Changing the narrative on substance use disorders

Maggie Jones is a third-year PharmD candidate at the Saint Joseph’s University Philadelphia College of Pharmacy.

Substance use disorders (SUDs) can affect anyone, just as cancer or any other numerous disease states out there. They are a result of many factors, including genetic risk factors, the ubiquity of alcohol, or the opioid epidemic. Pharmacists and future pharmacists have a duty to protect patients and make positive change in the profession.

Pharmacists have the ability to rewrite the script on who, what, where, and when medications are prescribed and which patients are screened for an SUD. Additionally, student pharmacists are the future of changing the narrative around SUDs through efforts to make stigma and derogatory language regarding SUDs a thing of the past. Whether you make the trip to the APhA Institute on Substance Use Disorders or work locally to educate yourself and your community on SUDs, you can not only change your patients’ lives, but also your own.

Be the voice

Student pharmacists can be the ones to change how to approach, speak, and care for people (including health care providers) with SUDs. While there are some who cannot comprehend or sympathize with the realities of patients with SUDs, student pharmacists can be the voice to educate and advocate for this population. Through APhA–ASP’s Operation Substance Use Disorders, student pharmacists go into the community and give naloxone training, prevent misuse of prescription medication, educate on proper means of medication disposal, and support patients in recovery. I highly encourage other student pharmacists to get involved with this patient care project as a way to collaborate for the common goal of proper medication use and disease prevention.

Student pharmacists are also essential in diminishing the stigma around SUDs, both in the workplace with established health care professionals and in the community. With the privilege of dispensing controlled substances, pharmacists are just as susceptible to an SUD as the public and other health care professionals are. At the APhA Institute, attendees hear from recovering pharmacists who have to earn back the public trust in their practice. Through firsthand experiences like that of the APhA Institute and knowledge from therapeutics courses, we are the voice and credibility for recovering pharmacists and patients; we are the source to say SUD is a disease, not a choice, and one can overcome addiction.

Stigma encompasses the shame that may come with an SUD, and it is a major component of why patients may not seek help. I challenge you to start changing your vocabulary around SUDs and introduce correct terminology into your practice.

For example, the National Institute on Drug Abuse (NIDA) has a page called Words Matter that can direct you to nonstigmatizing language when talking about or to patients with an SUD.¹ I believe in the future, NIDA should seek a new name, as it is self-contradictory to use “drug abuse” in the title of an organization because the term “abuse” is stigmatizing. “Illicit use” or “misuse” should be used instead. This is a prime example of how health care is trying to move away from stigma, yet we have underpinnings of it running throughout the language in our health systems.

In short, words do matter, and with simple language adjustments, we can improve the patient experience for the better.

Build your toolbox

Pharmacy is an ever-evolving profession with new medications and treatment strategies emerging each year, so building a foundational toolbox of knowledge regarding the disease states that plague the country is critically important. By the time you make it to practice, you will start to refine and upgrade your toolbox with the latest and greatest methods to treat patients. The APhA Institute provides new building blocks to add to that foundation, as SUDs seldom make it to core curriculum in pharmacy school.

Live, lead, and love through the APhA Institute

Attending the APhA Institute is one of those experiences for which words don’t do justice. The Institute allows you to participate in real Alcoholics Anonymous, Narcotics Anonymous, and Al-Anon meetings. Through these conversations, the mind and heart are exposed to the raw emotions of people who had or currently have an SUD. These emotional, yet constructive meetings are supplemented by didactic sessions in which attendees learn the neuropsychology, pharmacology, and treatment of SUDs.

Everyone is bound by their connection to SUDs, whether it be personal and/or professional. This shared connection will forever turn strangers into friends and colleagues to lean on in the future to heal the stigma, pain, and trauma that come with SUDs. With this network, attendees fuel the fight against the opioid epidemic and SUDs.

This experience provides an opportunity to undergo a paradigm shift in the realm of substance use education. New perspectives brought by many different experts will allow you to immerse yourself in the evolving field of pharmacotherapy for SUDs. While I learned a great deal of pharmacy knowledge, I gained an even greater appreciation that the similarities in attendees’ experiences with SUDs were far greater than the differences, and that is what brought the group closer.

My life’s work
Did you know that almost 90% of the U.S. population has access to a pharmacy within 5 miles of their residence?² This statistic is resounding, as pharmacists are at the forefront of overdose prevention and education as well as mental health first aid.

Harm reduction strategies for SUDs are becoming more and more accessible to the public. For example, the recent availability of naloxone as an OTC product has opened the door to saving more lives. I encourage you to seek out facilities in your community that offer fentanyl test strips and syringe exchange programs as additional ways to help others.

Minimizing the stigma around SUDs and maximizing pharmacotherapy in conjunction with psychotherapy is what I’m dedicating my life’s work to as a grateful member of the Al-Anon community. As a result of my work, I was honored to be a 2023 Ronald L. Williams Memorial Fund recipient, and attended the APhA Institute in Salt Lake City this past June. If you ever get the opportunity to attend the APhA Institute like I did, I hope by the end you will leave ready to do the following—just as I have:

• Live to serve others.
• Lead with passion.
• Love all of your patients regardless of their condition.

References

1. National Institute on Drug Abuse. Words matter: Preferred language for talking about addiction. Gaithersburg, MD: National Institute on Drug Abuse. Available at: https://nida.nih.gov/research-topics/addiction-science/words-matter-preferred-language-talking-about-addiction. Accessed July 24, 2023.

2. Berenbrok LA, Tang S, Gabriel N, et al. Access to community pharmacies: a nationwide geographic information systems cross-sectional analysis. JAPhA. 2022;62(6):1816–1822.