Risk,	  Recognize,	  Resolve:	  Addic2on	                   in	  the	            Pharmacy	  Profession	  	                ...
Learning	  Objec2ves	  •  1.	  Iden=fy	  risk	  factors	  for	  pharmacy	  professionals	  that	     may	  influence	  the	...
Disclosure	  Statement	  Brian	  Fingerson	  has	  no	  financial	  rela=onships	  with	  proprietary	  en==es	  that	  pro...
Brian	  Fingerson,	  RPh	  •  President,	  KYPRN	  –	  Kentucky	  Professionals	  Recovery	     Network	  since	  1986	  •...
What	  do	  you	  know?	  Self-­‐Assessment	  Ques2ons	  T	  or	  F	  •  In	  a	  diagnosis	  of	  addic=on	  using	  DSM	...
And	  why	  should	  we	  learn	  about	  addic2on	  in	                       pharmacy	  professionals?	  Crit	  Care	  M...
Crit	  Care	  Med.	  2007	  Feb;35(2	  Suppl):S106-­‐16	                                  Baldisseri	  MR.	  •  INTRODUCTI...
Why	  do	  people	  take	  drugs	  “recrea2onally”	  in	      the	  first	  place?	  
People	  Take	  Drugs	  To:	  • Feel	  good	  (sensa2on	  seeking)	  • Feel	  be[er	  (self-­‐medica2on)	  
A	  major	  reason	  people	  take	  	  a	  psychoac2ve	  drug	  is	  they	                 like	  what	        it	  does	...
Prolonged drug use changesthe brain in fundamental and     long-lasting ways
Reward Pathway                 Frontal	  Cortex	                                    Wow!!!	    Addiction     is a         ...
Young adults 	  may	   be less              	   	   	   	   	  likely to develop serious alcohol    and other drug problem...
AA	  Grapevine	  e-­‐poll	    Ques2on:	  At	  what	  age	  did	    you	  have	  your	  first	  drink?	  	     Total	  Respo...
Addic2on:	  One	  Defini2on	  •  A	  primary,	  chronic,	  neurobiological	  disease,	     with	  gene2c,	  psychosocial,	 ...
Addic2on	  behaviors:	  •  Impaired	  control	     over	  drug	  use	  •  Compulsive	  use	  •  Con2nued	  use	     despit...
Fr	  Vernon	  Johnson’s	  defini2on	  of	  addic2on	  •  “”Alcoholism,	  chemical	  addic2on,	  is	  a	     disease,	  the	...
DSM	  IV:	  Diagnosis	  of	  Addic2on	                 (3	  out	  of	  7	  in	  past	  12	  months)	  1.  Tolerance	  2.  ...
DSM-­‐V	  
Risk	  as	  a	  healthcare	  professional?	   Don’t	  know	  of	    anyone	  yet	  whose	    reason	  for	    becoming	  ...
Risk	  Factors	  •  General	  Public	  =	  10%	  •  Pharmacists	  and	  some	  other	     health	  care	  professionals	  ...
So…Why	  an	  increased	  risk	  factor?	  •    Access	  to	  drugs	  •    Stress	  •    Knowledge	  •    Family	  history...
 And	  how	  can	  this	  be,	  you	  say?	  •  Dean	  Dabney	  in	     JAPhA,	  May/June	     2001	  •  Vol.	  41,	  No.	...
Who	  was	  asked?	  •  It	  was	  a	  random	  sample	  of	     licensed,	  prac2cing	  pharmacists	     who	  were	  mem...
  	  And	  what	  did	  the	  study	   	                                  	  show?	  •  40%	  indicated	  using	  PAPD	   ...
DENIAL – not just a river in Egypt*                    Yes – it has been said before!•  Don’t	  •  Even	  •  Know	  •  I	 ...
Denial	                      from	  Knots	  by	  R.D.	  Lang	  •  There	  must	  be	  something	  the	     ma[er	  with	  ...
Denial	  con2nued:	  •  He	  does	  not	  think	  there	  is	  anything	  the	     ma[er	  with	  him	  because	  one	  of...
