Opioid-Related Activities: Category and Tag Definitions

Three whitecoats in lab talking.

These Categories and Tags were developed by AACP staff members, with the assistance of volunteer members of the AACP Substance Use Disorder Special Interest Group, and assigned to activities being conducted by schools and colleges of pharmacy to address the current opioid overdose crisis.

Categories

Advocacy: A formal action (e.g., standing order, PDMP) at a local, state, region, national or international level that involves pharmacists or other health care practitioners support or involvement in combating the opioid crisis.

Education: A process targeting any group that involves the distribution or acquisition of knowledge, skills, values, beliefs and/or habits regarding any aspects of the opioid crisis. The tag(s) should include who provides the education and the target audience(s) of the education.

Practice: An activity that is implemented in a pharmacy practice setting that addressed the opioid crisis on an individual or population-level.

Research: A formal investigation into any aspect of the opioid crisis that has an established purpose(s) and/or research question(s), including generation of statistics, utilization of medication(s), perception(s), treatment effectiveness, new treatment(s), scholarship of teaching and learning (SOTL), etc. 

Service: An activity that is initiated or maintained to address the opioid crisis on individuals or communities (including public outreach and awareness efforts that do not involve education).

Tags

Community Service

Drug Disposal – activities that promote appropriate disposal of drugs and medications, including distribution of disposal bags, education about proper disposal methods. 

Drug Diversion – activities related to diversion of appropriately prescribed opioids into inappropriate uses, including research into drug diversion patterns and promotion or practice of prescribing practices that prevent diversion.

Drug-Take Back – activities that promote the collection of drugs; typically drug-take back activities are not also tagged as “Drug Disposal” or “Drug Diversion;” exceptions include comprehensive activities that include components encompassing two or more of these activities.

First Responder – activities that involve educating or partnering with police, firefighters or EMTs to improve response to overdoses or the opioid epidemic more broadly.

Opioid Overdose/Risk Assessment – activities that focus on the prevention and education about opioid overdose, including recognizing signs of overdose, as well as those that focus on specific risk of overdose (as opposed to risk of developing opioid use disorder); educational activities about naloxone were typically also tagged as “Opioid Overdose/Risk Assessment.”

Opioid Stewardship – activities that promote or advance a coordinated effort(s) to reduce unnecessary prescriptions for opioids.

Public Outreach – activities intended to raise awareness and knowledge about the opioid epidemic and substance use disorder; includes lectures, seminars, health fairs, walks/runs.

Screening Brief Intervention and Referral to Treatment (SBIRT) – an evidence-based, comprehensive public health approach to identify patients who use alcohol and other drugs (including opioids) at risky levels with the goal of reducing and preventing related health consequences, disease, accidents and injuries.

Education

Continuing Education – education for health professionals; not to be co-tagged with “Didactic.”

Didactic (includes lecture, small group discussion, laboratory exercise, simulation, case studies) – formal educational activities for health professions students that are planned in advance by the educator and do not include practice activity by the student/trainee; excludes continuing education activities.

Elementary School Students – activities in which the intended audience is elementary school students and other elementary school stakeholders (e.g., teachers, administrators). 

Experiential – educational activities that include the student/trainee being immersed and engaged in a health care practice setting (typically pharmacy), includes IPPE and APPE rotation activities.  This does not include any didactic training to prepare the student/trainee for experiential preparation.

Generation RX – activities that utilize the materials and programs to prevent the misuse of prescription drugs which are developed through Generation Rx, a collaboration between The Ohio State University and the Cardinal Health Foundation.  Most colleges and schools of pharmacy have a Generation RX student chapter.  

Interprofessional Education (IPE) – activities in which pharmacists, pharmacy faculty or student pharmacists engage in educational experiences (didactic, experiential or continuing education) with practitioners, faculty or students from other health professions; experiential education activities may also be tagged Interprofessional Practice (IPP).

Opioid Prescribing – activities that focus on decision-making regarding opioid prescriptions at the time of treatment.

Other Faculty - activities that target or are in partnership with faculty from schools outside the college or school of pharmacy; excludes IPE activities where non-pharmacy faculty role is didactic.

Other Health Professions Students – activities that target or are in partnership with students from health professions outside pharmacy.

Secondary School (Middle School/High School) Students - activities in which the intended audience is middle or high school students and other secondary school stakeholders (e.g., teachers, administrators). 

Student Pharmacists – activities involving student pharmacists at colleges and schools of pharmacy; includes educational activities targeting student pharmacists.

University-Wide Community – activities that target or engage the wider university community beyond the college or school of pharmacy.

Funding

For-profit Funding – activities that received funding, including materials and gifts-in-kind, from for-profit entities such as pharmaceutical companies and retail pharmacies; activities in which pharmacy faculty or students partnered with a for-profit entity to create a product were excluded from this tag.

Government Funding – activities that received funding from Federal, State or local (city, county or municipal) sources.

Internal Funding – activities paid for by funds from the college or school of pharmacy or its parent institution; includes activities paid for by community donations and Clinical and Translational Science Institute (CTSI’s).

Non-profit Funding – activities that received funding, including materials and gifts-in-kind, from non-profit entities such as community coalitions, foundations; includes local and municipal entities such as school boards and sanitation departments. 

Healthcare Professionals

Community Practice – activities that relate to community pharmacies (e.g., chain pharmacy, independent pharmacy, mass merchandiser pharmacy).

Health-Systems – activities occurring in or addressing practices at hospitals and health-systems composed of multiple care sites.

