Tip of the Week: Using Effective Management to Combat Substance Use Disorder and Other Public Health Concerns

The ability of pharmacists in the United States to dispense naloxone in many states could be a considerable help for this public health problem.

Pharmacists are in position to be among the most important public health leaders. Substance use disorder has been a concern for decades, and the misuse of opioids has already exacerbated an enormous toll on the lives of Americans. This includes abuse of both illicit substances and prescription medications initially prescribed with benevolent intentions. The ability of pharmacists in the United States to dispense naloxone in many states could be a considerable help for this public health problem. However, uptake of pharmacists doing so is still far from maximized.

Investigators conducted a study to learn more about how pharmacists can support a sustainable approach to providing naloxone in the community, with results published in Research in Social and Administrative Pharmacy.1 The authors describe factors currently known, or at least strongly suspected, to impact the uptake of pharmacy-based naloxone (PBN) dispensing, including number of full-time pharmacists at a location, adequacy of pharmacist training, and time constraints. Their study undertook interviews of pharmacy leaders to help better understand how pharmacy staff can optimize PBN.

Their interviews uncovered 5 themes, as follows:

  1. Importance of staff training: to mitigate hesitance in its dispensing and encourage staff to ask questions;
  2. Strength through coordination of efforts: strengthening partnerships with hospital emergency departments, substance use disorder clinics, insurers, employers, and regulators;
  1. Taking a community leadership role: pharmacy as a profession and pharmacy organizations strengthen their organizational cultures to address this community health concern;
  2. Persisting stigma: ongoing attitudes that substance abusers to not “deserve” treatment; and
  3. Ongoing workflow challenges: inability to bill for services, and not having the right people positioned to receive patients presenting with substance use disorder.

The results of this study highlight the importance of pharmacy leadership and effective management. As the authors suggest, changes must be made at the staff, process, and organizational levels. Pharmacy managers and executive team members must examine their organizational philosophy to include a more public health-oriented mission. This includes paying more than just lip service to the problem; thus, training personnel, helping them seek proper continuing education and professional development, and positioning them in workflow operations so that health professionals can meet head on this, and other, public health problems. Needed organizational changes is another example of an unmet need for which pharmacy can stake a claim in its pursuit of better patient outcomes.

Additional information about Organizational Structure and Behavior and Value-Added Services as a Component of Enhancing Pharmacists’ Roles in Public Health in Pharmacy Management: Essentials for All Practice Settings, 5e.

Shane P. Desselle, RPh, PhD, FAPhA, Professor Social/Behavioral Pharmacy at Touro University California in Vallejo.

REFERENCE

Donovan E, Bratberg J, Baird J, Burstein D, et al. Pharmacy leaders’ beliefs about how pharmacies can support a sustainable approach to providing naloxone to the community. Res Social Adm Pharm. 2020;16(10);143-1497.