HCP	  good	  at	  “cover	  up”	  and	  if	               confronted	  will	  deny	  •  Denial	  is	  not	  just	  a	  rive...
Blackouts	                   -­‐	  Once	  a	  person	  has	  had	  one	  	                              Fr	  Vernon	  John...
Problems	  seen:	  •  Slurred	  speech	  –	     frequent	  drunkenness	  •  Personal	  problems	  •  Paren2ng	  problems	 ...
Problems	  con2nued:	  •  Frequent	  promises	  to	  cut	  back	  •  Avoiding	  social	  func2ons	  unless	     “altered”	...
Impairment	  signs/symptoms	  in	  the	                        workplace:	  •  Changes	  in	  the	  manner	  in	  which	  ...
Workplace	  con2nued:	  •  Poor	  record	  keeping	  •  Problems	  with	  concentra2on	  •  Med	  errors	  or	  whatever	 ...
Workplace	  con2nued:	  • Paranoia	  • Frequent	  trips	  to	  the	    bathroom	  • Mood	  swings	  • Periods	  of	  unemp...
Am	  I	  an	  alcoholic?	  •  1.	  	  Have	  you	  ever	  decided	  to	  stop	  drinking	  for	  a	     week	  or	  so,	  ...
Am	  I	  an	  alcoholic?	  •  5	  -­‐	  Do	  you	  envy	  people	  who	  can	  drink	     without	  gesng	  into	  trouble...
Am	  I	  an	  alcoholic?	  •  9	  -­‐	  Do	  you	  tell	  yourself	  you	  can	  stop	  drinking	     any	  2me	  you	  wa...
p9	                             CAGE-­‐AID	      • Cut	  down	      • Annoyed	      • Guilty	      • Eye	  opener	  CAGE-A...
CAGE-­‐AID	  1.	  Have	  you	  felt	  you	  ought	  to	  cut	  down	  on	  your	  drinking	        or	  drug	  use?	  2.	 ...
CRAFFT	  Ques2ons	  5.  Have	  you	  ever	  ridden	  in	  a	  CAR	  driven	  by	  someone	       (including	  yourself)	  ...
But	  I	  can’t	  be	  one!!!!!!!!!!	  
If…then	  three	  courses	  of	  ac2on:	  •  Sober	  up	  •  Get	  locked	  up	  •  Get	  covered	     up	  =	  PUAD	  	  
Do	  they	  have	  to	  reach	  this	  level?	  
It	  is	  this	  serious	  folks!	  
To	  whom	  do	  I	  turn	  for	  help?	    Do	  you	  call	  the	     professional’s	  licensing	     Board?	    Board	...
There	  is	  an	  op2on	  in	  some	  states	    You	  could	  call	  your	     state’s	  recovery	     program	    I	  ...
Referral	  by:	  •    Board	  •    Self	  •    Colleague	  or	  employer	  •    Family	  •    Interven2on	  •    ***anonym...
Why	  do	  they	  ask	  for	  help?	  • Liver	  • Lover	  • Livelihood	  • Law	  
Then	  what	  happens?	  
Evalua2on	  •  KYPRN	  uses	  addic2ons	     psychiatrists	  and	     some2mes	  a	  residen2al	     3-­‐5	  day	  assessm...
Yes…Rehab	  does	  work!	  
Goals	  of	  Addic2on	  Therapy:	  •  Reduc2on	  or	  elimina2on	  of	  denial	  •  Increased	  self	  care	  •  Treatment...
Contracts	  •  For	  a	  specific	  length	  of	  2me	  –	  usually	  5	     yrs	  •  Shared	  with	  employer	  –	  if	  p...
Other	  things	  •  Mee2ng	     documenta2on	     forms	  •  Medica2on	  use	  lists	  •  Monthly	  self-­‐report	     for...
Pharmacist	  may	  have:	  •  Modifica2on	  of	  prac2ce	  type	  •  Prac2ce	  monitoring	  by	  peers/others	  •  Protocol...
Conclusion	  •  Substance	  abuse	  by	     HCP	  is	  a	  condi2on	  that	     has	  become	     increasingly	  recognize...
