I want to describe to you situations—just two, unfortunately, due to time constraints—that will give you a better understanding of the type of person or patient we can see on a daily basis at the pharmacy. That way you guys can understand exactly how a pharmacist can make a difference in identifying but also treating or preventing addiction to opioids especially.
I'll describe one patient. We'll call him Adam. He was a successful person, well-adjusted, from university, and a successful accountant living in Ottawa, doing quite well, with two children. He had a sports injury, went into treatment, and was prescribed short-acting narcotics. This led to overuse of the narcotic, then misuse of the narcotic, and eventually seeking the drug on the street.
He came to me at the pharmacy at a very young age, with two small children and a wife he was hiding his addiction from. He started into a methadone program that was unsuccessful at the pharmacy level.
I approached Adam and asked him why he was not continuing to take his methadone on a regular basis: what was going wrong? He said he was hiding his problem from his wife and trying to maintain a job. He was busy, dropping his kids off at day care at 8 a.m. and couldn't get to the pharmacy on time.
I simply provided him the option of coming 15 minutes earlier to the pharmacy. After a connection we made, he got compliant, he got better, and he finished using methadone.
Five months later, he called me from Disney World and said, “Thank you for making a difference to me. This is the first vacation I have had in five years with my family.”
This was not a person who you would normally think would have a problem with addiction. This was a person who was successful, well-adjusted, with no financial problems and no other comorbidities. He was simply prescribed medication post-injury.
The second patient I'll describe to you is probably the type of patient you're more familiar with, a product of the system. At five years old he was abused physically—as a child he was woken up in the morning by his parents dunning his forehead with a cigarette—which led to his being in and out of child care services. Obviously he then became addicted to drugs and alcohol, became HIV-positive and hepatitis C-positive. He presented to me at the pharmacy and we got to know each other well. He described the situation to me and said, “Listen, I never had a chance from the start.”
I simply asked him what he was doing now, and he told me that he was on a treatment program and doing quite well. He taught me how addiction can work. He's now reaching out to children. He's teaching them how to be safe from HIV. He's teaching them about proper needle exchanges. He's teaching kids how not to do drugs, to stay away from drugs. He volunteers at local churches. He tries to educate where possible. He's successful.
Will he ever stop using methadone? Maybe not. But it's important that you guys realize that addiction itself does not have any boundaries. It can affect many different classes of people in society, from the homeless to the well-adjusted.
It's important that everyone here today understands that pharmacists see these patients on a daily basis and can make a difference every day to keep them in the treatment and see them progress through treatment.