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The Interprofessional Role of the Pharmacists in the Opioid Epidemic

Written by Melissa Nguyen PharmD’19
Published on November 22, 2017

Pharmacists have a unique position in combating the opioid crisis due to their background in the appropriate use of medications. Many patients view physicians as their main provider when managing pain, yet pharmacists play a key role in this as well. As medication experts, pharmacists are experienced in avoiding opioid overdose and using opioids to treat pain. This blog will discuss how pharmacists can work in an interdisciplinary fashion with physicians, dentists, and physical therapists to combat the Opioid Epidemic.

The American Pharmacist’s Association has discussed achieving a proper balance when treating pain while reducing possibilities of abuse. Though it may not be easy, especially in opioid tolerant patients, balancing opioids should be considered an essential part of pharmacy practice. Pharmacists have a unique position when managing opioids to reduce the concern for tolerance and dependence leading to abuse in patients. Physicians and pharmacists can cooperate to reduce opioid dependence and pilot collaborative practice models to be used throughout the country. Pharmacists are capable of more than counseling patients behind the counter, and they should be included in the pain management team.  The Opioid Epidemic is complex and pharmacists are a critical part of its solution by effectively treating pain and reducing opioid dependence.

Pharmacists can screen for unnecessary opioid treatments, being that  not all painful conditions require an opioid. Many healthcare professionals may not be aware of the most appropriate methods to treat pain. For example, the American Dental Association considers non-steroidal anti-inflammatory agents as a first line option to treat acute pain. In the United States, dentists are right behind family physicians in the prescribing of all immediate release prescription opioids, despite this recommendation. Although dentists and pharmacists typically do not practice at the same site, their cooperation may be beneficial to decrease excessive opioid prescriptions and its potential for abuse. This may be due to an increased sense of accountability when health professionals collaborate, or recommendations provided by the pharmacists regarding patients’ allergies, dosing, and other non-opioid analgesic options.

In addition, pharmacists can also partner with physical therapists to treat pain using a non-opioid approach. In 2016, the Center for Disease Control (CDC) released guidelines on opioid prescribing. This included provisions that recommend non-opioid and non-pharmacological therapy in combination for chronic pain. When pharmacists create pain management plans, they keep in mind that opioids are not first-line for treating chronic pain. They assess non-opioid medications, its adverse effects, and non-pharmacological therapy and take them into consideration. Therefore, a physical therapist is a key element in non-pharmacological therapy. Although a patient may be apprehensive about physical therapy when their opioid medications are being reduced, strengthening their muscles is more effective in relieving chronic pain in comparison to opioids. Pharmacists and physical therapists can reduce opioid therapy by emphasizing non-opioid and non-pharmacological options.

Pharmacists can help solve the Opioid Epidemic because of their specialization in medication and its properties. They can effectively work together with multiple healthcare professionals to reduce opioid abuse while preserving pain management. Physicians have called upon increasing this inter-professional collaboration. The American Medical Association  has discussed the necessity of collaborative practice agreements and standing orders for naloxone in order to save lives. The CDC considers pharmacists to be an essential part of the healthcare team and should partner with prescribers to optimize opioid and non-opioid therapy to effectively treat pain. Needless to say, the pharmacists’ role in solving the Opioid Epidemic is crucial and multifaceted, ranging from behind the counter and with the prescriber.

Categories:  Mayes College of Healthcare Business and PolicyDepartment of Pharmaceutical and Healthcare BusinessPublic HealthHealth PolicyOpioidsSubstance Use Disorders InstituteDepartment of Health Policy and Public Health