To recognize National PTSD Awareness Month in June, 

 interviewed Jordan Tishler, MD, president of the Association of Cannabis Specialists, faculty at Harvard Medical School, and a cannabis specialist at inhaleMD, on how medical cannabis can be used to treat post-traumatic stress disorder (PTSD) among veterans and the general public.

During the discussion, Tishler explained what PTSD is and how it can impact the daily life of people living with the disorder.

Additionally, Tishler addressed how, although PTSD is commonly associated with veterans, the disorder is by no means exclusively present in this population. PTSD can affect a wide swath of individuals outside of the veteran population as well.

“PTSD is only the latest historical term for the kind of psychological damage that we see from wartime events, and as a result there's a lot of awareness of PTSD in the veteran population, and a fair bit of research into veteran PTSD, as well as cannabis use in the veteran PTSD population,” Tishler said. “But certainly, it is not the only population that is affected. We certainly see PTSD develop in rape survivors, for example, and people who've had traumatic or abusive childhoods.”

In light of the broad impact of PTSD on the lives of people suffering from the disorder, Tishler highlighted the importance of developing multiple treatment options in order to increase the likelihood of positive patient outcomes.

“I think any illness that is disruptive to people's lives is important, and PTSD is certainly disruptive,” Tishler said. “There are a number of treatments from the pharmacologic side of things, as well as psychological, like cognitive behavioral therapy, all of which have a place in treating this particular kind of illness. And for many people, these can be successful, but the success rate isn't as good as we would like it to be.”

Tishler noted that cannabis is capable of adding to the arsenal of treatments that can help to interrupt the cycle that people with the disorder often experience, which can include being triggered by internal or external events as they arise.

“This constellation of symptoms, whether it's the hyper vigilance or awakening from dreams, those sorts of things cannabis sort of blocks and the effects are rather broad,” Tishler said.

Tishler also addressed how cannabis can specifically help to treat patients with PTSD neurologically and some best practices around developing a treatment plan that incorporates cannabis therapy for a patient with PTSD.

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To recognize National PTSD Awareness Month in June, Pharmacy Times interviewed Jordan Tishler, MD, on how medical cannabis can be used to treat PTSD among veterans and the general public.

Expert: Cannabis Therapy Can Help Disrupt the Cycle for Patients with PTSD

 interviewed Susan Lang, MA, MBA, CEO of XIL Health and former senior executive at Express Scripts, on some of the ways pharmacies have been affected by the COVID-19 pandemic over the past year.

 What are some other ways pharmacies have been affected by the COVID-19 pandemic over the past year?

So, I think there are some really positive things that have come out of the pandemic. So, let's just talk about who is caring for Americans that are taking pharmaceutical drugs medicines.

In the United States, we're very high utilizers of drugs. This is a country that has an enormous work ethic and sort of this cultural attitude of you never give up, which means even when we're hurt or we don't feel well, we just keep working. So that's just sort of a normal part of American life.

We have about 60,000 pharmacies in the United States. So, 65,000 pharmacies, I think, really stepped up to the plate in a way that if we had just focused on hospital systems—which I ran hospital systems for 21 years, so very familiar with that system—but if we just focused on hospital systems, we could not have gotten out these shots everywhere that you could possibly think of, including to long-term care, to facilities that are typically underserved by hospital systems and clinics.

So, I think that's been a tremendously positive thing for pharmacies, for all of us to realize how critically important your pharmacist is in your care. So, that's one thing that has happened that I think actually would have taken years for folks to really understand how important they are in the supply of critical care.

I think the second issue is I think it's made pharmacies realize that they've got to rethink their business model. So, what's happening overall in the industry is the medical and the pharmacy benefits are blurring—they're merging together.

So, in this case, you have the blurring, also you have administration of a drug, which could be on the medical side, could be on the pharmacy side, and then you have the drug itself and the supply chain.

So, I think what they're looking at now is this is going to keep pushing them to rethink the business model and rethink about how do they actually offer services to the public to fill gaps in care that are out there everywhere, and manage populations that they might not have realized in the past.

So, I think those are going to be 2 critically strategic issues that are happening, and we'll have ongoing influences really on how pharmacies not only see their role but how the public will view them in terms of giving care overall.

Susan Lang, MA, MBA, CEO of XIL Health and former senior executive at Express Scripts, on some of the ways pharmacies have been affected by the COVID-19 pandemic over the past year.

Expert: COVID-19 Pandemic Has Pushed Pharmacies to Fill Gaps in Care, Rethink Business Model

Because health care is a constantly evolving field, research pharmacist Brian Wortz, PharmD, of Cancer Treatment Centers of America, said pharmacists must be aware of the newest findings and how they could impact their patients. Not only is this important, but Wortz said that pharmacists are perfectly positioned to be at the forefront of pharmaceutical research.