Treatment	  does	  work!	    The	  vast	  majority	  of	     Pharmacists	  who	     successfully	  complete	     treatmen...
“The	  alcoholic	  is	  like	  a	  tornado	  roaring	  through	  the	  lives	  of	                                     oth...
Page	  82	  also	  says:	  “Hearts	  are	  broken.”	  	  Our	  goal	  is:	  Recovery	                                  	  ...
Not	  this:	  
True	  or	  False	  •  “Alcoholism,	  chemical	  addic2on,	  is	  a	  disease,	     the	  very	  nature	  of	  which	  ren...
True	  or	  False	  •  In	  a	  diagnosis	  of	  addic2on	  using	  DSM	  IV	     criteria,	  one	  must	  exhibit	  any	 ...
True	  or	  False	  •  Gene2cs	  is	  the	  sole	  determining	  factor	     as	  to	  whether	  someone	  becomes	     ad...
True	  or	  False	  •  The	  prognosis	  for	  someone	  who	  is	     addicted	  to	  a	  substance	  includes	  these	  ...
Have	  you	  ever	  wondered?	  
Ques2ons?	  •  Brian	  Fingerson,	  RPh	  •  202	  Bellemeade	  Road	  •  Louisville,	  KY	     40222-­‐4502	  •  502-­‐74...
Thank	  you	                     Thank                   you                   Thank                   you                ...
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Risk recognize resolve_addiction_in_the_pharmacy_profession

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National Rx Drug Abuse Summit
Brian Fingerson

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Risk recognize resolve_addiction_in_the_pharmacy_profession

  1. 1. Risk,  Recognize,  Resolve:  Addic2on   in  the   Pharmacy  Profession     April  2  –  4,  2013   Omni  Orlando  Resort     at  ChampionsGate  
  2. 2. Learning  Objec2ves  •  1.  Iden=fy  risk  factors  for  pharmacy  professionals  that   may  influence  the  development  of  the  disease  of   addic=on.  •  2.  Iden=fy  the  signs  and  symptoms  of  the  disease  of   addic=on.  •  3.  Describe  the  resources  available  to  pharmacy   professionals  when  a  colleague  may  need  assistance   with  addic=on  or  substance  abuse  issues.  •  4.  Describe  the  structure  of  accountability  added  to  the   recovery  person  by  monitoring  with  a  Pharmacist   Recovery  Network.  
  3. 3. Disclosure  Statement  Brian  Fingerson  has  no  financial  rela=onships  with  proprietary  en==es  that  produce  health  care  goods  and  services.  
  4. 4. Brian  Fingerson,  RPh  •  President,  KYPRN  –  Kentucky  Professionals  Recovery   Network  since  1986  •  Clients/professions  include:  Accountants,  Pharmacy,   Den=stry,  Physical  Therapy,  Veterinary  Medicine,   Respiratory  Care,  Optometry,  Chiroprac=c,  Social   Work  •  Work  with  these  professionals  through  their  licensing   Boards  
  5. 5. What  do  you  know?  Self-­‐Assessment  Ques2ons  T  or  F  •  In  a  diagnosis  of  addic=on  using  DSM  IV  criteria,  one  must  exhibit  any   two  out  of  seven  of  the  criteria  within  the  past  six  months.    •  Gene=cs  is  the  sole  determining  factor  as  to  whether  someone  becomes   addicted  to  a  substance  or  process.  •  The  prognosis  for  someone  who  is  addicted  to  a  substance  includes  these   three:  1)  get  sober;  2)  get  locked  up;  or  3)  die.  •  Alcoholism,  chemical  addic=on,  is  a  disease,  the  very  nature  of  which   renders  the  vic=m  incapable  of  recognizing  the  severity  of  the  symptoms,   the  progression  of  the  disease,  or  of  accep=ng  any  ordinary  offers  of   help.  
