Pharmacists Can Impact Opioid Dependence Crisis

Pharmacists are an important but underutilized resource in the fight against prescription drug abuse, according to an expert in addiction pharmacy. Merrill Norton, Pharm.D., D.Ph., ICCDP-D, Clinical Associate Professor of the University of Georgia College of Pharmacy, is spearheading a movement to train pharmacists in substance abuse treatment, so they can recognize patients struggling with substance abuse and get them the help they need.

“Most colleges of pharmacy have very little to do with substance abuse,” said Dr. Norton, who is dually credentialed in addiction pharmacy and addiction counseling. “If we can train pharmacists, we could have another 100,000 individuals available to the public to help get people into treatment.”

Dr. Norton spoke about pharmacists’ role in impacting the opioid dependence crisis at the recent annual meeting of the American Association for the Treatment of Opioid Dependence.

Pharmacists face a number of challenges in trying to address opioid dependence, Dr. Norton says. The most pressing one is time. If a pharmacist suspects a patient is abusing opioids, it takes time to talk about treatment options. “The majority of community pharmacists are simply overwhelmed—they don’t have enough time.”

In addition, many pharmacists today don’t know their patients, making it more difficult to judge their behavior. “Community pharmacists used to know their patients,” Dr. Norton says. “Now everybody moves and people who are doctor shopping are also pharmacy shopping.”

Another challenge is knowing what the available treatment options are, and which ones are most appropriate for which patients. Most pharmacists are not aware of the many treatment options and the differences between them, Dr. Norton notes.

One positive development has been prescription data monitoring programs, which have made it easier for pharmacists in situations in which they suspect a patient may be abusing opioids, Dr. Norton says. “Now, if you think there’s something not right about a prescription, you can check the database and see if anything is out of line. It takes the judgment out of your hands. There’s a law that tells you to report anything that’s not right.”

Dr. Norton hopes a free three-hour continuing education program run by the University of Georgia College of Pharmacy, funded by the Georgia Prescription Drug Abuse Prevention Initiative, will be a model for other pharmacy schools to teach pharmacists about recognizing and dealing with prescription drug abuse. “We cover how you talk to an individual you suspect of abusing prescription drugs, and where you can make referrals,” he says.

The course teaches pharmacists about the problem of prescription drug abuse, describes the role of the pharmacist in prescription drug abuse prevention, and identifies the latest trends and obstacles in managing prescription drug abuse.

Dr. Norton is also developing an addiction pharmacy residency program at the University of Georgia that he hopes will be a model for other schools. “I want my students to know about the various models of opioid treatment, and where patients may fit into all of those models.”

On a national level, the College of Psychiatric and Neurologic Pharmacists is creating a Substance Abuse Task Force to address issues including buprenorphine prescribing and rescue of overdose victims with the opioid overdose antidote naloxone.

Says Dr. Norton, “With proper training, pharmacists can have a big impact on the opioid dependence crisis.”