The Addicts among Us

A study conducted in 2001-2002 in the United States estimated the lifetime prevalence of alcohol dependence (alcoholism) and of drug dependency (addiction) to be 12.5% and 2.6%, respectively.1,2 This suggests that at least 1 in 8 individuals will have a problem with alcoholism or addiction. Knowledge of the pharmacology of addicting substances might suggest that health professionals are at reduced risk for developing addictions, yet studies investigating health professional addiction, including pharmacists and student pharmacists, suggests no such protective effect. Some even suggest a higher prevalence of addictive disease in health professionals. Although we would hope that student pharmacists are not using recreational drugs, studies that we and others have conducted between 1984 and 1999 show substantial past-year self-reports of recreational use among student pharmacists, including use of marijuana (5.9% - 28%), amphetamines (1.2% - 6.8%), cocaine (0.5% - 13%), sedatives (3% - 9%) and opioids (0.7% - 5.1%).3-6 While these are very wide ranges and report recreational use rather than dependence, they nonetheless indicate that there are probably students in each of our colleges who are abusing substances recreationally while enrolled. What are you doing at your college to prevent substance abuse, to encourage those with substance abuse and dependence problems to obtain timely and appropriate assistance, and to educate the profession to appropriately and professionally deal with addicted and recovering patients and colleagues? Patient (including medication) safety is an urgent concern to health professionals. Do you have a functional and effective substance use disorder assistance policy? Do your PharmD graduates have a sufficient understanding of the psychological and social aspects of addiction, its treatment, and recovery support to provide appropriate care to those roughly 1 in 8 patients who will have a problem with addiction or alcoholism at some time during their life? I have appointed a Substance Abuse and Pharmacy Education Special Committee chaired by Dr. Paul Jungnickel from Auburn University. The Committee met in early October to begin to address the substance abuse needs of colleges of pharmacy. Among the tasks related to substance abuse identified and currently being addressed by the Committee are: (1) documentation of the impact of substance abuse on the practice of pharmacy; (2) potential revision of the Association's guidelines for the development of psychoactive substance use disorder policies for colleges of pharmacy and encouragement of the adoption of policies based on these guidelines7; (3) core curricular content, as well as educational needs, resources, and processes related to substance abuse; (4) education of faculty members and pharmacists; (5) ways to encourage all colleges of pharmacy to annually have student pharmacists and faculty members attend the University of Utah School on Alcoholism and Other Drug Dependencies Pharmacy Section; (6) examining Center for the Advancement of Pharmaceutical Education (CAPE) public health competencies that may be related to substance abuse; and (7) examining the possibility of inclusion of substance abuse related items on the North American Pharmacist Licensure Examination (NAPLEX). I anticipate that the committee will provide your college with resources that can assist you in your prevention, assistance, and educational efforts. As you move forward with your curricular modifications, I encourage you to anticipate the inclusion of resources to adequately prepare student pharmacists and graduates to provide appropriate care to “the addicts among us.”