  6. 6. And  why  should  we  learn  about  addic2on  in   pharmacy  professionals?  Crit  Care  Med.  2007  Feb;35(2  Suppl):S106-­‐16   Baldisseri  MR.   Cri=cal  Care  Medicine,  University  of  Pidsburgh  School   of  Medicine,  Pidsburgh,  Pennsylvania,  USA.     OBJECTIVE:  The  objec1ve  of  the  ar1cle  is  to  present  the   available  data  from  the  literature  on  substance  use   disorders  in  healthcare  professionals.  Prevalence,  risk   factors,  treatment  op1ons,  and  reentry  into  clinical   prac1ce  are  discussed.  
  7. 7. Crit  Care  Med.  2007  Feb;35(2  Suppl):S106-­‐16   Baldisseri  MR.  •  INTRODUCTION:  Impairment  of  a  healthcare  professional  is   the  inability  or  impending  inability  to  prac5ce  according  to   accepted  standards  as  a  result  of  substance  use,  abuse,  or   dependency  (addic5on).  The  term  substance  use  disorder  can   be  divided  into  substance  abuse  and  dependence  (addic1on).   Substance  abuse  results  in  adverse  social  and  professional   consequences.  Addic5on  manifests  as  physiologic  and   behavioral  symptoms  related  to  a  maladap1ve  paLern  of   substance  use.  •  MAIN  RESULTS:  It  is  es1mated  that  approximately  10%  to   15%  of  all  healthcare  professionals  will  misuse  drugs  or   alcohol  alcohol  some  1me  during  their  career.  
  8. 8. Why  do  people  take  drugs  “recrea2onally”  in   the  first  place?  
  9. 9. People  Take  Drugs  To:  • Feel  good  (sensa2on  seeking)  • Feel  be[er  (self-­‐medica2on)  
  10. 10. A  major  reason  people  take    a  psychoac2ve  drug  is  they   like  what   it  does  to  their  brains  
  11. 11. Prolonged drug use changesthe brain in fundamental and long-lasting ways
  12. 12. Reward Pathway Frontal  Cortex   Wow!!!   Addiction is a Opiatesbrain disease Alcohol Cocaine Amphetamines Marijuana
  13. 13. Young adults  may   be less          likely to develop serious alcohol and other drug problems if the age of first use is delayed beyond childhood or adolescence
  14. 14. AA  Grapevine  e-­‐poll   Ques2on:  At  what  age  did   you  have  your  first  drink?     Total  Responded:  7947     0-­‐11   2308  votes  (29.04  %)   12-­‐18   5110  votes  (64.3  %)   19-­‐26   420  votes  (5.29  %)   27-­‐40   52  votes  (0.65  %)   41  or  older   57  votes  (0.72  %)  
  15. 15. Addic2on:  One  Defini2on  •  A  primary,  chronic,  neurobiological  disease,   with  gene2c,  psychosocial,  and   environmental  factors  influencing  its   development  and  manifesta2ons.    It  is   characterized  by  behaviors  that  include  one   or  more  of  the  following:  
  16. 16. Addic2on  behaviors:  •  Impaired  control   over  drug  use  •  Compulsive  use  •  Con2nued  use   despite  harm  •  Craving  
  17. 17. Fr  Vernon  Johnson’s  defini2on  of  addic2on  •  “”Alcoholism,  chemical  addic2on,  is  a   disease,  the  very  nature  of  which  renders  the   vic2m  incapable  of  recognizing  the  severity   of  the  symptoms,  the  progression  of  the   disease,  or  of  accep2ng  any  ordinary  offers  of   help.”  
  18. 18. DSM  IV:  Diagnosis  of  Addic2on   (3  out  of  7  in  past  12  months)  1.  Tolerance  2.  Withdrawal  Loss  of  Control:  3.  Used  more  and  longer  than  planned  4.  Unsuccessful  a[empts  to  quit  or  control  use  5.  Excessive  2me  spent  obtaining,  using,  or         recovering  from  use  6.  Important  ac2vi2es  given  up  7.  Con2nued  use  despite  adverse  consequences  
  19. 19. DSM-­‐V  
  20. 20. Risk  as  a  healthcare  professional?   Don’t  know  of   anyone  yet  whose   reason  for   becoming  a   pharmacist  was   drug  access.    But… maybe  so?  