Impaired Health Professionals – activities involving health professionals with substance use disorder or those targeting treatment or education to health professionals with substance use disorder; note activities involving the APhA Institute are co-tagged “Impaired Health Professionals."

Interprofessional Practice (IPP) – activities in which pharmacists, pharmacy faculty or students engage or collaborate together in health care practice settings with practitioners, faculty, or students from other health professions; includes collaborative practice agreements.

Other Health Professionals – activities that target or are in partnership with health professionals outside of pharmacy.

Pharmacists – activities that target or are enacted by practicing pharmacists; note that “Pharmacists” and “Pharmacy Faculty” tags have distinct application,

Pharmacy Residents – activities that target (education) or involve pharmacy residents.

Partnering/Collaboration

Associations/Societies – activities that involve partnership with or funding, materials or resources provided from non-profit associations and/or societies.

For-profit Partners(s) – activities in which pharmacy faculty or students collaborated with for-profit entities, such as pharmaceutical companies to create or distribute materials, develop programs,  or contribute to a research project.

Multiple School Collaborations – activities involving faculty, students or staff from multiple educational institutions; excludes activities that involve multiple schools or colleges within a single institution (e.g., College of Pharmacy and Medicine at UNC).

Non-profit Partner(s) - activities in which pharmacy faculty or student pharmacists collaborated with non-profit entities, e.g. to create or distribute materials, develop or deliver programs; includes local and municipal entities such as school boards and sanitation departments; excludes law enforcement and health departments, which were tagged separately.

Regulation

Collaborative Practice Agreement (CPA) – activities that occur under a formal agreement between a pharmacist and physician or other provider; should be co-tagged with “Other Health Professionals.”

Federal Government – activities performed in partnership with the Federal government; does not include activities that use pre-existing Federal resources, e.g. CDC guidelines on opioid prescribing; note that in cases of Federal government funding for an activity, “Government Funding” tag was used instead

Guidelines – activities related to the promulgation or incorporation into practice of guidelines developed by the Federal Government (e.g., SAMSHA, CDC) or other expert panel on an aspect related to opioids (e.g., prescribing).

Health Departments – activities done in collaboration with health departments (local or state); excludes activities involving state departments of health and human services, which were tagged as “State Government”; includes activities using health department materials and resources.

Law Enforcement – activities done in partnership with law enforcement agents or agencies or intended to educate law enforcement agents; includes many, but not all, drug take-back activities.

Legislation – activities in which respondents advocate for, draft or take formal actions related to legislation at the local, state or federal level.

Prescription Drug Monitoring Program (PDMP) – activities related to state programs that monitor the prescribing and dispensing of opioid prescriptions; often co-tagged “Opioid Stewardship.”

State Board of Pharmacy – activities done in partnership with or with guidance from a state board of pharmacy.

State Government - activities funded by or performed in partnership with state governments, including health and human services departments. 

Research

Community-Based Research – research activities occurring within or pertaining to ambulatory care or community practice settings. 

Opioid Trends (includes Patterns) – activities that track, study or educate about opioid use among different populations and regions, both in static snapshots and over time; includes trends in naloxone use.

Practice-Based Research – research activities that take place within a pharmacy practice setting.

Published article (peer-reviewed) - articles authored by faculty, students or staff at pharmacy schools that report on their activities and undergo peer-review prior to publication.

Survey Research – research activities that include survey research; excludes market surveys or educational assessment.

Treatment

Abuse Deterrent Opioid Formulation – activities related to the development or distribution of opioid formulations with physical or chemical properties that make the formulation resistant to expected routes of abuse such as chewing, snorting, smoking and injecting.

Ambulatory Care Practice – activities related to treatment or services provided in an outpatient basis.  Examples include clinics, offices of physicians and other healthcare providers, dialysis centers).  This does not include the traditional community pharmacy practice settings (e.g., retail pharmacy, independent pharmacy).

Buprenorphine – activities related to the use and/or distribution of buprenorphine, an opioid partial agonist, for medication-assisted treatment (MAT) of opioid use disorder (OUD); trade name Subutex.

Harm Reduction – activities that promote or implement strategies to decrease the negative consequences of opioid use or opioid use disorder, such naloxone availability, needle/syringe exchange, supervised injecting sites or fentanyl testing; excludes opioid replacement therapies, including those using methadone or buprenorphine, which were tagged as “Medication Assisted Therapy (MAT).” Excludes didactic education of student pharmacists about naloxone that doesn’t also include distribution, lay education or other service component.

Medication-Assisted Treatment (MAT) – activities related to pharmacologic treatment of substance use disorder, including opioid replacement therapies, e.g., buprenorphine and methadone; excludes naloxone/Narcan.

Naloxone – activities related to education about and distribution of naloxone for reversing opioid overdoses; frequently co-tagged with “Opioid Overdose/Risk Assessment” and “Harm Reduction.”

Office-Based Opioid Treatment (OBOT) – activities involving treatment of substance use disorder in an outpatient health care setting.  This should typically also be tagged with “Ambulatory Care.”

Pain/Pain Management – activities that relate to pain or pain management; includes didactic education and courses about pain management, research on alternative treatments for pain and practices that provide alternatives to or reduced usage of opioids for pain.

Substance Use Disorder – activities that increase understanding of or knowledge about SUD through education, research or service or that involve formal actions related to medical, health or public policies and practices related to substance use disorder.   

Substance Use Disorder Treatment – activities related to education about, access to or provision of substance use disorder treatment; includes Medication-Assisted Treatment (MAT).