Pharmacists should treat patients who have opioid use disorders, not police them

Abstract

Pharmacists are caught in the throes of a relentless overdose crisis that has already claimed half a million lives and threatens to claim thousands more. The addiction treatment system is fragmented and inadequate to meet demand. Few physicians provide medications for opioid use disorder (MOUDs), the most effective form of evidence-based treatment, and insufficient treatment options leave patients vulnerable to overdose.Pharmacists routinely interact with patients who have OUD but lack ways to treat them. The primary tools that pharmacists have received to curb the crisis are prescription drug monitoring programs (PDMPs), big data surveillance technologies that they can use to track patients’ medication acquisition patterns. Pharmacists like PDMPs because they help them make decisions efficiently. However, PDMPs are enforcement technologies, not health care tools; therefore, pharmacists typically use PDMPs to police patients instead of treating them. Policing patients not only fails to help combat overdose, but can also exacerbate harm.Informed by a decade’s worth of interviews with pharmacists before and after PDMP implementation, I argue that pharmacists should be better equipped to help patients with OUD. Specifically, clinical and community pharmacists should mobilize to provide MOUDs through collaborative practice agreements with physicians. Studies show that collaborative practice models are effective at reducing the risk of overdose and saving money and physicians’ time. And pharmacists have the clinical competencies necessary to provide MOUDs for patients. Pharmacists must overcome legal, economic, and interprofessional barriers to do so, but giving pharmacists the tools to treat patients will affirm their professional commitment to caring for patients and saving lives.