title: Indian Health Service pharmacists engaged in opioid safety initiatives and expanding access to naloxone.
abstract: OBJECTIVE
  To develop effective pharmacy-based interventions to mitigate harm from opioid use disorders. Programs include responsible opioid prescribing, expanded access to medication-assisted treatment (MAT), naloxone, and community interventions.
  
  
  METHODS
  Clinical pharmacists practicing at Indian Health Service (IHS) locations in the Southwest, Midwest, and Great Lakes regions. These pharmacists serve culturally diverse American Indian populations throughout the United States and interface with tribal and federal programs to impact the opioid epidemic in Indian Country.
  
  
  METHODS
  Pharmacists have reduced barriers to care by expanding clinical practices to include novel approaches in pain management clinics and MAT programs.
  
  
  METHODS
  As part of a multidisciplinary team, IHS pharmacists provide comprehensive patient care while focusing on the prevention of opioid dependence and opioid overdose death.
  
  
  RESULTS
  Pharmacists have also expanded professional competencies to include coprescribing naloxone and training first responders on naloxone use.
  
  
  RESULTS
  Pharmacists within IHS have proactively completed advanced training on responsible opioid prescribing, augmented services to increase access to MAT for American Indians and Alaska Natives, and increased access to naloxone for opioid overdose reversal. Pharmacists have also developed a comprehensive training program and program measurement tools for law enforcement officers serving in tribal communities. These materials were used to train 350 officers in 6 districts and conduct a mass naloxone dispensing initiative across Indian Country. Pharmacists have consequently developed successful community coalitions that are focused on saving lives.
  
  
  CONCLUSIONS
  Pharmacist involvement in key initiatives including responsible opioid prescribing, expanded access to MAT, and expanded access to naloxone for trained first responders, coupled with an emphasis on enhanced education, illustrates pharmacists' impact with the opioid epidemic.
authors.forename: Hillary
authors.initials: H
authors.lastname: Duvivier
authors.forename: Samantha
authors.initials: S
authors.lastname: Gustafson
authors.forename: Morgan
authors.initials: M
authors.lastname: Greutman
authors.forename: Tenzin
authors.initials: T
authors.lastname: Jangchup
authors.forename: Ashlee Knapp
authors.initials: AK
authors.lastname: Harden
authors.forename: Aimee
authors.initials: A
authors.lastname: Reinhard
authors.forename: Keith
authors.initials: K
authors.lastname: Warshany
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D002983:Clinical Competence; D062787:Drug Overdose / Q000188:drug therapy*; D006297:Health Services Accessibility; D006801:Humans; D009270:Naloxone / Q000008:administration & dosage* / Q000600:supply & distribution; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000600:supply & distribution; D009293:Opioid-Related Disorders / Q000150:complications / Q000517:prevention & control; D059408:Pain Management / Q000379:methods; D010348:Patient Care Team / Q000458:organization & administration; D010593:Pharmaceutical Services / Q000458:organization & administration; D010595:Pharmacists / Q000458:organization & administration*; D010818:Practice Patterns, Physicians'; D014481:United States; D016549:United States Indian Health Service
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone