Module 4, Overview of Harm Minimisation and the Role of Pharmacists

Question 1

What is harm minimisation?

Answer 1

• to build safe, healthy and resilient Australian communities through preventing and minimising alcohol, tobacco and other drug related health, social, cultural and economic harms among individuals, families and communities

Question 2

Explain drug dependence in terms of psychological & physical dependence?

Answer 2

Psychological- also termed addiction

• the user feels they can’t go without the drug e.g. marijuana, LSD, MDMA

Physical- also termed dependence

• involves physical withdrawal & tolerance e.g. narcotics, benzodiazepenes, alcohol, tobacco

The Dopamine hypothesis of addiction

• all addictive drugs strongly increase dopamine concentration in target structures of the mesolimbic projection
• this suggests that high levels of dopamine may actually be at the origin of the adaptive changes that underlie dependence & addiction

Question 3

What does the national drug strategy state?

Answer 3

Question 4

What are some opioid facts?

Answer 4

• in 2007-2008 pharmaceutical opioids accounted for 8 in 10 hospita admissions
• over an 11 yo period more than 800 people had died from script opioids
• many oxycodone related deaths occurred in people who also reported a chronic medical condition or chronic pain
• opioid prescriptions have increased from 2.4 million in 1992 to 7 million in 2007
• approx. 1 in 5 > 45 yo will have been prescribed an opioid in the past year
• oxycodone is noe the 7th most common drug prescribed in general practice

Question 5

Describe the misuse of pharmaceuticals?

Answer 5

• pharmaceuticals for illicit use are detected almost twice as frequently as heroin
• they are the fourth most detected drug after cannabis, amphetamines and MDMA
• includes anabolic steroids, benzos, narcotics, dexy, methylphenidate
• 28% of injecting drug users admitted to using oxycontin

Question 6

What is Project STOP?

Answer 6

• an initiative used to assist in the reduction of pseudoephedrine diversion
• assist pharmacists in decision making and aids with record keeping and reporting obligations
• in QLD, WA, NT, SA, Aus Capital Territory a legislative mandatory model is in place

Question 7

Identify the role of pharmacists in addressing substance use problems…

Answer 7

• watch for patients with abnormal behaviour
• watch for ‘doctor shopping’
• keep a check on patient histories re benzos/ narcotics & reasonable time intervals between scripts
• contact prescriber PRN
• be aware of signs of intoxication
• be available and empathetic to anyone asking advice & keep up to date with knowledge of illicit drugs and where to refer for help

Question 8

What are some harm minimisation services in pharmacy?

Answer 8

• opioid substitution services
  
  • methadone
  • buprenorphine
  • buprenorphine/ naloxone
• needle & syringe supply services- FITPACK