Pharmacist Services in the Opioid Crisis: Current Practices and Scope in the United States

Introduction: Pharmacist roles promoting safe opioid use are recognized in literature and practice. Pharmacists can offer services such as counseling on opioid risks, naloxone dispensing, education on opioid storage and disposal, prescription drug monitoring program (PDMP) utilization, opioid deprescribing, and providing resources for addiction treatment to help mitigate the opioid crisis. Objective: This commentary seeks to describe current and potential roles for pharmacists to combat the United States opioid crisis and identify key factors affecting service provision. Methods: The paper summarizes evidence-based studies describing current pharmacist roles and services, factors affecting service implementation, and strategies to further improve pharmacist roles and services related to promoting safe opioid use for patients. Results: Pharmacists recognize their roles and responsibilities to counsel patients on opioid risks, dispense naloxone, educate on opioid storage and disposal, utilize prescription drug monitoring programs (PDMPs), offer opioid deprescribing, and provide resources for addiction treatment. However, pharmacists express low confidence, time, and training as barriers to service provision. This suggests a need for structured training, resources, and organizational support for pharmacists to improve confidence and participation in such services. Conclusions: Although pharmacists are aware of roles and responsibilities to help reduce the opioid crisis, more training, education, organizational support and resources are needed to increase their ability to embody these roles.

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Addressing the Opioid Epidemic: Recommended Solutions from Physicians

Qualitative Research in Medicine & Healthcare ◽

10.4081/qrmh.2020.8619 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Jessica Cataldo ◽

Sandra Collins ◽

Richard C Mckinnies ◽

Jane Nichols ◽

Thomas A Shaw

Keyword(s):

United States ◽

Active Role ◽

The United States ◽

Opioid Epidemic ◽

Opioid Misuse ◽

Opioid Use ◽

Multifaceted Approach ◽

Improve Treatment ◽

Opioid Crisis ◽

A Current

The purpose of this study was to assess physicians’ accounts related to the current opioid epidemic and to identify solutions that they feel would be most successful in addressing opioid misuse and overuse. A survey was administered a group of physicians obtained from a nationwide database. Nearly all physicians surveyed believed there was a current opioid crisis in the United States and that physicians should take an active role in addressing opioid use in patients. Four key themes emerged regarding solutions to the opioid crisis: i) policy change, ii) improve treatment, iii) education, and iv) alternative treatment. The diversity of responses highlighted the need for a multifaceted approach to address opioid misuse and abuse.

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Implications of the Opioid Crisis for the American Disability Community

Rehabilitation Research Policy and Education ◽

10.1891/re-19-25 ◽

2020 ◽

Vol 34 (4) ◽

pp. 265-274

Author(s):

Mykal J. Leslie ◽

Kathleen Sheppard-Jones ◽

Malachy L. Bishop

Keyword(s):

United States ◽

Rehabilitation Counseling ◽

The United States ◽

Opioid Use Disorder ◽

Opioid Use ◽

Research Education ◽

Opioid Crisis ◽

Increased Risk ◽

The Relationship

PurposeThe profession of rehabilitation counseling has long been responsive to emerging disabilities. To date, however, the profession's attention and response to the ongoing opioid crisis in the United States has been incommensurate with the scope and detriment of opioids and opioid use disorder (OUD) on Americans with disabilities. The opioid crisis, including the overuse, abuse, and overdose rates associated with prescription and illegal opioids, affects people of all ages and backgrounds. However, people with disabilities are at increased risk for developing OUDs, and they experience greater barriers to OUD treatment than people without disabilities.MethodThis article describes the origins and development of this crisis, the relationship between disability and increased risk for OUD, and the barriers to treatment that exist. We then evaluate the role of rehabilitation counseling, including the need for further action in advocacy, research, education, and policy.Results and ConclusionsThroughout this article, we encourage a more urgent and concerted response than seems to be the case presently.

