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Available online at ajdhs.com 

Asian Journal of Dental and Health Sciences 
Open Access to Dental and Medical Research 

Copyright  © 2024 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 
which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided 

the original author and source are credited  

 

 

The Role of Pharmacists in Opioid Addiction Management 
Pallav Dave * 

Regulatory Compliance Analyst, Louisville, KY, 40223, USA 

Article Info: 
_____________________________________________ 
Article History: 

Received   09 January 2024   
Reviewed 17 February 2024 
Accepted   01 March 2024 
Published 15 March 2024 

_____________________________________________ 
Cite this article as:  

Dave P, The Role of Pharmacists in Opioid Addiction 
Management, Asian Journal of Dental and Health 
Sciences. 2024; 4(1):51-56 

DOI: http://dx.doi.org/10.22270/ajdhs.v4i1.71       

_____________________________________________ 

*Address for Correspondence:   

Pallav Dave, Regulatory Compliance Analyst, 
Louisville, KY, 40223, USA 

Abstract 
_________________________________________________________________________________________________________________ 

Opioid addiction claims thousands of lives every year in the United States. The prevalence of misuse, 
abuse, and overdose continues to rise despite the measures and initiatives taken by the federal 
government and other government agencies to manage the problem. These efforts have led to a re-
evaluation of the role different healthcare providers can play to ensure the problem is adequately 
addressed. Being one of the most accessible healthcare providers to patients under opioid therapy, 
pharmacists are better positioned to deal with opioid addiction. They dispense millions of opioids 
every year making them better positioned to screen for patients who are likely to develop an 
addiction problem and refer them to treatment resources before the abuse escalates to opioid use 
disorder (OUD). The aim of this review is to explore the role of pharmacists in opioid addiction 
management including prevention, screening, education, naloxone prescribing, counselling, and 
referral to treatment resources. The review also provides pertinent information regarding the 
current state of the opioid crisis in the US, including recent data on prevalence and opioid-related 
deaths. Exploring the role of pharmacists is instrumental in coming up with effective measures that 
can help in opioid addiction management.  

Keywords: opioids, opioid addiction management, pharmacists, opioid misuse, opioid abuse, opioid 
use disorder  

 

Introduction 

Opioids are crucial in the management of pain. Various studies 
have established that prescription opioids are instrumental in 
managing pain, particularly in the short term.1, 2 However, 
despite their significance in the management of pain, prolonged 
use without medical supervision can increase the risk of 
dependence and lead to addiction. The recent 2022 data by 
National Survey on Drug Use and Health is an indication of the 
opioid problem in the US with 8.9 million people who are 12 
years and older having misused opioids while another 6.1 
million being diagnosed with OUD in the last year.3 Managing 
opioid addiction is paramount considering the number of 
deaths attributed to opioid addiction. In the past two decades 
alone, opioid overdose deaths in the US have gone up 
significantly from around 21,089 in 2010 to approximately 
70,000 in 2020.4,5 In 2021, deaths linked to synthetic opioids 
other than methadone were approximately 70,601.4 On 
average, 1 death in every 22 in the US in 2021 was attributed to 
opioid toxicity.6 Of these deaths, the most affected are younger 
adults aged 25 to 34 years.7 The early loss of life means years of 
loss of productivity. Abuse and misuse of opioids also increase 
health risks and complications which has a major toll on public 
health. In 2017 alone, the opioid epidemic cost the US $1.02 
trillion, with approximately $35 billion being on healthcare and 
treatment.8 

Considering the magnitude of opioid misuse, abuse, and OUD as 
exemplified by available population data, there is a need for 
measures to increase awareness of the risks associated with 
opioids and put proper addiction management strategies in 
place. An interdisciplinary approach to addiction management 
including involving different professionals in prescribing and 
managing opioid addictions can enhance clinical outcomes.9 

Pharmacists can be instrumental in addiction management 
because of their role in opioid dispensing and the training they 
have in medication safety and management.10 This review 
explores the role of pharmacists in opioid addiction 
management including how they can help in harm reduction, 
prescription of naloxone for overdose treatment, and referral to 
addiction management resources.  

