Addiction treatments in pharmacies could help combat the opioid crisis
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Medications can help people quit opioids, but fewer than 15% of patients who could benefit from those medications actually receive them. Researchers based at Rhode Island Hospital tested one possible remedy - offering addiction treatment in pharmacies. From member station WBUR, Martha Bebinger reports.
MARTHA BEBINGER, BYLINE: Mike, a longtime heroin user, was waiting for a bus when he saw an ad for the study. We agreed not to use his full name because he has used illegal drugs. If Mike enrolled in the study, he could get free buprenorphine, brand name Suboxone, at a nearby pharmacy. Mike was in recovery at the time, on buprenorphine, but somebody had stolen his supply.
MIKE: I was very gloomy. I didn't know what I was going to do. I didn't want to go back on drugs. And I happened to see the sign. It was a godsend.
BEBINGER: Mike went right to the closest participating pharmacy and had a new buprenorphine prescription that day. Andrew Terranova, who manages the pharmacy where Mike went, says people often search for openings and wait hours, if not days, for a first treatment appointment.
ANDREW TERRANOVA: Patients were grateful that they were able to come in, meet with somebody that day and get seen.
BEBINGER: Terranova works for Genoa Health Care, a national pharmacy network often inside community mental health centers. For this study, Terranova and pharmacists in six high-overdose areas learned how to document a person's drug history and assess their state of withdrawal. During the initial visit, Terranova would call a physician or nurse who could write a prescription. Treatment on demand may help explain why patients enrolled at pharmacies were 72% more likely to continue treatment for at least a month than were patients who went to more traditional treatment centers. The study's lead author, Traci Green, says it shows pharmacies are an effective way to expand addiction treatment.
TRACI GREEN: We need a lot more if we're going to try to turn the tide in the opioid crisis, so the pharmacists are at the ready.
BEBINGER: The National Association of Chain Drug Stores says community pharmacies are an untapped resource in the opioid crisis. But Dr. Margaret Jarvis, chief of addiction medicine at Geisinger Health System in Pennsylvania, says she isn't sure mainstream pharmacies are ready to offer addiction treatment along with flu shots or blood pressure checks. The main reason, says Jarvis, is stigma.
MARGARET JARVIS: It's everywhere - everywhere. There's not a place in our society - especially within the health care industry - where that doesn't exist.
BEBINGER: There are other reasons the study results could be hard to replicate. Jarvis says physicians may not want to hand over some authority to pharmacists. Pharmacies nationwide are short-staffed, and there's a funding dilemma. Anne Burns with the American Pharmacists Association says, right now, there's no way to pay pharmacists for addiction counseling and care because they are not considered medical providers.
ANNE BURNS: There would have to be a payment model identified and to prioritize a service like this over some of the other activities that are going on in the pharmacy.
BEBINGER: But what could be more important than helping people avoid deadly street drugs, asks Mike? He remembers the cravings taking hold that day at the bus stop, before Mike turned and saw the ad for free buprenorphine.
MIKE: The alternative would have been fentanyl, which is a crapshoot. I've seen too many people die.
BEBINGER: Researchers are talking to the Genoa pharmacy chain about expanding this pilot as the U.S. sets new records for deaths after a drug overdose.
For NPR News, I'm Martha Bebinger in Boston.
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