Confronting a crisis, VCU School of Pharmacy shifts curriculum on opioids
By Karolina Blaziak
Communications Associate, VCU School of Pharmacy
With thousands of Virginians affected by the opioid crisis, the VCU School of Pharmacy has added to its curriculum material about how pharmacists can respond.
An article about these curriculum changes has been accepted by the American Journal of Pharmaceutical Education. The article, “Preparing pharmacy students to manage the opioid crisis,” also discusses the background of opioid prescriptions and pain management, and the rise of opioid misuse to an epidemic in the United States.
Opioid overdoses have killed more Virginians each year than car crashes or guns, with more than 4,000 deaths between 2012 and 2017, according to the Virginia Department of Health. That has made overdoses the No. 1 cause of unnatural death in the state.
In 2016, Virginia’s health commissioner declared opioid addiction a public-health emergency. The commissioner issued a standing order authorizing pharmacists via a statewide standing order to dispense naloxone to any person requesting the drug.
To prepare pharmacy students for this responsibility, a number of activities were added to the pharmacy curriculum. In the fall 2017 semester the VCU School of Pharmacy offered a new laboratory activity in opioid-overdose management to its third-year pharmacy students.
With the statewide reach of the problem there has been “a new change in culture and awareness about opioid overdoses,” said Krista Donohoe, Pharm.D., an associate professor in the Department of Pharmacotherapy and Outcomes Science at the VCU School of Pharmacy.
The laboratory course taught 130 VCU pharmacy students what to do in the event of a patient overdose, along with a discussion of the Prescription Drug Monitoring Program, and how to do opioid calculations. The instructors — Donohoe and fellow VCU School of Pharmacy Pharmacotherapy and Outcomes Science faculty members Laura Morgan, Pharm.D., and Kacie Powers, Pharm.D. — wanted to prepare the pharmacy students to counsel patients and their families on opioid overdoses using naloxone.
Pharmacists can play a critical role in combating the opioid crisis. They have regular contact with patients and track their prescriptions through a database called the Prescription Drug Monitoring Program that lists medications prescribed and how frequently they are being dispensed.
The pharmacy students practiced with different prescription-monitoring database scenarios to learn how to identify red flags for opioid misuse.
For example, if a patient’s records show multiple visits to doctors or pharmacies, the pharmacist should recognize this as a possible red flag, and contact the prescriber to warn about potential opioid misuse, said Morgan, an associate professor in the VCU School of Pharmacy’s Department of Pharmacotherapy & Outcomes Science who served on a statewide Task Force on Prescription Drug and Heroin Abuse for then-Gov. Terry McAuliffe.
Students also practiced calculations needed to safely switch patients from one opioid to another such as from oral administration to intravenous.
In a survey conducted at the end of the course, students gave the curriculum changes high marks and said the class gave them the knowledge and confidence needed to care for their patients in the community.
“We’re going to continue it. Definitely,” Donohoe said.
Additional listed authors for the journal article are Thuy T. Tran, Pharm.D.; Ph.D. candidate Fawaz M. Alotaibi, Pharm.D.; and Archana Raghavan, Pharm.D.
For more information: Greg Weatherford, VCU School of Pharmacy director of communications