Addressing the Opioid Crisis—The Need for a Pain Management Intervention in Community Pharmacies in Canada: A Narrative Review

Author:

Cid Ashley12ORCID,Ng Angeline1,Ip Victoria1ORCID

Affiliation:

1. Ontario Pharmacists’ Association, Toronto, ON M5H 3B7, Canada

2. School of Pharmacy, University of Waterloo, Kitchener, ON N2G 1C5, Canada

Abstract

Background: The opioid crisis is a public health concern in Canada with a continued rise in deaths and presents a significant economic impact on the healthcare system. There is a need to develop and implement strategies for decreasing the risk of opioid overdoses and other opioid-related harms resulting from the use of prescription opioids. Pharmacists, as medication experts and educators, and as one of the most accessible frontline healthcare providers, are well positioned to provide effective opioid stewardship through a pain management program focused on improving pain management for patients, supporting appropriate prescribing and dispensing of opioids, and supporting safe and appropriate use of opioids to minimize potential opioid misuse, abuse, and harm. Methods: A literature search was conducted in PubMed, Embase and grey literature to determine the characteristics of an effective community pharmacy-based pain management program, including the facilitators and barriers to be considered. Discussion: An effective pain management program should be multicomponent, address other co-morbid conditions in addition to pain, and contain a continuing education component for pharmacists. Solutions to implementation barriers, including pharmacy workflow; addressing attitudes beliefs, and stigma; and pharmacy remuneration, as well as leveraging the expansion of scope from the Controlled Drugs and Substances Act exemption to facilitate implementation, should be considered. Conclusions: Future work should include the development, implementation, and evaluation of a multicomponent, evidence-based intervention strategy in Canadian community pharmacies to demonstrate the impact pharmacists can have on the management of chronic pain and as one potential solution to helping curb the opioid crisis. Future studies should measure associated costs for such a program and any resulting cost-savings to the healthcare system.

Funder

Ontario Health Mental Health and Addictions Centre of Excellence

Publisher

MDPI AG

Subject

Pharmacology (medical),General Pharmacology, Toxicology and Pharmaceutics

Reference41 articles.

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2. (2022, October 12). Substance-Related Overdose and Mortality Surveillance Task Group (SOMS-TG) of the Special Advisory Committee (SAC) on the Epidemic of Opioid Overdoses—Public Health Agency of Canada. Apparent Opioid and Stimulant Toxicity Deaths: Surveillance of Opioid- and Stimulant-Related Harms in Canada January 2016 to March 2022. Government of Canada. Published September 2022. Available online: https://health-infobase.canada.ca/src/doc/SRHD/Update_Deaths_2022-09.pdf.

3. (2022, October 12). Substance-Related Overdose and Mortality Surveillance Task Group (SOMS-TG) of the Special Advisory Committee (SAC) on the Epidemic of Opioid Overdoses—Public Health Agency of Canada. Opioid and Stimulant Poisoning Hospitalizations: Surveillance of Opioid- and Stimulant-Related Harms in Canada January 2016 to March 2022. Government of Canada. Published September 2022. Available online: https://health-infobase.canada.ca/src/doc/SRHD/Update_Hospitalizations_2022-09.pdf.

4. The role of pharmacists in opioid stewardship: A scoping review;Gondora;Res. Soc. Adm. Pharm.,2022

5. Canadian Centre on Substance Use and Addiction (2022, October 14). Canadian Drug Summary: Prescription Opioids. Published July 2020. Available online: https://www.ccsa.ca/sites/default/files/2020-07/CCSA-Canadian-Drug-Summary-Prescription-Opioids-2020-en.pdf.

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