Study Highlights Pivotal Role of Pharmacists in Opioid Use Disorder Recovery

The opioid use disorder (OUD) epidemic continues to affect millions of individuals, which creates challenges for the affected individual, their loved ones, the health care system, and society. According to the Centers for Disease Control and Prevention, in 2020, an estimated 2.7 million individuals in the United States aged 12 years and older struggled with challenges associated with OUD, and the numbers continue to expand.¹ Moreover, overdoses due to OUD have been recognized as a primary injury-related cause of death in the United States and appear to have augmented during the COVID-19 pandemic, with more than 100,000 overdose deaths reported in 2022.

When compared to standard care, the implementation of pharmacy-based care was correlated with greater rates of retention in OUD treatment, according to a recent pilot study published in the New England Journal of Medicine.² The study was a feasibility pilot trial conducted by researchers at Brown University, Rhode Island Hospital, and the University of Rhode Island from February 2021 through April 2022. The research involved 6 behavioral health pharmacies and 21 pharmacists who were trained to implement facilitated, unobserved (“take-home”) induction by the participant and to provide ongoing follow-up care at the pharmacy.

For the study, 100 patients initiated the use of buprenorphine after visiting a specially trained pharmacist. Once stabilized on buprenorphine, 58 patients were randomly assigned to receive either continued care in the pharmacy or standard care at a clinic or physician’s office. After 1 month, patients in the pharmacy care group displayed greater rates of retention. Twenty-five patients (89%) continued to receive treatment in the pharmacy, while only 5 patients (17%) continued in the standard care group.

“Pharmacists—not just physicians and clinicians at doctors’ offices—can safely and effectively start patients with opioid use disorder on lifesaving treatments without a prior visit to a physician,” the researchers noted.

In a corresponding press release,³ Traci Green, lead study author and codirector of Rhode Island Hospital’s Center of Biomedical Research Excellence on Opioids and Overdose, said, “Dramatically increasing capacity to provide good, lifesaving treatment for people with opioid use disorder through pharmacies is an approach that could be ramped up today. It is a game-changer.”

“Treatment with medications can only work if it is available and accessible in the community. Our study showed that the pharmacy treatment model increases access, which benefits a diverse patient population and increases equity,” said another author, Josiah D Rich, MD, a professor of medicine and epidemiology at Brown University. “To have so many people in the pharmacy group continue on with their care was completely unexpected. The results from this pilot study show how pharmacies can be an effective and viable pathway to treatment for opioid use disorder.”

Conclusion

As the opioid crisis persists both globally and in the United States, numerous health and professional organizations continue to implement measures to address it. Evidence demonstrates the value of a multidisciplinary approach to responding to the opioid epidemic. As front-line health care providers with drug expertise and easy accessibility, pharmacists have one of the most significant roles in addressing OUD by educating patients and intervening clinically as patients with OUD journey to recovery. Pharmacists have many roles, and if they work in conjunction with other health care providers on patient education and monitoring, maybe more patients can be helped.  

Every day, pharmacists in various health care settings continue to positively impact the health and well-being of the patients they care for. This pilot study adds to the overwhelming evidence of the valuable, evolving, and multifaceted roles of pharmacists.

References:

1. Opioid use disorder. Centers for Disease Control and Prevention. Updated August 30, 2022. Accessed January 25, 2023. https://www.cdc.gov/dotw/opioid-use-disorder/index.html
2. Green TC, Serafinski R, Clark SA, Rich JD, Bratberg J. Physician-delegated unobserved induction with buprenorphine in pharmacies. N Engl J Med. 2023;388(2):185-186. doi:10.1056/NEJMc2208055
3. Pharmacists can start patients on road to recovery from opioid use disorder, study shows. News release. Brown University. January 11, 2023. Accessed January 25, 2023. https://www.brown.edu/news/2023-01-11/pharmacy-addiction-treatment