Because health care is a constantly evolving field, research pharmacist Brian Wortz, PharmD, of Cancer Treatment Centers of America, said pharmacists must be aware of the newest findings and how they could impact their patients.

Following Clinical Research is Essential for Practicing Pharmacists

Pharmacy Times spoke to Dr.Douglas Scharre, neurologist and director of the division of Cognitive Neurology at Ohio State Wexner Medical Center, about the latest FDA approved drug for Alzheimer disease.

Pharmacy Times spoke to Dr. Douglas Scharre, neurologist and director of the division of Cognitive Neurology at Ohio State Wexner Medical Center, about the latest FDA approved drug for Alzheimer disease.

What To Know About Aducanumab and Slowing the Progression of Alzheimer Disease

 interviewed Jay Lieberman, MD, a pediatric infectious disease specialist and the senior medical director of PRA Health Sciences, on the value of the pharmacist in administering COVID-19 vaccines to adolescents and children.

Lieberman was a speaker at the World Vaccine Congress in a session on COVID-19 disease and vaccines for adolescents and children, specifically in light of his unique perspective on the subject due to having enrolled his twin daughters in the Moderna COVID-19 vaccine trial.

In your opinion, what is the value of the pharmacist in administering vaccine during the COVID-19 pandemic to children and adults?

 Yeah, I think pharmacists and pharmacies can play a very, and are playing a very, important role in vaccinating individuals against COVID-19.

To continue the family affair here, my wife is a hospital pharmacist, and when the vaccine first got licensed, obviously, she got herself vaccinated. She was first in line.

But she also made it her personal mission to vaccinate as many people as possible. That meant learning the systems, and there were challenges in getting in the queue to get back to various sites, and it varied city by city, county by county, state by state.

She worked hard, including waking up at 3 am sometimes to get a family member who was eligible to be vaccinated an appointment at CVS, for example, and so she made that her personal mission.

In addition, she's worked well more than a dozen clinics now in her hospital at community sites. She was at Disneyland administering vaccine. She recruited friends of hers, fellow pharmacists, physicians, nurses to set up a clinic at the site. As a result, I mean thousands of people who would not have been vaccinated that day were able to get vaccinated.

So, the when the rollout first started for vaccination, a lot of it was obviously big pods, big sites. But it's now moved into pharmacies, and finally into physicians’ offices.

So, improving access and people know their local pharmacy, they go there—having access there is a tremendous advance. We want to make it easy for people to be able to get vaccinated.

Absolutely. On that note, do you think children would feel safe, or I mean, potentially not if Disneyland is the other option, but potentially safer than maybe certain mass vaccination sites at their local pharmacy versus some of these other locations?

 Yeah, again, it's what's easily accessible. Where do people feel comfortable? Obviously, pharmacies play an important role in vaccinating adults against influenza, pneumonia, and shingles, and I think COVID-19 fits in very nicely.

So, again, having local access, convenient access enhances the ability for people to get the vaccine when they want it.

Right. What are your hopes for the future in regard to COVID-19 vaccine development and administration among adolescent and children populations?

 Yeah. So, first, I'd comment that obviously in the United States, we've made tremendous progress in reducing the incidence of COVID-19. It's important to understand and recognize that that success is almost entirely due to vaccination.

So, the issue we have now is to increase vaccination rates among adults and now teenagers in the United States who, for whatever reason, might have been hesitant or waiting.

We've got to expand vaccination to younger ages, so in addition to the 12-year-old daughters, we've got a 9-year-old and a 7-year-old, and we want them vaccinated as well.

Again, vaccinating them protects them, it protects us, it protects the people we care about, and allows them to be going back to doing the things that children and teenagers should do.

 I also just mentioned how successful we've been in the United States. Unfortunately, not everybody in the world has access, and there are just tragedies ongoing in many parts of the world.

So, vaccines have to get out to them as well. It's not only the right thing to do, the ethical thing to do, the humanitarian thing to do, but it also helps protect us because this virus is global.

The more the virus is allowed to circulate unchecked in communities, the greater the likelihood of new variants emerging. So, we're feeling pretty comfortable in the United States right now, and hopefully things will continue to go smoothly, but it'd be a mistake to say we're done.

Again, the path out is vaccines, and it's got to be global. So, that's the hope for the future, and hopefully for the near future.

Yeah, absolutely. Thank you so much for taking the time to speak with me today, Dr. Lieberman.

 Alana, thank you very much. Really appreciate it.

Jay Lieberman, MD, a pediatric infectious disease specialist and the senior medical director of PRA Health Sciences, discusses the value of the pharmacist in administering COVID-19 vaccines to adolescents and children.

