Pharmacy personnel are under considerable stress. They also are surrounded by, and work with, substances that have the potential to be misused or abused.

Pharmacy personnel have been known to become addicted, or impaired at work. This might or might not involve them illegally diverting medications for their own personal use.

Many employers have an employee assistance program (EAP), usually an outside agency with trained professionals to assist employees with any number of problems, including personal issues, work stress problems, and disorders, such as depression, and substance abuse. Additionally, many states have programs assisting pharmacists with substance use disorders.

Researchers reviewed the prevalence of state substance use disorder (SUD) programs aimed to help pharmacy professionals, including technicians and interns, return to active practice. Their 2017 review, published in the Journal of the American Pharmacists Association, found that 46 states have such programs.

The authors provide the contact information, and model structure used by those states. They contend that frequent updating of program information is critical for those who might require assistance. They argued for the need of a central database that enables rigorous evaluation of program outcomes while protecting client anonymity.

The authors also provided information about changes in program structure over the years. In the 1990s, 25 programs were operated by state pharmacy associations; 5 were operated by the state board of pharmacy, 6 were operated by independent committees, 3 were operated by volunteer pharmacists, and 6 listed their operational model as “other.” This last category included collective health care groups, departments of professional regulation, hospital pharmacy associations, nursing programs, and nonprofit corporations. The trend over the years has shown a marked decrease in the predominant structure of state association–based programs, down from 25 to 8. The move is toward use of EAP consulting groups, specialized HMOs, and even state boards of pharmacy.

Pharmacy managers invariably face employees suffering from various personal issues that require special attention and/or counseling, and at some point will be confronted with the issue of an impaired employee. The manager must be aware of company policies if the SUD or other disorder is impacting the employee’s work, and particularly if it might compromise patient safety. The manager also must be familiar with state laws/regulations in this area.

Guided by company policy and state law, the manager must show compassion and empathy, and avail employees of resources, but also follow appropriate rules and regulations dealing with progressive discipline, if necessary. The manager must consult company policy, and state rules regarding confidentiality/privacy issues relating to employees facing such challenges, and in regard to hiring a new employee that was treated previously for an SUD and looking to regain employment.

Additional information about medication therapy management and management functions can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. You or your institution can subscribe to AccessPharmacy to access the textbook.
Shane P. Desselle, RPh, PhD, FAPhA, is Professor of Social/Behavioral Pharmacy at Touro University California. He is author of Chapter 1: The “Management” in Medication Therapy Management and Management Functions in the textbook Pharmacy Management: Essentials for All Practice Settings, 5e.

Light KE, Goodner K, Seaton VA, et al. State programs assisting pharmacy professionals with substance use disorders. J Am Pharm Assoc. 2017;57:704-710.