Misuse of opioid painkillers continues to cause deaths on both sides of the Atlantic. Pharmacists are commonly cited as uniquely qualified to manage and prevent the misuse of this class of drugs, owing to their frequent contact with patients and prescriptions, but it is not always obvious where they should start.
The terminology used to describe addiction has, historically, been confusing. In the United States, the terms dependence and abuse have now been replaced by substance use disorder (alcohol use disorder or opioid use disorder, for example).
This book is a comprehensive resource that covers most aspects of this global epidemic. Each of the ten chapters addresses an important issue, and is written by a clinician with experience and expertise in working with patients who have opioid use disorders.
The first two chapters discuss the scope of the problem of substance abuse and the neurobiology of opioid use disorders. Subsequent chapters describe the role of the pharmacist in screening and caring for patients, medication to treat opioid overdose and maintenance treatment modalities, pain management, detection and deterrence of substance abuse and drug diversion, substance use disorders within the pharmacy profession and the future educational curriculum requirements for pharmacy practice.
A most useful chapter looks at the use of opioids in pregnant and postpartum women, and caring for infants with neonatal abstinence syndrome (withdrawal symptoms caused by in utero exposure to certain drugs).
Each chapter includes ‘practice points’, which come directly from the contributors’ medical, nursing or pharmacy clinical experiences. The appendices provide useful information, such as references, resources and a most helpful naloxone product comparison table. Intranasal naloxone, which is used widely in the United States, features prominently. This might be useful to British practitioners working in drug treatment services — UK regulations have recently been amended to allow the supply of intranasal naloxone for emergency use.
Although reference is made to reducing and monitoring the prescribing of opioids, it is disappointing that no mention is made of removing the very large quantities of legally prescribed, unused and unwanted opioids that can be found in homes in the community.
This slim volume will help pharmacists and other professionals to understand what they can do to prevent, monitor and treat opioid use disorders to reduce the tragic loss of life as a result of opioid misuse.
Laurence A Goldberg
Norton M, ed. The Pharmacist’s Guide to Opioid Use Disorders. Pp x+200. Price $39. Maryland: American Society of Health-System Pharmacists; 2018. ISBN 978-1-58528-586-0