Prevalence of Opioid Misuse, Abuse, and Deaths 
in the US 

Recent data from the Substance Abuse and Mental Health 
Service Administration (SAMHSA), National Institute on Drug 
Abuse, and Centers for Disease Control and Prevention (CDC) 
show that opioid dependence and deaths are increasing in the 
US despite the reduction in the number of opioid 
prescribing.3,4,11 The last two decades have recorded significant 
numbers of individuals affected by the opioid epidemic with the 
most being young adults.7 According to the CDC, the number of 
opioids prescribed to patients increased significantly from the 
1990s which corresponds to the rise in the number of 
overdoses and deaths.12 Approximately, 280,000 people died 
from prescription-related opioids between 1999 and 2021.12  In 
1999, only 3,442 deaths were reported compared to 16, 416 
deaths reported in 2021 which is an indication of the escalation 
in the number of deaths attributed to opioids.4 Deaths related 
to other opioids other than prescription opioids also increased 
significantly during this period. The CDC reported 
approximately 645,000 deaths between 1999 to 2021 while 
another study reported 422 605 deaths between 2011 and 
2021. 12,6 

In addition to deaths attributed to opioids, the number of 
people who misused or abused opioids also increased 

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[52]                                                                                                                                                                                                                                            AJDHS.COM 

significantly in the last two decades. In 2022, 8.9 million people 
who were 12 years and older misused opioids.3 Among these, 
1.1 million were aged 18 to 25 years while 7.4 million were 
adults aged 26 years and older. 3 Another 6.1 million people had 
OUD with adults aged 26 years and older accounting for 5.4 
million while those aged 18 to 25 accounting for 424,000. 3  

The high number of people misusing, abusing, and dying from 
opioid-related deaths is attributed to several factors key among 
them being high-volume prescribing and ease of accessibility of 
the drugs. The number of opioid prescribing has gone up in the 
last two decades with 2012 recording a prescription rate of 81.3 
per 100 persons.13 Between 2013 to 2016, the US accounted for 
the largest per-capita consumption of opioids in the world.14,15 
Although opioids play a significant role in managing pain, a 
large number of patients prescribed opioids end up abusing or 
misusing them. A study by Vowles et al.16established that 21% 
to 29% of patients who were prescribed opioids ended up 
misusing them and another 8% to 12% developed OUD. Despite 
the decline in the rates of prescribing in recent years, the 
number of people dying from opioid-related deaths continues 
to rise showcasing a discrepancy between safe prescribing and 
opioid assess. The discrepancy could also mean that the 
number of people abusing other forms of opioids including 
heroin and synthetic opioids has increased. Considering the 
high rate of misuse and abuse associated with opioids, there is 
a need to identify individuals at risk of opioid addiction to 
ensure healthcare professionals are knowledgeable and can be 
able to intervene before the abuse turns to OUD.  

Risk Factors for Opioid Misuse and Abuse 

Identifying people who are at risk of opioid misuse or abuse is 
vital in fighting opioid addiction. Identifying these risks makes 
it possible to assess them and put measures in place to manage 
them effectively. Various factors increase the risk of opioid 
misuse and abuse including individual factors, demographic 
factors, pain-related factors, sociodemographic factors, 
psychosocial factors, drug-related factors, and factors related to 
alcohol and substance use disorders.17 Although independently 
these factors are not likely to increase the risk of misuse, a 
combination of two or three increases the risk significantly.  

Demographically, young, white, and non-urban American males 
are more likely to have a prescription opioid misuse and abuse 
problem compared to other population groups.18, 17 However, 
this could be changing. The recent 2022 National Survey 
showed that rates of misuse were higher among multiracial 
groups at 4.5%, followed by Blacks at 4.1%, and Hispanics at 
3.4%.3 Whites had a misuse percentage of 3.0% while Asians 
were at 1.5%.3 One of the factors why prescription opioid abuse 
is more associated with white men is because the rate of 
prescription for opioids in emergency departments and 
primary care practices is much higher.19 Emotional issues and 
affective distress were also identified as factors that increased 
the risk of misuse and abuse with women who had these 
problems being more likely to misuse or abuse opioids.17  

Socioeconomic factors also play a crucial role in determining if 
an individual is likely to have an opioid abuse problem. 
Individuals who do not have health insurance, are unemployed, 
have work-related accidents or disability, and those who do not 
graduate high school have a higher risk of abuse.20,21 

One of the most consistent factors associated with the opioid 
abuse problem is a history of substance use disorders (SUD). 
Various studies have found that individuals who have a history 
of SUD are at a higher risk of opioid abuse.22,23 Coincidentally, 
individuals who experience chronic pain have higher rates of 
SUDs.17 According to a national epidemiologic survey, these 
rates are higher than those observed in the general 
population.24 Considering the rates of SUDs are higher in 

individuals struggling with chronic pain, it leaves a dilemma on 
how patients who struggle with pain can be managed effectively 
using opioids without the risk of addiction.  

