Nova Scotia

How Nova Scotia pharmacists help in the fight against opioid addiction

Plenty of discussion about how to deal with the opioid addiction crisis in Canada has focused on the role of doctors, even though some patients see their pharmacist more often than any other health-care professional.

Over 20 pharmacies are part of the Bloom Program, which helps people with mental health and addiction issues

The Bloom Program in Nova Scotia helps pharmacists work with patients with mental health and addiction issues. (Toby Talbot/Associated Press)

Plenty of discussion about how to deal with the opioid addiction crisis in Canada has focused on the role of doctors, even though some patients see their pharmacist more often than any other health-care professional.

That's why a Nova Scotia pharmacist and professor believes pharmacists play a key role in dealing with this issue.

Every prescription involves "a pharmacist, a physician and a patient, so there's a natural triad there," said Dr. David Gardner, who works in the department of psychiatry and college of pharmacy at Dalhousie University.

In Atlantic Canada, the opioids in question are not smuggled medications— they're prescribed.

Gardner said pharmacists usually have daily interactions with patients coming in for drugs like methadone to deal with opioid withdrawal. They may also see patients who are receiving medication for pain but using it for other reasons, or are on a medication that may not be safe for them, he said. 

"It's critical that the pharmacist is involved," Gardner told CBC's Information Morning.

'Very novel' work in Nova Scotia

There is a program in Nova Scotia that helps pharmacists deal with patients with mental health and addiction issues.

The Bloom Program, which is funded by the Nova Scotia Department of Health and Wellness, has been running for just over two years. The work started a few years back under the name More than Meds.

"We're doing something very novel here," said Gardner. "It's very different."

Pharmacists go through a nine-step process to become part of the program. A key part is knowing who's out there in the community to support patients, Gardner said, such as doctors, community advocates or a mobile crisis team.

Conversations in private

Patients who sign up for the program meet with a pharmacist in a private consultation room.

The pharmacist then does an assessment. They chat with the patient to get permission to share the patient's confidential health information with certain people selected by the patient. That could include a doctor or family member.

This is important because people who live with mental illness are sometimes not able to recognize when they're not doing well, Gardner said. With the conversation, a pharmacist has permission to call someone who helps care for the patient.

"The conversations change when you're in private, compared to when you're at the counter," Gardner said.

Patient support 

One pharmacist recently told Gardner about a man who's on methadone maintenance and comes in every day. 

The pharmacist noticed a behaviour change when the man started arriving at very different times for his dose.  

He told the pharmacist he'd been selling some of his methadone to get narcotics and opiates to inject.

"The pharmacist recognized that this man is really struggling with his illness and needed care," Gardner said. "It was through the pharmacist that a trigger was changed to support him."

The man was comfortable speaking with the pharmacist because he'd built a relationship with him, Gardner said. 

Out of the more than 300 pharmacies in the province, 23 are involved in the Bloom Program. More pharmacies are on a wait list.

With files from CBC's Information Morning