative effects of prolonged opioid use.…”

“…For instance, it is easy to use and adaptable meaning it can be applied in different healthcare settings. 31 Providing training to pharmacists on its proper use can ensure positive outcomes in opioid addiction prevention.…”