  21. 21. Risk  Factors  •  General  Public  =  10%  •  Pharmacists  and  some  other   health  care  professionals  =  HCP  =   12-­‐16%  
  22. 22. So…Why  an  increased  risk  factor?  •  Access  to  drugs  •  Stress  •  Knowledge  •  Family  history  =  1   parent  20-­‐25%   chance,  2  parents   30-­‐50%  
  23. 23.  And  how  can  this  be,  you  say?  •  Dean  Dabney  in   JAPhA,  May/June   2001  •  Vol.  41,  No.  3    •  Use  of  Mind  Altering   or  Poten2ally   Addic2ve  Prescrip2on   Drugs  (PAPD)  
  24. 24. Who  was  asked?  •  It  was  a  random  sample  of   licensed,  prac2cing  pharmacists   who  were  members  of  APhA  in   the  fall  of  1996.  
  25. 25.    And  what  did  the  study      show?  •  40%  indicated  using  PAPD   without  1st  obtaining  an   Rx  •  20%  reported  5  or  more   life2me  episodes  •  6%  reported  10  or  more   life2me  episodes  •  6%  iden2fying  as  being   drug  abusers  •  Drugs  obtained  by   stealing  drugs  from   employers  or  forging  Rx  
  26. 26. DENIAL – not just a river in Egypt* Yes – it has been said before!•  Don’t  •  Even  •  Know  •  I  •  Am  •  Lying  
  27. 27. Denial   from  Knots  by  R.D.  Lang  •  There  must  be  something  the   ma[er  with  him  because  he  would   not  be  ac2ng  as  he  does  unless   there  was.    Therefore  he  is  ac2ng  as   he  is  because  there  is  something  the   ma[er  with  him.  
  28. 28. Denial  con2nued:  •  He  does  not  think  there  is  anything  the   ma[er  with  him  because  one  of  the  things   that  is  the  ma[er  with  him  is  that  he  does   not  think  that  there  is  anything  the  ma[er   with  him.  •  Therefore  we  have  to  help  him  realize  that,   the  fact  that  he  does  not  think  there  is   anything  the  ma[er  with  him  is  one  of  the   things  that  is  the  ma[er  with  him.  
  29. 29. HCP  good  at  “cover  up”  and  if   confronted  will  deny  •  Denial  is  not  just  a  river  in  Egypt  •  Paranoia  and  irritability  •  Depression  •  Use  of  large  quan22es  of  alcohol  –  more   than  normal  or  more  than  others   present  •  Blackouts  
  30. 30. Blackouts   -­‐  Once  a  person  has  had  one     Fr  Vernon  Johnson  •  1)  You  can  never  tell  how  much  of  the   chemical  it  will  take  to  put  you  into  the   blackout  again.  •  2)  You  can  never  tell  how  long  the  blackout   will  last.  •  3)  There  is  no  connec2on  between  our  value   system  and  what  we  will  do  in  a  blackout.  
  31. 31. Problems  seen:  •  Slurred  speech  –   frequent  drunkenness  •  Personal  problems  •  Paren2ng  problems  •  Sexual  dysfunc2on  or   promiscuity  •  Insomnia  •  Having  ONLY  friends   who  like  to  party  
  32. 32. Problems  con2nued:  •  Frequent  promises  to  cut  back  •  Avoiding  social  func2ons  unless   “altered”  •  Memory  problems  •  Mood  swings  •  Blaming  of  behavior  on  others  •  Withdrawal  into  isola2on  
  33. 33. Impairment  signs/symptoms  in  the   workplace:  •  Changes  in  the  manner  in  which   pa2ents  and  colleagues  are  treated  •  Deteriora2on  of  personal   appearance  and  hygiene  •  Loss  of  interest  in  work,  or….  •  “Super  Pharmacist”  or  Super   whatever  
  34. 34. Workplace  con2nued:  •  Poor  record  keeping  •  Problems  with  concentra2on  •  Med  errors  or  whatever  •  Absenteeism  or  tardiness,  esp.   on  day  following  days  off  •  Pa[ern  of  frequent  job  changes  
  35. 35. Workplace  con2nued:  • Paranoia  • Frequent  trips  to  the   bathroom  • Mood  swings  • Periods  of  unemployment  
  36. 36. Am  I  an  alcoholic?  •  1.    Have  you  ever  decided  to  stop  drinking  for  a   week  or  so,  but  only  lasted  for  a  couple  of  days?   2  -­‐  Do  you  wish  people  would  mind  their  own   business  about  your  drinking-­‐-­‐  stop  telling  you   what  to  do?   3  -­‐  Have  you  ever  switched  from  one  kind  of   drink  to  another  in  the  hope  that  this  would   keep  you  from  gesng  drunk?   4  -­‐  Have  you  had  to  have  an  eye-­‐opener  upon   awakening  during  the  past  year?  
