Confronting the National Opioid Crisis

Illustration, man in open pill bottle looking up towards glowing light


Opioid abuse, now a public health crisis in the United States, presents an urgent call to action to the pharmacy community. Pharmacy schools are educating students and patients and taking steps at local and national levels to effect change.

By Jane E. Rooney

It was a record-setting year, but in the grimmest terms: Drug overdoses reached a new high in 2017, with 47,600 deaths caused by drugs such as fentanyl and heroin as well as prescription drugs, according to the Centers for Disease Control and Prevention (CDC). Deaths attributed to opioids in the United States were nearly six times greater in 2017 than they were in 1999. Opioids were involved in more than two-thirds of overdose deaths in 2017, and U.S. overdose death rates linked to synthetic opioids increased more than 45 percent from 2016 to 2017.

A report from the Office of the Surgeon General and the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that the crisis is being driven by three trends: an increase of prescription opioid overdose deaths since 1999; the fourfold increase in heroin overdoses since 2010; and the tripling death rate for synthetic opioids like fentanyl since 2013. A recent New York Times article noted that drug overdoses have contributed to a fall in life expectancy and are now the leading cause of death for adults under 55.

Despite this bleak picture, there is a glimmer of good news. Opioid prescribing was down 28 percent since it peaked at 81.3 prescriptions per year per every 100 Americans in 2012, according to a Washington Post editorial published earlier this year. CDC data show a leveling off of prescription drug deaths, which could be due to prescription drug monitoring programs. Through a series of articles in this issue, Academic Pharmacy Now will explore what is being done on the national level to address the crisis and the role academic pharmacy is playing; what research projects pharmacy schools are pursuing; and what other activities schools are engaged in to help patients and providers as well as to prepare future pharmacists to take the next steps to eradicate this epidemic.

Surveying the Landscape

To discover how involved they are and what types of activities pharmacy schools are undertaking to combat this public health crisis, AACP conducted an environmental scan from July to September 2018. Respondents submitted a summary of activities and whether any outcomes emerged (e.g., the number of students educated or patients taught, peer-reviewed papers, etc.). With 144 schools (75 percent) submitting at least one activity, AACP collected 398 activities for its final analysis, which is available at

We want to provide that information so people within the Academy will be able to learn from each other and maybe even partner together. No one wants to spend time recreating something if it’s already been done.

Dr. Lynette Bradley-Baker

“The opioid epidemic is something that is ever-present in all walks of life and we understand the role that pharmacists could and should play with helping to combat it or prevent it in the first place,” said Dr. Lynette Bradley-Baker, AACP’s senior vice president of public affairs and engagement. “Various institutional members are doing some great things, such as building coalitions and working with other institutions on their campus to help with the education of future practitioners, but we did not have a sense of what academic pharmacy as a whole was doing to help with this. We wanted to be able to have conversations within the healthcare community about what academic pharmacy is doing in this area. We want to provide that information so people within the Academy will be able to learn from each other and maybe even partner together. No one wants to spend time recreating something if it’s already been done.”

When AACP sent out the call for information, it broadly defined an “activity” as a collaboration, initiative, lecture, partnership or program, and did not restrict participation based on who was involved (whether it was an individual, a department or a group of students). AACP offered guidance in terms of categories, which included advocacy, education, teaching, practice, research and/or service. “The majority of submitted activities had an education focus,” Bradley-Baker said. “The one thing we expected to have more of was research. We know that a lot of our schools are involved with investigation of new agents for pain that are non-addicting. We also have research dealing with perceptions regarding naloxone and perceptions about the role of the pharmacist in fighting the epidemic.”

Anyone can access AACP’s searchable database, which includes a summary of each school’s activity and a point of contact. Bradley-Baker added that AACP is devising a process to continuously collect information on what schools are doing to address the crisis and will likely put out a call for updates in July. “There will be more schools that submit their activities in this area. Everyone is doing something. They are educating and training students about the epidemic and getting them to be part of the solution in their community.”

Increasing Involvement

AACP’s Substance Use Disorder SIG helped classify the activities for the scan and is taking the lead on analyzing the findings to prepare a summary for the American Journal of Pharmaceutical Education. “There are a lot of people doing wonderful things. The scan provides more transparency and identifies the people leading this effort and resources we can turn to,” said SIG Chair Dr. Tran Tran, associate professor at Midwestern University’s Chicago College of Pharmacy. “We now know who those leaders are and who has been working on this for a long time and has the experience. We can align them with others who are motivated so their efforts are much more productive. Even if this is not a specialty you’re working in, you know it’s affecting a large enough percent of the population that it impacts other co-morbidities. The scan gives us a better idea of the breadth of this problem and how many people are working on it.”

The SIG’s mission is to collaboratively promote and enhance interprofessional and public education concerning substance misuse prevention and treatment, to promote and foster the provision of evidence-based substance use disorder treatment and recovery support services for professionals and the public, and to promote scholarly inquiry concerning substance use disorders as it impacts the profession of pharmacy, pharmacy collaborators and the public. Tran said the SIG wants to do more collaborative, interdisciplinary research on substance use and to learn what roles SIG members are playing in terms of advocating for policy change. She thinks the topic is included in the curriculum at most schools, but in a limited way.

“It’s problematic because there are not a lot of pharmacists who are specifically trained in substance use disorder or addiction,” she acknowledged. “Even the people teaching it may not be as knowledgeable about recent advances. I think everybody is aware we need to do more but we’re doing it through trial and error. Other healthcare professions are going through the same thing. How do we address this? Are we doing it effectively? Who do we turn to for expertise?”

The Chicago College of Pharmacy is addressing issues such as language terminology, stigma and naloxone as required training for all pharmacists. “We are spreading it throughout the four years in the curriculum so it has more of an impact and allows students to think more about it, and maybe help in the community and think about substance abuse and awareness,” Tran explained. Pharmacists across all disciplines will have to address the opioid epidemic in some way.

Given that the epidemic starts with medications and is treated with medications, she continued, “This is a really important role for pharmacists. They are naturally in a position to fill that role to make a dent in terms of combatting the issue. As an Academy, it’s important that we have people to spearhead that effort.”

Jane E. Rooney is managing editor of Academic Pharmacy Now.