“What I often find, and what I am guilty of too, is just assuming that the doctor is covering it (risks of opioids), but I don't know that that's actually the case.”8

-Community pharmacist

References: 1. Health Canada. Canadian Pain Task Force, June 2019 Report - Chronic pain in Canada: Laying a foundation for action. Available at: https://www.canada.ca/content/dam/hc-sc/documents/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2019/canadian-pain-task-force-June-2019-report-en.pdf(Open in a new window). Accessed August 27, 2021. 2. Antoniou T, Pritlove C, Shearer D, et al. A qualitative study of a publicly funded pharmacy-dispensed naloxone program. International Journal of Drug Policy. 2021;92:103146. 3. Healthcare Providers Service Organization. Pharmacist Spotlight: Communication. Available at: https://www.hpso.com/Documents/Risk%20Education/individuals/Claim-Reports/Pharmacist/Communication-Spotlight.pdf(Open in a new window). Accessed July 27, 2021. 4. Canadian Medical Protective Association. Preventing the misuse of opioids. Available at: https://www.cmpa-acpm.ca/en/advice-publications/browse-articles/2015/preventing-the-misuse-of-opioids(Open in a new window). Accessed July 27, 2021. 5. Tsuyuki R et al. Canadian national consensus guidelines for naloxone prescribing by pharmacists. Canadian Pharmacists Journal. 2020;153(6):347-351. 6. Ontario Pharmacists Association. Pharmacist clinical tool for initiating naloxone discussions. Available at: https://opatoday.com/wp-content/uploads/Practice/Tools/Naloxone/Pharmacist-Clinical-Tool-for-Initiating-Naloxone-Discussions.pdf(Open in a new window). Accessed July 27, 2021. 7. Mueller SR et al. Attitudes toward naloxone prescribing in clinical settings: a qualitative study of patients prescribed high dose opioids for chronic non-cancer pain. Gen Intern Med. 2016;32(3):277-283. 8. Thakur T, Chewning B. Using role theory to explore pharmacist role conflict in opioid risks communication. Research in Social and Administrative Pharmacy. 2020;16(8):1121-1126. 9. Dassieu L, Heino A, Develay É, et al. “They think you’re trying to get the drug”: Qualitative investigation of chronic pain patients’ health care experiences during the opioid overdose epidemic in Canada. Canadian Journal of Pain. 2021;5(1):66-80.

PP-NAR4-CA-00087_11-2022 EN

Pain takes many forms: it can be acute (e.g., due to surgical procedures), or chronic (e.g., associated with conditions requiring long-term therapy).1

When talking to your patients, since every patient is different, try to first understand how they are feeling so you can adapt your discourse to their situation:2-4

  • Some patients may feel uncomfortable or scared of the fact that opioids are being introduced into their treatment plan. Discuss the side effects but try to balance them with the benefits they will experience. Explain the risks of accidental poisoning, as well as the role of naloxone for emergency use to reverse a known or suspected opioid overdose.4-6
    • Ask open-ended questions that allow you to assess a patient’s responsiveness in a busy pharmacy environment: e.g., How do you feel about taking this medication?3
    • Frame risks in a way that is understandable using analogies: e.g., Think of it like having a fire extinguisher in the kitchen. You hope you don’t need it, but you are prepared if you do.2,6,7
  • A study conducted in the United States showed that many patients were not aware their medication was an opioid.8 Ensure your patient understands their prescription; define, in patient-friendly language, what opioids do to the human body and their potential risks.4,5
  • Anticipate how to deal with a hostile response: e.g., I’m not an addict. Is that what you see me as after coming to your pharmacy for 5 years? Give me a break! 3
    • Put their worries to rest by reassuring them that it is a standard step in your pharmacy to offer a take-home naloxone kit to ALL patients receiving an opioid prescription.5
    • Explain that they always have a right to refuse.6
Communication is key! Keep in mind that some people may have been influenced by the negative connotations that media coverage has given to opioid use.9 Remind your patients that anyone using opioids may be at risk for an accidental poisoning.5

Your patients are counting on you! At the same time, they don’t know what they don’t know! Talk to them about accidental opioid overdose and offer NARCAN® Nasal Spray with every opioid prescription.