  37. 37. Am  I  an  alcoholic?  •  5  -­‐  Do  you  envy  people  who  can  drink   without  gesng  into  trouble?   6  -­‐  Have  you  had  problems  connected  with   drinking  during  the  past  year?   7  -­‐  Has  your  drinking  caused  trouble  at   home?   8  -­‐  Do  you  ever  try  to  get  "extra"  drinks  at  a   party  because  you  do  not  get  enough?  
  38. 38. Am  I  an  alcoholic?  •  9  -­‐  Do  you  tell  yourself  you  can  stop  drinking   any  2me  you  want  to,  even  though  you  keep   gesng  drunk  when  you  dont  mean  to?   10  -­‐  Have  you  missed  days  of  work  or  school   because  of  drinking?   11  -­‐  Do  you  have  "blackouts"?   12  -­‐  Have  you  ever  felt  that  your  life  would  be   be[er  if  you  did  not  drink?  
  39. 39. p9   CAGE-­‐AID   • Cut  down   • Annoyed   • Guilty   • Eye  opener  CAGE-AID: CAGE QuestionsAdapted to Include Other JAMA 252:1905-1907, 1984Drugs Am J Med 82:231-235, 1987
  40. 40. CAGE-­‐AID  1.  Have  you  felt  you  ought  to  cut  down  on  your  drinking   or  drug  use?  2.  Have  people  annoyed  you  by  cri=cizing  your  drinking   or  drug  use?    3.  Have  you  felt  bad  or  guilty  about  your  drinking  or  drug   use?      4.  Have  you  ever  had  a  drink  or  used  drugs  first  thing  in   the  morning  to  steady  your  nerves,  get  rid  of  a   hangover,  or  get  the  day  started?        Screen  posi5ve  score  =  1+or  2+              
  41. 41. CRAFFT  Ques2ons  5.  Have  you  ever  ridden  in  a  CAR  driven  by  someone   (including  yourself)  who  was  “high”  or  had  been  using   alcohol  or  drugs?  6.  Do  you  ever  use  alcohol  or  drugs  to  RELAX,  feel  beder   about  yourself,  or  fit  in?  7.  Do  you  ever  use  alcohol/drugs  while  you  are  by  yourself,   ALONE?  8.  Do  your  family  or  FRIENDS  ever  tell  you  that  you  should  cut   down  on  your  drinking  or  drug  use?  9.  Do  you  ever  FORGET  things  you  did  while  you  were  using   alcohol  or  drugs?  10.  Have  you  goden  into  TROUBLE  while  you  were  using         alcohol  or  drugs?      Screen  posi5ve  score  =  2+          
  42. 42. But  I  can’t  be  one!!!!!!!!!!  
  43. 43. If…then  three  courses  of  ac2on:  •  Sober  up  •  Get  locked  up  •  Get  covered   up  =  PUAD    
  44. 44. Do  they  have  to  reach  this  level?  
  45. 45. It  is  this  serious  folks!  
  46. 46. To  whom  do  I  turn  for  help?    Do  you  call  the   professional’s  licensing   Board?    Board  balances   regula2on  with   compassion    Is  it  a  bad  person  in   need  of  punishment  or   an  ill  person  in  need  of   care?  
