Pharmacists as Anti-Stigma Champions: Key Strategies to Expand Buprenorphine Access for OUD

The battle against the opioid epidemic requires more than just new medications; it demands a transformation in how healthcare providers, especially pharmacists, approach patients with Opioid Use Disorder (OUD). In an interview Caroline Pearson, Executive Director at the Peterson Health Technology Institute (PHTI), outlined the urgent actions necessary to reduce the severe stigma around OUD and leverage policy changes to maximize patient access to life-saving medications like buprenorphine.

Every Day in Treatment is Life-Saving

Pearson emphasized the profound clinical importance of treatment retention, stating that every day a person stays in treatment is a day they are safer from overdose. She highlighted that the period immediately following treatment is one of the highest-risk times for overdose.

When asked about the clinical meaning of an additional 13 days of treatment retention—a metric seen in some studies—Pearson was clear:

Clinically Meaningful: Thirteen days is a significant improvement, exceeding the efficacy seen with many other interventions in the field.
Not Satisfactory: Given the long and complex nature of the OUD journey, 13 days is not enough. Continuous efforts are needed for longer-term, more effective treatment options.

Promising Innovations in OUD Recovery

New models of care are proving vital in supporting long-term recovery:

Virtual Care and Digital Support: Moving peer support and group conversations into virtual platforms (like Zoom) makes it more convenient for patients to participate, building upon decades of trust in peer support models while reducing barriers to access.
Contingency Management (CM): This evidence-based program uses monetary rewards that accrue as a patient adheres to their treatment plan. CM has been proven effective across various substance use disorders, including OUD, and is an area PHTI is eager to explore further.

The Pharmacist’s Dual Mandate: Anti-Stigma and Advocacy

Pearson outlined three critical areas where pharmacists, providers, payers, and policymakers must act to help OUD solutions reach their full potential:

1. Eliminate Stigma in the Pharmacy

The most urgent call to action for pharmacists is to confront the magnitude of stigma that still exists around OUD. Pearson noted that patients have reported feeling uncomfortable at pharmacies, and some pharmacies hesitate to stock buprenorphine due to unfounded concerns about the customer base.

Pharmacists must conduct an internal check to ensure they are creating an environment that is recovery-friendly and welcoming, making people feel invited to continue their treatment without judgment.

2. Ensure Financial Accessibility

Payers and public health agencies must ensure robust insurance coverage for OUD treatment programs. Financial barriers are a “real concern” that often prevents individuals from sticking with their treatment plan, highlighting the necessity of reducing out-of-pocket costs and other financial hurdles.

3. Preserve Policy Flexibilities

Policymakers and providers must work to sustain the regulatory changes initiated during the pandemic that have successfully expanded access to buprenorphine:

Removal of the X-Waiver: This landmark change eliminated a major barrier, allowing any practitioner with a standard DEA license to prescribe buprenorphine for OUD.
Expanded Teleprescribing: Current temporary rules allowing for the teleprescribing of buprenorphine have significantly improved patient access. Preserving these flexibilities is deemed critical to ensuring buprenorphine remains readily available to every patient who needs this clinically effective medication.

In sum, the pharmacist’s role transcends dispensing—it is a critical public health function encompassing clinical monitoring, anti-stigma efforts, and policy advocacy to support the long and vital journey of OUD recovery.