Systems form to help impaired pharmacists

Drug Store News, Nov 19, 1990 by Elizabeth Richardson

Systems form to help impaired pharmacists

NEW YORK - When pharmacists speak of recovery, it's usually the recovery from illness experienced by their patients. Yet, pharmacists themselves may need help in recovering - not from flu, allergies or colds, but from another disease: chemical dependency.

It's been estimated that 10 percent to 15 percent of the pharmacists in today's workforce have, or have had, a problem with drugs or alcohol. Virtually ignored for years, the victims of this disease had almost nowhere to turn for help. But perceptive pharmacy leaders are now discovering the depth of the problem and are helping to pave the path of recovery for hundreds of "impaired" pharmacists.

Forty-six states currently have programs for recovering pharmacists in some stage of development, according to Ron Williams, coordinator of the American Pharmaceutical Association's (APhA) recovering pharmacists network. APhA began its networking program in 1983, with the establishment of the pharmacists section of the University of Utah School of Alcoholism and Other Drug Dependencies.

The pinnacle of recovery programs, the Utah school runs a week of curriculum during the summer for people interested in substance abuse programs, either for professional or personal reasons. The pharmacists' section largest section out of 18 different groups at the school, and many of the state-organized programs have been based on its ideas and concepts.

One such program was initiated in 1981 at the Texas Pharmaceutical Association (TPA). Through some intensive planning and research, the Texas Pharmacists Recovery Network was begun in 1983. "When we started, we found there were very few programs available for impaired professionals, but we thought there might be a need for pharmacists," said Jean Sheffield, TPA's director of organizational affairs and pharmacists recovery network. "What we found was that there was a whole lot more chemical abuse than we'd ever dreamed." The Texas program has grown to 322 participants, who have received help from over 100 volunteer intervenors throughout the state.

While different states have different structures for the program, most have three primary sources for a pharmacist to be referred to their programs: self-referral, state board referral, and referrals from family, friends or colleagues. Confidentiality is a must in all state programs, and protection of licenses is a key priority. "We can't let the board know if a person is in the program," said Fred Hirning, a coordinator for the California program. "We can't even let the spouse or employer know unless there's a signed release form from the pharmacist."

Increasing support

State pharmacy boards have become increasingly supportive of recovery programs. With five state board members at last summer's University of Utah school, APhA's Williams calls it a "breakthrough." "No program in any state can be successful if it doesn't work with the state board of pharmacy," he said. In many states, the board will refer pharmacists to the state program, in lieu of or in conjunction with a disciplinary action. If the pharmacist successfully completes the program, the cases are often dropped.

The new push in recovery programs now centers on colleges of pharmacy. While the attitude of some deans is still somewhat unapproachable, strides have been made to help students address the problem in its early stages. In 1988, the American Association of Colleges of Pharmacy (AACP) approved guidelines for developing pharmacy school recovery programs, and a number of schools are currently trying to incorporate these guidelines.

In a recent AACP survey, 80 percent of pharmacy school faculty members supported the concept of chemical dependency as a disease, and 90 percent advocated student recovery programs, said Jeff Baldwin, an associate professor for the University of Nebraska's drug abuse project. "The attitude is gradually changing," he said. AACP is encouraging colleges to develop programs that clearly articulate to the student to get help in college. It just gets worse later."

Many states, like Mississippi, have run symposiums for pharmacy students. "We recently had a symposium where classes were dismissed for the day, but the students were required to attend our session," said Brian Crabtree, a member of the Mississippi Association of Recovering Pharmacists (MARP) and an assistant professor at the state's school of pharmacy. "The key is to provide educational programs early on, so that problems don't occur later."

Surprisingly, most recovering pharmacists are the brightest in the profession, says TPA's Sheffield. "They feel they can't possibly get into trouble; after all, they're drug experts, and they can handle it," she said. "But they get into trouble before they know it."

Most recovering pharmacists have cross addictions - drugs and alcohol. The pharmacists' favorite mode of ingestion is by mouth, says Sheffield, since that's what they're exposed to every day. Rarely, and usually in the late stages of addiction, are pharmacists injecting drugs. "Most say the last time they used syringes was in the lab on rats," she said.