  47. 47. There  is  an  op2on  in  some  states    You  could  call  your   state’s  recovery   program    I  publish  my  office/ home  phone  number    The  website   www.usaprn.org  has  a   directory  of  state   programs  
  48. 48. Referral  by:  •  Board  •  Self  •  Colleague  or  employer  •  Family  •  Interven2on  •  ***anonymous  
  49. 49. Why  do  they  ask  for  help?  • Liver  • Lover  • Livelihood  • Law  
  50. 50. Then  what  happens?  
  51. 51. Evalua2on  •  KYPRN  uses  addic2ons   psychiatrists  and   some2mes  a  residen2al   3-­‐5  day  assessment  •  Results  of  evalua2ons   will  determine  to  a  large   extent  what  type  of   treatment.    It  may  be   AA/NA,  IOP,  Long-­‐term   residen2al  or  other  or  a   combina2on  
  52. 52. Yes…Rehab  does  work!  
  53. 53. Goals  of  Addic2on  Therapy:  •  Reduc2on  or  elimina2on  of  denial  •  Increased  self  care  •  Treatment  of  medical  and  psychiatric   problems  •  Treatment  of  co-­‐morbid  family  •  Educa2on  to  protect  himself  or  herself  from   substance  abuse  disease  
  54. 54. Contracts  •  For  a  specific  length  of  2me  –  usually  5   yrs  •  Shared  with  employer  –  if  per2nent  •  May  limit  number  of  hours  worked  •  Approved  prac2ce  site  or  type  •  CAPTASA,  U  of  Utah,  SE  PRN  
  55. 55. Other  things  •  Mee2ng   documenta2on   forms  •  Medica2on  use  lists  •  Monthly  self-­‐report   form  •  Urine  Drug  Screens  
  56. 56. Pharmacist  may  have:  •  Modifica2on  of  prac2ce  type  •  Prac2ce  monitoring  by  peers/others  •  Protocols  for  required  mood-­‐altering  drugs   for  a  legi2mate  medical  problem  •  Consequences  should  she  return  to  substance   use  
  57. 57. Conclusion  •  Substance  abuse  by   HCP  is  a  condi2on  that   has  become   increasingly  recognized   over  the  past  20+   years.    We’ve  worked   hard  to  develop   treatment  protocols   and  support  programs.  
  58. 58. Treatment  does  work!    The  vast  majority  of   Pharmacists  who   successfully  complete   treatment  and   par2cipate  in  a{ercare   monitoring  CAN  and   DO  successfully  return   to  prac2ce.    HIRE  THE  RECOVERING   PROFESSIONAL  
  59. 59. “The  alcoholic  is  like  a  tornado  roaring  through  the  lives  of   others.”  page  82   From  the  book:  “Alcoholics  Anonymous”  
  60. 60. Page  82  also  says:  “Hearts  are  broken.”    Our  goal  is:  Recovery    From  the  book:  “Alcoholics  Anonymous”   Recovery:  by   Mike  Vye  
  61. 61. Not  this:  
  62. 62. True  or  False  •  “Alcoholism,  chemical  addic2on,  is  a  disease,   the  very  nature  of  which  renders  the  vic2m   incapable  of  recognizing  the  severity  of  the   symptoms,  the  progression  of  the  disease,  or   of  accep2ng  any  ordinary  offers  of  help.”  •  TRUE  
  63. 63. True  or  False  •  In  a  diagnosis  of  addic2on  using  DSM  IV   criteria,  one  must  exhibit  any  2  out  of  7   of  the  criteria  within  the  past  6  months.  •  FALSE  
  64. 64. True  or  False  •  Gene2cs  is  the  sole  determining  factor   as  to  whether  someone  becomes   addicted  to  a  substance  or  process.  •  FALSE  
  65. 65. True  or  False  •  The  prognosis  for  someone  who  is   addicted  to  a  substance  includes  these   three:  1)  get  sober;  2)  get  locked  up;  or   3)  DIE  •  TRUE  
  66. 66. Have  you  ever  wondered?  
  67. 67. Ques2ons?  •  Brian  Fingerson,  RPh  •  202  Bellemeade  Road  •  Louisville,  KY   40222-­‐4502  •  502-­‐749-­‐8385  •  Email  =  kyprn@a[.net      
  68. 68. Thank  you   Thank you Thank you Thank you

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