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Bethany DiPaula, PharmD, BCPP

CPNP membership turned out in record numbers to attend this year’s premeeting symposium on the role of the pharmacist in medication assisted treatment (MAT). Over 150 attendees actively participated in this engaging program designed to showcase practice settings where psychiatric pharmacists partner with prescribers to provide collaborative care for patients with substance use disorders. The majority of attendees noted that they were either currently engaged in MAT and wanted to learn more or would like to be engaged and wanted to learn how to start.

Christopher M. Jones, PharmD, MPH, Director of the National Mental Health and Substance Use Policy Laboratory US Department of Health and Human Service started the program with a relevant presentation on MAT need and capacity at state and national levels. While the number of physicians obtaining DATA waivers continues to increase, many physicians treat fewer patients than allowed and for shorter durations. Nurse practitioners (NP) and physicians assistants (PA) are applying for DATA waivers but generally in small numbers with less than 3% of NP and 1.5% of PA currently waivered. The 2016 National Survey on Drug Use and Health found that 62% of patients with OUD experienced comorbid mental illness within the last year. Dr. Jones concluded that psychiatric pharmacists are highly skilled and can play a role by engaging with clinicians to facilitate expansion and implement MAT across practice settings.

A panel discussion followed. Bethany DiPaula, PharmD, BCPP, Sarah T. Melton, PharmD, BCPP, BCACP, FASCP, Troy A. Moore, Pharm.D., M.S., BCPP, and Gayle L Callahan CRPH, PharmD, BCPP each provided MAT practice descriptions. Bethany DiPaula and Sarah Melton described pharmacists drug therapy management practices in urban vs. rural settings. Troy Moore reviewed the clinical pharmacist specialist role in treating OUD in the Veterans Administration (see figure below). Gayle Callahan offered insight into implementing a naltrexone XR program within a large Florida healthcare system.

Attendees broke into small groups to discuss the necessary steps for implementing MAT into their practice settings, while facilitators circulated. A larger discussion ensued including how CPNP might assist in these efforts. Some of the suggestions, which will be reviewed by CPNP’s Substance Use Steering Committee, included sharing of ideas and drug therapy management protocols, encouraging the publication of practice outcomes data, and developing a mentor system to assist pharmacists in establishing MAT practices.

Raymond C. Love, PharmD, BCPP, FASHP, provided insight on engaging legislators, professional organizations and state administrators to promote the role of pharmacists in MAT. A second active learning session followed where attendees identified opportunities for change and then discussed strategies to implement.

The learners left with innovative approaches to include pharmacists on the MAT interprofessional team and to design and execute effective practice protocols. In addition, the attendees explored the pharmacist’s role in addressing controversies and challenges in providing MAT with regard to state and federal level limitations. The goal was for each participant to complete the premeeting symposium with one to two key activities that they would be willing to pursue in practice. Over 92% of attendees reported that the content would have a positive impact on their practice.

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