Pharmacists’ Attitudes Toward Naloxone and Medications for Opioid Use Disorder
Pharmacists are trusted health care providers who play an important role in educating and caring for patients, including those with substance use disorders.
Increasingly, pharmacy organizations have been advocating for pharmacists to have increased involvement in providing care for patients at risk of an opioid overdose and with an opioid use disorder (OUD).
There are many ways pharmacists can help, including:
- educating patients about proper storage and disposal of opioids and side effects;
- using prescription drug monitoring data systems;
- alerting prescribers about patients’ prescriptions, misuse, and complex medication interactions that could increase overdose risk;
- dispensing prescribed medications for opioid use disorder treatment like buprenorphine and naltrexone;
- dispensing naloxone to patients and caregivers and educating them about opioid overdose and naloxone use.
Pharmacy organizations have also begun campaigning to expand pharmacists’ role in OUD care by waivering them to prescribe buprenorphine, and some discussion has been had around including pharmacies as methadone dispensing sites as well. However, as organizations consider these expanded roles, getting a better sense of pharmacists’ attitudes toward OUD-related medications is needed.
As part of NIDA Clinical Trials Network protocol CTN-0075, this scoping literature review aimed to identify, evaluate, and summarize published literature describing pharmacists’ attitudes toward naloxone, methadone, buprenorphine, and naltrexone.
A total of 1323 articles were identified in major scientific literature databases, with 7 meeting the specific inclusion criteria (original U.S. research, about pharmacists’ attitudes toward naloxone and OUD medications).
The studies revealed that pharmacists were generally supportive of naloxone dispensing, though some were not comfortable giving out naloxone without a physicians’ prescription or as part of a provider’s care plan. They were also very supportive of dispensing buprenorphine; however, nearly 60% of respondents in one study had refused to fill a buprenorphine prescription greater than 1 to 2 times per week, largely because of fear of diversion or misuse.
For both naloxone and buprenorphine, pharmacists reported a need for additional education and training, increased time for interacting with patients, support from management, and integration of medication dispensing and patient counseling into their existing workflows. Pharmacists also need better awareness about standing order laws for naloxone.
Studies included in the review revealed that education and training in particular was associated with increased comfort, confidence, and willingness of pharmacists to work with patients filling prescriptions for naloxone or buprenorphine.
Conclusions: Overall, pharmacists were positive in their attitudes toward increased practice responsibilities for patients at risk of an opioid overdose or with opioid use disorder. Pharmacists must receive more training and education to be current in their understanding of OUD medications, and they must be supported in order to provide effective care to this patient population.
Citation: Muzky A, et al. Pharmacists’ Attitudes Toward Dispensing Naloxone and Medications for Opioid Use Disorder: A Scoping Review of the Literature. Substance Abuse 2019 (in press).