Indian Health Service pharmacists engaged in opioid safety initiatives and expanding access to naloxone

J Am Pharm Assoc (2003). 2017 Mar-Apr;57(2S):S135-S140. doi: 10.1016/j.japh.2017.01.005.

Abstract

Objective: To develop effective pharmacy-based interventions to mitigate harm from opioid use disorders. Programs include responsible opioid prescribing, expanded access to medication-assisted treatment (MAT), naloxone, and community interventions.

Setting: Clinical pharmacists practicing at Indian Health Service (IHS) locations in the Southwest, Midwest, and Great Lakes regions. These pharmacists serve culturally diverse American Indian populations throughout the United States and interface with tribal and federal programs to impact the opioid epidemic in Indian Country.

Practice description: Pharmacists have reduced barriers to care by expanding clinical practices to include novel approaches in pain management clinics and MAT programs.

Practice innovation: As part of a multidisciplinary team, IHS pharmacists provide comprehensive patient care while focusing on the prevention of opioid dependence and opioid overdose death.

Evaluation: Pharmacists have also expanded professional competencies to include coprescribing naloxone and training first responders on naloxone use.

Results: Pharmacists within IHS have proactively completed advanced training on responsible opioid prescribing, augmented services to increase access to MAT for American Indians and Alaska Natives, and increased access to naloxone for opioid overdose reversal. Pharmacists have also developed a comprehensive training program and program measurement tools for law enforcement officers serving in tribal communities. These materials were used to train 350 officers in 6 districts and conduct a mass naloxone dispensing initiative across Indian Country. Pharmacists have consequently developed successful community coalitions that are focused on saving lives.

Conclusions: Pharmacist involvement in key initiatives including responsible opioid prescribing, expanded access to MAT, and expanded access to naloxone for trained first responders, coupled with an emphasis on enhanced education, illustrates pharmacists' impact with the opioid epidemic.

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects*
  • Clinical Competence
  • Drug Overdose / drug therapy*
  • Health Services Accessibility
  • Humans
  • Naloxone / administration & dosage*
  • Naloxone / supply & distribution
  • Narcotic Antagonists / administration & dosage
  • Narcotic Antagonists / supply & distribution
  • Opioid-Related Disorders / complications
  • Opioid-Related Disorders / prevention & control
  • Pain Management / methods
  • Patient Care Team / organization & administration
  • Pharmaceutical Services / organization & administration
  • Pharmacists / organization & administration*
  • Practice Patterns, Physicians'
  • United States
  • United States Indian Health Service

Substances

  • Analgesics, Opioid
  • Narcotic Antagonists
  • Naloxone