Expert: With Pediatric COVID-19 Vaccinations, ‘It'd Be a Mistake to Say We're Done’

In his work with Cancer Treatment Centers of America, research pharmacist Brian Wortz, PharmD, specializes in oncology clinical research. In an interview with 

Wortz said he enjoys the innovation in his research, especially when their findings have the potential to drastically impact patients’ lives.

In an interview with Pharmacy Times, Brian Wortz, PharmD, said he enjoys the innovation in his research, especially when their findings have the potential to drastically impact patients’ lives.

Oncology Space Provides Dynamic Opportunities for Research Pharmacists

Evinacumab-dgnb (Evkeeza; Regeneron Pharmaceuticals, Inc.) was approved earlier this year as an adjunct to other low-density lipoprotein cholesterol (LDL-C) lowering therapies to treat patients aged 12 years and older with homozygous familial hypercholesterolemia (HoFH). According to Regeneron, evinacumab-dgnb is the first FDA-approved treatment that binds to and blocks the function of angiopoietin-like 3 (ANGPTL3), a protein that plays a key role in lipid metabolism.

HoFH, also known as homozygous FH, is an ultra-rare inherited condition that affects approximately 1300 patients in the United States HoFH occurs when 2 copies of the familial hypercholesterolemia (FH)-causing genes are inherited, 1 from each parent, resulting in dangerously high levels (>400 mg/dL) of LDL-C. Patients with HoFH are at risk for premature atherosclerotic disease and cardiac events as early as their teenage years.

Evinacumab-dgnb is the first FDA-approved treatment that binds to and blocks the function of angiopoietin-like 3, a protein that plays a key role in lipid metabolism.

Pharmacist Medication Insights: Evinacumab-dgnb for High Cholesterol

Working in clinical research combines skills from both the retail and health system pharmacy spaces, as well as other, more unique skillsets, according to research pharmacist Brian Wortz, PharmD, of Cancer Treatment Centers of America, in an interview with 

All pharmacists have responsibilities around inventory, storage, and other day-to-day concerns, but Wortz said research pharmacists also must view these issues through the lens of protocol rules established by the trial sponsors. They must also consider emerging safety concerns or adverse effects that were previously unknown in the drugs they are researching.

Working in clinical research combines skills from both the retail and health system pharmacy spaces, as well as other, more unique skillsets, according to research pharmacist Brian Wortz, PharmD, of Cancer Treatment Centers of America, in an interview with Pharmacy Times. 

Research Pharmacists Have Unique Responsibilities

Several third-year pharmacy students at the Washington State University College of Pharmacy and Pharmaceutical Sciences said they were involved with COVID-19 testing and vaccination efforts, including organizing mass vaccination events and testing patients in their communities.

For example, although he lives further away from the main campus in Spokane, Trevor Schultz said he has gotten involved through his internship position. Schultz said he has worked with his mentor to launch vaccination efforts in his community and added that he volunteered over winter break to get the first clinic up and running.

Pharmacy Students Were Crucial to COVID-19 Testing, Vaccination Efforts

 interviewed Jonathan Spicer, MD, associate professor of surgery at McGill University and medical director of the McGill University Health Center Thoracic Oncology Network, on his presentation at the 2021 American Society of Clinical Oncology Annual Meeting on surgical outcomes from the phase 3 CheckMate 816 trial assessing nivolumab plus platinum-doublet chemotherapy (chemo) vs chemo alone as neoadjuvant treatment for patients with resectable non-small cell lung cancer.

During the discussion, Spicer addresses what is still needed to be investigated for future research on this topic, and how this research is important to the field.

 Well, I think there's always the need for more research. Even though we're excited about these new findings, we know that we're a long way from fixing all the problems.

I think with about a quarter of patients—and it's important to remember that this is an intent-to-treat basis, so even people who didn't make it to surgery are in that denominator, which means that the actual number who had complete responses may actually be higher, but I think the conservative estimate of 25% of people having no detectable tumor cells that are still alive in the resected specimen tumor and lymph nodes is a very important finding. We need to figure out how to predict that.

Since other studies have shown that this might occur in as many as 60% of people, really finding out what that real number is with more of these similar studies that will be coming out over the coming years—being able to predict that event so maybe one day we may not need to consider surgery or we may be able to significantly curtail the extent of the operation or other ways of knowing whether the patient has had a complete response or not—I think these are really the key questions.

Local therapy generally brings consequences, morbidity, function loss, and so if we can find ways of reducing the need for that, I think that would be valuable to patients.

Jonathan Spicer, MD, medical director of the McGill University Health Center Thoracic Oncology Network, discusses what is still needed to be investigated in the future following the phase 3 trial assessing nivolumab plus platinum-doublet chemotherapy as neoadjuvant treatment for resectable non-small cell lung cancer.