Other risk factors that were associated with opioid misuse and 
abuse were mental health diagnoses including psychotic and 
anxiety disorders,24, 22 pain severity,17 genetic factors,17 and 
geographical factors. With regard to geographical factors, a high 
number of opioid prescriptions were mostly concentrated in 
counties in the western and southern states.25 Besides, 
hospitalizations related to opioid overdoses between 2000 to 
2012 were also concentrated in the South region. 18 Controlling 
for risk factors associated with misuse and abuse is vital in 
opioid addiction management. For pharmacists, identifying 
these risk factors is vital in ensuring they are knowledgeable 
and can be able to intervene to manage opioid addictions.  

Role of Pharmacists in Addressing the Opioids 
Epidemic  

Addressing the opioid epidemic requires the involvement of 
different healthcare providers who are in contact with patients 
being prescribed opioids. In the US, involving community 
pharmacists in dealing with opioid addiction is instrumental 
considering they dispense approximately 131 million 
prescription opioids every year.26 Besides, pharmacists are 
knowledgeable about the mechanism of action of medications 
and are in a better place to identify patients who are at risk of 
addiction. The CDC Clinical Practice Guideline for Prescribing 
Opioids for Pain recognizes the crucial role of pharmacists in 
opioid prescription, especially their role in opioid dispensing 
and naloxone prescribing.27 Various studies highlight the 
importance of pharmacists in ensuring opioid safety including 
prevention, surveillance, and treatment of OUD.28,29,30 With the 
help of  Prescription Drug Monitoring Programs (PDMPs), 
pharmacists are better positioned to control prescriptions and 
identify patients who have a higher risk of opioid addiction.31 
The PDMP enables pharmacists to screen for opioid misuse and 
discuss opioid-related treatment with patients.32 In addition to 
PDMP, pharmacists have access to naloxone which is 
instrumental in reversing opioid overdose. A study done in 
Canada established that pharmacists play a crucial role in the 
distribution of naloxone as part of the public health initiative in 
dealing with the opioid crisis.33 Community pharmacies were 
accessible to patients and being a key point of naloxone 
distribution they were instrumental in preventing overdoses. 
Other than emergency treatment, pharmacists can play a 
crucial role in prevention, which is recognized as instrumental 
in preventing the likelihood of developing abuse or OUD.  

Role of Pharmacists in Addiction Management  

Pharmacists play a crucial role in opioid prescription which 
makes them better positioned to prevent misuse and abuse. 
Prevention is recognized as instrumental in dealing with 
substance use disorder and addiction management and can be 
used as an early intervention measure to deal with opioid 
addiction.31 Prevention is recognized as instrumental in 
delaying both the onset and progression of substance use 
disorders which makes it instrumental in addiction 
management. Successful prevention of opioid addiction and 
abuse can involve a number of measures including addressing 
risk factors, screening, education, and discouraging use among 
other measures. Using models such as the Screening, Brief 
Intervention and Referral to Treatment (SBIRT) model as a 
guide to prevention can enable pharmacists to achieve optimal 
outcomes.31 The model provides a comprehensive approach 
that allows healthcare providers to carry out screening, 
prevention, and timely referral to patients who have SUD.34 The 
model is vital in the management of people with SUD including 
identifying those at risk of developing the problem. By using the 



Pallav Dave                                                                                                                                 Asian Journal of Dental and Health Sciences. 2024; 4(1):51-56 

[53]                                                                                                                                                                                                                                            AJDHS.COM 

SBIRT model, pharmacists can be able to screen for people who 
have high OUD risk, initiate discussions about the problem, and 
provide interventions if necessary. Screening is recognized as 
an instrumental measure in preventing opioid use disorder, 
especially in clinical and community settings.28 Using screening 
as an intervention measure for opioid addiction management 
has a lot of potential with some surveys showing that 
community pharmacists have a positive attitude towards 
screening and are interested in using screening to help patients 
that have OUD.35,36 The SBIRT model also recommends brief 
intervention before referring patients for treatment. The main 
aim of the brief intervention is to explore an individual’s 
motivation to change by increasing their insight and awareness 
about risks associated with substance abuse.31 Pharmacists can 
play this role effectively considering they are knowledgeable 
about the risks associated with opioid abuse. They are also 
better positioned to give advice to patients on the negative 
effects of prolonged opioid use. Pharmacists are also better 
positioned to know patients who need a referral to treatment 
resources for OUD even though they cannot do the referral 
themselves.30 They are more knowledgeable about outpatient 
treatment centers and can provide this information when 
necessary. The SBIRT model has been proven instrumental in 
screening, initiation of treatment, and referral of patients that 
have a substance use disorder but its efficacy is limited because 
results of clinical trials are mixed.37,38 Despite these limitations, 
it has various areas of strength that can prove instrumental in 
addressing opioid use disorder. For instance, it is easy to use 
and adaptable meaning it can be applied in different healthcare 
settings.31 Providing training to pharmacists on its proper use 
can ensure positive outcomes in opioid addiction prevention.  

