British Columbia Centre on Substance Use, University of British Columbia, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
College of Pharmacy, Oregon State University/Oregon Health and Science University, Robertson Collaborative Life Science Building, 2730 SW Moody Ave, CL5CP, Portland, OR, 97201-5042, USA.
Addict Sci Clin Pract. 2019 Sep 2;14(1):30. doi: 10.1186/s13722-019-0158-0.
The global rise in opioid-related harms has impacted the United States severely. Current efforts to manage the opioid crisis have prompted a re-evaluation of many of the existing roles in the healthcare system, in order to maximize their individual effects on reducing opioid-associated morbidity and preventing overdose deaths. As one of the most accessible healthcare professionals in the US, pharmacists are well-positioned to participate in such activities. Historically, US pharmacists have had a limited role in the surveillance and treatment of substance use disorders. This narrative review explores the literature describing novel programs designed to capitalize on the role of the community pharmacist in helping to reduce opioid-related harms, as well as evaluations of existing practices already in place in the US and elsewhere around the world. Specific approaches examined include strategies to facilitate pharmacist monitoring for problematic opioid use, to increase pharmacy-based harm reduction efforts (including naloxone distribution and needle exchange programs), and to involve community pharmacists in the dispensation of opioid agonist therapy (OAT). Each of these activities present a potential means to further engage pharmacists in the identification and treatment of opioid use disorders (OUDs). Through a careful examination of these approaches, we hope that new strategies can be adopted to leverage the unique role of the community pharmacist to help reduce opioid-related harms in the US.
全球阿片类药物相关危害的增加对美国造成了严重影响。目前,为了应对阿片类药物危机,人们正在重新评估医疗体系中许多现有的角色,以最大限度地发挥它们在减少阿片类药物相关发病率和预防过量死亡方面的作用。作为美国最容易接触到的医疗保健专业人员之一,药剂师非常适合参与此类活动。从历史上看,美国药剂师在监测和治疗药物使用障碍方面的作用有限。这篇叙述性综述探讨了描述利用社区药剂师的作用来帮助减少阿片类药物相关危害的新方案的文献,以及对美国和世界各地已经实施的现有实践的评估。检查的具体方法包括促进药剂师监测阿片类药物使用问题的策略,增加以药房为基础的减少危害的努力(包括纳洛酮分发和针具交换计划),以及让社区药剂师参与阿片类激动剂治疗(OAT)的发放。这些活动中的每一项都为进一步让药剂师参与识别和治疗阿片类药物使用障碍(OUD)提供了潜在的手段。通过对这些方法的仔细研究,我们希望能够采用新的策略,利用社区药剂师的独特作用,帮助减少美国的阿片类药物相关危害。