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Adolescent-Serving Addiction Treatment Facilities in the United States and the Availability of Medications for Opioid Use Disorder

Journal of Adolescent Health ◽

10.1016/j.jadohealth.2020.03.005 ◽

2020 ◽

Vol 67 (4) ◽

pp. 542-549 ◽

Cited By ~ 4

Author(s):

Rachel H. Alinsky ◽

Scott E. Hadland ◽

Pamela A. Matson ◽

Magdalena Cerda ◽

Brendan Saloner

Keyword(s):

United States ◽

Addiction Treatment ◽

The United States ◽

Opioid Use Disorder ◽

Opioid Use ◽

Treatment Facilities

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A Public Health Strategy for the Opioid Crisis

Public Health Reports ◽

10.1177/0033354918793627 ◽

2018 ◽

Vol 133 (1_suppl) ◽

pp. 24S-34S ◽

Cited By ~ 53

Author(s):

Brendan Saloner ◽

Emma E. McGinty ◽

Leo Beletsky ◽

Ricky Bluthenthal ◽

Chris Beyrer ◽

...

Keyword(s):

Public Health ◽

Harm Reduction ◽

Addiction Treatment ◽

The United States ◽

Current Data ◽

Structural Factors ◽

Opioid Use ◽

Public Health Perspective ◽

Injury Death ◽

Opioid Crisis

Drug overdose is now the leading cause of injury death in the United States. Most overdose fatalities involve opioids, which include prescription medication, heroin, and illicit fentanyl. Current data reveal that the overdose crisis affects all demographic groups and that overdose rates are now rising most rapidly among African Americans. We provide a public health perspective that can be used to mobilize a comprehensive local, state, and national response to the opioid crisis. We argue that framing the crisis from a public health perspective requires considering the interaction of multiple determinants, including structural factors (eg, poverty and racism), the inadequate management of pain, and poor access to addiction treatment and harm-reduction services (eg, syringe services). We propose a novel ecological framework for harmful opioid use that provides multiple recommendations to improve public health and clinical practice, including improved data collection to guide resource allocation, steps to increase safer prescribing, stigma-reduction campaigns, increased spending on harm reduction and treatment, criminal justice policy reform, and regulatory changes related to controlled substances. Focusing on these opportunities provides the greatest chance of making a measured and sustained impact on overdose and related harms.

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Economic Studies on the Opioid Crisis: Costs, Causes, and Policy Responses

Oxford Research Encyclopedia of Economics and Finance ◽

10.1093/acrefore/9780190625979.013.283 ◽

2021 ◽

Author(s):

Johanna Catherine Maclean ◽

Justine Mallatt ◽

Christopher J. Ruhm ◽

Kosali Simon

Keyword(s):

United States ◽

Spillover Effects ◽

The United States ◽

Economic Research ◽

Opioid Overdose ◽

Second Phase ◽

Negative Consequences ◽

Opioid Use ◽

Opioid Prescribing ◽

Opioid Crisis

The United States has experienced an unprecedented crisis related to the misuse of and addiction to opioids. As of 2018, 128 Americans die each day of an opioid overdose, and total economic costs associated with opioid misuse are estimated to be more than $500 billion annually. The crisis evolved in three phases, starting in the 1990s and continuing through 2010 with a massive increase in use of prescribed opioids associated with lax prescribing regulations and aggressive marketing efforts by the pharmaceutical industry. A second phase included tightening restrictions on prescribed opioids, reformulation of some commonly misused prescription medications, and a shift to heroin consumption over the period 2010 to 2013. Since 2013, the third phase of the crisis has included a movement toward synthetic opioids, especially fentanyl, and a continued tightening of opioid prescribing regulations, along with the growth of both harm reduction and addiction treatment access policies, including a possible 2021 relaxation of buprenorphine prescribing regulations. Economic research, using innovative frameworks, causal methods, and rich data, has added to our understanding of the causes and consequences of the crisis. This body of research identifies intended and unintended impacts of policies designed to address the crisis. Although there is general agreement that the causes of the crisis include a combination of supply- and demand-side factors, and interactions between them, there is less consensus regarding the relative importance of each. Studies show that regulations can reduce opioid prescribing but may have less impact on root causes of the crisis and, in some cases, have spillover effects resulting in greater use of more harmful substances obtained in illicit markets, where regulation is less possible. There are effective opioid use disorder treatments available, but access, stigma, and cost hurdles have stifled utilization, resulting in a large degree of under-treatment in the United States. How challenges brought about by the COVID-19 pandemic may intersect with the opioid crisis is unclear. Emerging areas for future research include understanding how societal and health care systems disruptions affect opioid use, as well as which regulations and policies most effectively reduce potentially inappropriate prescription opioid use and illicit opioid sources without unintended negative consequences.

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