Education is an additional measure that is reported in the 
literature as being vital in addiction management. Various 
studies have found a positive correlation between education-
related activities and positive outcomes when it comes to the 
prevention of opioid misuse and abuse.39,40,10. Pharmacists are 
better positioned to provide education to patients because of 
the important role they play in opioid dispensing. Different 
studies have noted improvements in patient outcomes 
following education-based interventions.39,30. In addition to 
providing education to patients, pharmacists can also be a 
valuable resource for training and educating healthcare 
providers who are involved in opioid addiction management.10 
Considering their knowledge in pharmacology, they are better 
placed to provide training and continuing education to other 
healthcare providers involved in opioid addiction management 
such as counsellors. Their role in providing training is 
documented in research, particularly on the proper use of 
naloxone for patients to law enforcers and other community 
members.41,42  

Pharmacists also play a crucial role in addiction management 
through safe dispensing. Using PDMPs is recognised as one 
measure that can ensure safe opioid dispensing to prevent 
misuse or abuse. PDMP is a risk mitigation practice that is 
recognized as instrumental in the effective monitoring of opioid 
use by healthcare providers.43 PDMPs ensure safe prescribing 
because they track how controlled substances are prescribed.10 
CDC recognises PDMPs as instrumental in ensuring safe 
prescribing because they provide healthcare providers with 
timely information about patients’ prescriptions and 
behaviours that can contribute to misuse or abuse.27 Having 
access to timely information and patients’ history of 
prescription opioids can enable pharmacists to have targeted 
responses to prevent misuse or abuse. Considering that more 
than 50 states have operational PDMPs, then it is a critical 
avenue for timely opioid addiction management. Besides, it is 
recommended by the CDC Clinical Practice Guideline as a 
measure that can help to determine whether patients are 
receiving opioid doses that put them at higher risk of overdose. 

However, when using risk mitigation practices such as PDMP it 
is important to acknowledge the challenges that pharmacists 
may face especially when dealing with customers in a customer-
service setting and put measures in place to minimize them to 
be able to achieve optimal outcomes.  

An additional role that pharmacists can play in addiction 
management is providing medication-assisted treatment 
(MAT). MAT entails the use of the Food and Drug 
Administration (FDA) approved prescription medications to 
treat opioid addiction.10 Examples of such medications include 
methadone, naltrexone, and buprenorphine.44 The use of MAT 
in treating opioid addiction is proven in the literature. Different 
studies have established that the use of these medications is 
effective in reducing and treating opioid overdoses.45,44 MAT 
helps to reduce illegal opioid use by reducing the craving for 
opioids and providing relief for individuals experiencing 
withdrawal syndrome. When used in treating opioid addiction, 
the medication has been shown to reduce the number of fatal 
overdoses.10 Because of their role in opioid dispensing, 
pharmacists can provide MAT and support in substance abuse 
treatment centers.  

Pharmacists can also deal with opioid addiction through the 
distribution of naloxone and opioid rescue kits. Naloxone plays 
an instrumental role in opioid overdose reversal and is 
recognised as an effective measure that can help in addressing 
the opioid epidemic.31 The role of pharmacists in naloxone 
distribution is recognised in research. Community pharmacies 
are recognised as key distribution points for naloxone because 
of their accessibility to patients.33 In addition to being key 
distribution points for naloxone, pharmacists are recognised as 
instrumental in providing education on their proper use to 
patients and support persons including law enforcement and 
members of the community.31,10,41 Through effective naloxone 
distribution and dispensing, pharmacists can be able to deal 
with addiction management by preventing overdoses.  

