A recent discussion highlighted the critical role of psychiatric pharmacists in improving access to medications for opioid use disorder (MOUD). Ashley Maister, PharmD, and Aaron Salwan, PharmD, both board-certified clinical pharmacy specialists, shared their insights with Pharmacy Times regarding innovative approaches to optimize treatment for patients with substance use disorders (SUD).
The conversation underscored how psychiatric pharmacists leverage their independent scope of practice to enhance patient care. At the US Department of Veterans Affairs, Maister emphasized the importance of collaboration among healthcare providers, noting that psychiatric pharmacists are often instrumental in ensuring that long-acting injectable therapies are readily available. These medications are subject to Risk Evaluation and Mitigation Strategies (REMS), which can complicate the ordering process for providers.
“We work to simplify the ordering process,” Maister explained. “Our goal is to ensure that healthcare providers and patients are not only aware of how to initiate treatment but also understand how to maintain the medication effectively.”
Salwan added that they have developed a microinduction protocol for buprenorphine, aimed at making it more accessible for individuals still using opioids. This protocol allows for treatment initiation in a controlled manner, reducing the risks associated with withdrawal and overdose.
The pair also discussed the challenges faced by patients who often use multiple substances. They have found success in employing phenobarbital to assist patients in safely withdrawing from benzodiazepines, which has improved the overall withdrawal experience. “Patients have reported much better experiences compared to previous attempts,” Maister noted.
Collaborative Approaches and Reducing Stigma
In their respective roles, both Maister and Salwan serve as consultants for more complex cases. Salwan highlighted the value of their extensive network, stating, “Having access to a strong community of psychiatric pharmacists allows us to address nuances in treatment that may not align with traditional approaches.”
They also emphasized the importance of education in combating stigma associated with substance use disorders. Salwan actively involves pharmacy students in patient interactions to model compassionate communication. “We need to make patients feel heard, which unfortunately isn’t always the case in other specialties,” he said.
Maister echoed this sentiment, advocating for greater understanding within healthcare settings. She pointed out that while some harm reduction tools, like test strips, may be illegal in certain states, they play a crucial role in patient safety. “Education is key to ensuring that these tools are available and understood within the healthcare team,” she said.
The discussion concluded with a call for continued interdisciplinary collaboration. By advocating for and educating healthcare professionals about the needs of patients with SUD, psychiatric pharmacists can significantly contribute to a more supportive and effective healthcare environment.
Through their work, Maister and Salwan exemplify how psychiatric pharmacists are not only integral in optimizing medication but also in fostering a compassionate approach to substance use treatment. Their efforts illustrate a commitment to improving patient outcomes and reducing stigma, ultimately enhancing the quality of care for individuals struggling with addiction.
