Disclaimer: The content of this article is not an indictment or personal attack on the pharmacy profession. Especially, not a blanket reflection of all practicing pharmacists. The article is purely meant to increase awareness on mental health challenges among pharmacists.
A close friend and colleague once asked me if I had ever contemplated ending my life. I remember thinking at the time, what a dark question to ask someone on a Sunday evening. In his opinion, the fact that I had to pause and reflect on it, instead of giving a straight ‘no’ answer meant that maybe I had gone through some trying times. Maybe I had.
You see, mental health disorder is the reality of many individuals and pharmacists in particular are vulnerable to being led into a dark path of addiction. Studies show that between 7% to 25% of pharmacists either misuse or abuse opioids and anti-anxiety medicines. To many in the profession, mental illness is an ugly topic, adorned with a black veil of stigma. But for the sake of the profession it may be time to unveil.
Why Focus on Pharmacists?
Just as the next person, pharmacists face the same life stresses, distress, disappointment and sadness that come with family and careers. However, as the rightfully licensed key custodians of medicines, pharmacists enjoy almost free rein when it comes to access to medicines. This means they are at an increased risk of substance use disorder. Studies back this claim;
- 46% of pharmacists have used controlled substances without a prescription.
- Pharmacists with alcohol abuse problems have a three-fold risk of relapse
- Between 1%-6% of pharmacist students were current opioid users at the time of the study
Armed with knowledge on the scope of drug classes, pharmacokinetics and pharmacodynamics, there is no telling how far a pharmacist struggling with addiction can go. He fully understands the potential side effects, adverse drug reactions and other negative eventualities but he is also fully aware of the sensations and escape therein. This mistakenly gives an aura of invincibility.
Pharmacists are at the heart of health service delivery and the life of patients are always on the line when dispensing medicines. They therefore need to be in the right frame of mind with an unquestionable level of judgement. One can’t recommend or dispense a wrong drug, strength, duration or even fail to seek an allergy history as this could spell the end of a patient.
What are the signs?
The first step in assisting a colleague struggling with substance abuse is to know what to look out for:
- Disinterest in work responsibilities and avoiding social encounters with colleagues due to substance use
- Showing up to wok intoxicated
- Pilferage of controlled drugs
- Sudden financial requests without a justifiable reason
- Neglected physical appearance and hygiene
- Difficulty concentrating
- Random unexplained outbursts expressing overwhelming frustration
Read also: How to boost pharmaceutical manufacturing in Africa (africanpharmaceuticalreview.com)
What are the consequences?
The negative effects of misuse and abuse of drugs impact both the pharmacist as well as the patient.
A pharmacist struggling with substance abuse risks disciplinary sanctions from the profession’s regulatory body. A possibility of this is withdrawal of his practice license and eventually his job. With this loss of income, comes an inability to provide for oneself and family leading to an overwhelming feeling of shame and inadequacy. In addition, a continued use of these controlled prescription drugs may lead to health deterioration and sometimes loss of life through overdose.
Patients are always at risk when handled with health care workers struggling with addiction. As explained previously, medication related errors can lead to unwarranted morbidity and mortality among patients.
It is also important to mention that, substance abuse can also take a huge emotional and financial toll on close family and friends.
So what can be done?
The approach has to be three-pronged; promotive, preventative and curative.
Promotive
The topic of mental health and substance abuse has to be a mainstay in all pharmacy related curricula. In a more exponential learning manner, students need to be taught how to navigate career related stresses and how to seek help when overwhelmed. Continuous on-job training has to be introduced on how to detect mental related disorders, how to manage them and how to provide support to colleagues struggling with the same.
Preventive
Take breaks. Someone once said that employees who have lost their lives are replaced at their workplace before their bodies are cold. Seriously if you feel overwhelmed take your annual leave, take a vacation, recharge your batteries. Additionally incorporate in your day, an activity that brings you joy. It could be running in the gym, watching a movie, talking to a friend. Whatever it is, do it.
Curative
Interestingly studies have shown that pharmacy personnel who have gone through a recovery from addiction program, stood a better chance of maintaining sobriety. The African Pharmacy Boards need to recognize that substance use disorders can affect pharmacy personnel and hence should establish a Pharmacy Recovery Network. This could be a confidential program that makes treatment referrals and monitors recovery of pharmacy professionals struggling with SUD.
