Q&A: Impact of Stigma on Pharmacists with SUD, Importance of Mental Health Care

Approximately 1 in 9 pharmacists will suffer from a substance use disorder at some point in their career and 46% report having used controlled substances without a prescription. This is due in part to factors associated with their work environment, including long hours, burnout, and constant exposure and access to controlled substances. However, the stigma around addiction prevents many from seeking help due to feelings of shame and embarrassment.

Q&A: Impact of Stigma on Pharmacists with SUD, Importance of Mental Health Care / Daniels C - stock.adobe.com

Drug Topics recently spoke with Sara T. Thomason, PharmD, BCPP, BCACP, CGP, FASCP, professor and chair of Pharmacy Practice at the Gatton College of Pharmacy at East Tennessee State University, who serves on the Virginia Board of Pharmacy and the Virginia Opioid Abatement Authority, about the impact of stigma on pharmacists who are dealing with substance use disorder, the importance of mental health care, and how schools support pharmacy students dealing with addiction.

READ MORE: For Pharmacists With Substance Use Disorders, Recovery Is Possible

Drug Topics: How can stigma impact a pharmacist who is dealing with a substance use disorder? What can be done to help erase that stigma?

Sarah T. Thomason, PharmD, BCPP, BCACP, CGP, FASCP: Stigma is still so prevalent and when you're a healthcare professional that has the disease of addiction, it's even worse because there's such shame. I know a lot of pharmacists that have a substance use disorder [that] started when they were in a college of pharmacy, which is I work now. I think a lot of schools are really [trying to] bring addiction education into the curriculum so that these pharmacists do understand this is not a moral failure. [Having a substance use disorder] is not because you're weak. It is because you have a disease. It takes treatment. It's chronic. It's relapsing. You have to understand that it's long term treatment to get into long term recovery for most people. I think education [is key], especially starting [with] student pharmacists, but also doing continuing education with our licensed pharmacists, so that they feel more comfortable if they see someone [dealing with] a substance use disorder that they help intervene and get them the treatment they need and support them, instead of making them feel that they're less than or that there's something wrong with them.

Drug Topics: How important is mental healthcare for pharmacists?

Thomason: I think with the stress, with a lot of the workplace conditions, anxiety and depression are very common among pharmacists, but also other healthcare professionals as well. We learn that these are diseases, but when it comes to getting help for ourselves, a lot of people are still reluctant because they're embarrassed and they don't equate having depression or anxiety with hypertension or cholesterol. It's all very similar. It's just hard getting people to accept that still. If you understand you have an anxiety disorder [or] you have depression or a mood disorder, if you get it effectively treated, either with medications or with therapy, you can get much better and that decreases your risk of trying to use other substances to treat that anxiety like alcohol, for example. That's probably one of the most common things we see with our pharmacists. [They] will go home and use alcohol to sleep or to decrease their anxiety and that can lead to where they're having 5 or 6 drinks a night, and then they're coming in in the morning impaired. I think just recognizing that they do have a problem, and not being embarrassed to ask for help and to get the treatment.

Drug Topics: What would you say to a pharmacist who is dealing with a substance use disorder who may be hesitant about seeking help?

Thomason: I think I would just talk to them about what's going on in their brain. Why are they feeling the need and the cravings and the compulsions to use these substances? Try to understand if they've had trauma in the past. Just talk to them about why they're probably using these substances and that if they have no hope, to have hope, because all substance use disorders are treatable. Where I work with patients with addiction on a regular basis, this patient population can get better so quickly. I think just steering them into the right way to go to get treatment, as well as the right provider. Making sure they're looking at underlying disease states like anxiety or depression or mood disorders, retention issues, can be very helpful. That is also going to be helpful to treat that substance use disorder in the long run, as well.

Drug Topics: Are schools generally supportive of pharmacy students who are dealing with a substance use disorder?

Thomason: What I have seen across the country are there schools that are very much there for students that have substance use disorders, and there are schools that are not. So, as soon as a student fails a drug fails a drug test, or they test for something that they're not prescribed, they're dismissed instead of getting help. And I'm just really proud of our college where when we have a student that we suspect of a substance use disorder, we are with them the whole way—getting them assessed, making sure they get treatment and then allowing them to come back when they're in recovery. In Tennessee, the Tennessee pharmacist Recovery Network allows our students to participate in that. So, our students are right there with other pharmacists that are in recovery and we've just had amazing results with that. I wish it were like that across the United States, but I think more schools need to make sure they have addiction education, but also the empathy and compassion to understand this is a disease, and we need to support our students that develop it.

Drug Topics: Why do you think some schools are less supportive of pharmacy students with substance use disorders?

Thomason: It is involved because you are getting them assessed for what's going on with their substance use, but as well as their mental health. [Students] have to take a leave of absence, you have to work with them to make sure they're following up with recovery networks and doing what they're supposed to. Then when they come back, making sure they're integrating back in a different class, usually. So, I think a lot of schools just traditionally haven't spent the time or had faculty that understand this and want to help and have the compassion to do it.

READ MORE: Discussing Resources for Pharmacists with Substance Use Disorder

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