Other additional measures that can help pharmacists deal with 
opioid addiction include providing medication therapy 
management (MTM), counselling, and referral to addiction 
treatment resources. The main aim of MTM is to optimize 
patient outcomes especially when it comes to effective 
medication use.46 This is done by identifying and addressing 
problems related to the prescribed drug problems such as 
misuse or mismanagement. Pharmacists are in a unique 
position to do MTM for opioids because of their role in 
dispensing. By using tools such as PDMP, pharmacists can know 
patients who are at risk of opioid misuse and abuse and 
intervene by either recommending medication review or 
suggesting measures that can help to address the misuse before 
it escalates. Providing counseling is also a measure that can help 
with opioid addiction management. Counseling is mainly done 
in addiction treatment and rehabilitation centers but 
pharmacists are in a unique position to provide counselling 
because of their unique role that allows them to be in contact 
with patients.47,48,49 Providing counseling on the risks of 
overdose, for example, can ensure that patients are more 
knowledgeable on why overdosing is risky. Pharmacists can 
also address the safe disposal of opioids and safe storage.50 
Pharmacists are also uniquely positioned to provide referrals to 
addiction treatment resources. Because they often interact with 
patients, they are in a unique position to identify patients who 
may have undiagnosed OUD and provide referrals to addiction 
treatment resources.28 Pharmacists are also in a better position 
to identify resources that are available to patients within the 
community making them vital in opioid addiction 
management.50 Chisholm-Burns et al.,10 also recognise that 
pharmacists could be instrumental in referring patients to MAT 
programs and making sure they adhere to treatment.  



Pallav Dave                                                                                                                                 Asian Journal of Dental and Health Sciences. 2024; 4(1):51-56 

[54]                                                                                                                                                                                                                                            AJDHS.COM 

The following review contributes significantly to the existing 
research by identifying the role of pharmacists as instrumental 
in dealing with opioid addiction. It provides different 
interventions that pharmacists can engage in to prevent opioid 
misuse, abuse, and OUD. Identifying different ways in which 
pharmacists can help in dealing with opioid addiction 
management, cements their role as crucial in dealing with the 
opioid epidemic being experienced in the US. Though the role 
of pharmacists is recognised as instrumental, several barriers 
exist that may hinder the effective implementation of the 
interventions discussed above. For instance, pharmacists may 
not be better positioned to provide screening and counseling 
because of the limited duration of interaction with the patients. 
Pharmacists may also not be better positioned to provide 
medication-assisted treatment (MAT) because their role is 
limited to dispensing. However, considering the enormous 
potential that pharmacists possess in opioid addiction 
management, creating an enabling environment that can 
increase their readiness to provide the above-discussed 
interventions is paramount in the opioid epidemic. Providing 
education, training, and putting guidelines in place, for example, 
are some of the measures that can ensure pharmacists' 
readiness to reduce opioid misuse and abuse. Although this 
paper clearly outlines the role that pharmacists can play in 
opioid addiction management, it has its limitations. The scope 
of this paper mainly focuses on the role of pharmacists in the US 
which makes it challenging to generalize results to other 
regions and countries affected by the opioid epidemic. The 
paper is also limited by the fact that rigorous data extraction is 
not followed. The paper only includes articles that the author 
deems applicable to inform this research.  

Conclusion 

The US is still grappling with the opioid epidemic necessitating 
measures to manage addiction and prevent overdose deaths. 
Pharmacists are recognised as instrumental in opioid addiction 
management because of the crucial role they play in opioid 
dispensing and their direct involvement with patients. This is 
particularly the case for community pharmacists who are in a 
position to identify signs of misuse and provide interventions 
before patients reach the critical point of addiction. 
Pharmacists can provide various interventions including 
prevention, screening, education, overdose prevention through 
naloxone prescribing, counseling, and referral to treatment 
resources. Using models such as SBIRT can help pharmacists 
screen for patients who are at risk of addiction, provide brief 
interventions, and refer them to proper treatment resources. 
Using tools such as PDMP can ensure pharmacists have access 
to data on patients and are able to identify those who are at an 
increased risk of opioid misuse and abuse. Overall, 
implementing these measures can play a crucial role in helping 
to reverse the worrying statistics about opioid prevalence and 
morbidity. 

Abbreviations 

OUD: Opioid Use Disorder 

SAMHSA: Substance Abuse and Mental Health Service 
Administration 

CDC: Centers for Disease Control and Prevention 

PDMP (s): Prescription Drug Monitoring Programs 

MAT: Medication-assisted Treatment 

FDA: Food and Drug Administration  

SBIRT: Screening, Brief Intervention and Referral to Treatment 

SUD: Substance Use Disorder  

MTM: Medication Therapy Management  

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Pallav Dave                                                                                                                                 Asian Journal of Dental and Health Sciences. 2024; 4(1):51-56 

[55]                                                                                                                                                                                                                                            AJDHS.COM 

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