Combatting opioid misuse, overuse and abuse: a systematic review of pharmacists' services and outcomes

<b>Aim:</b> To examine the range of services pharmacists provide and their impact on patient outcomes, harm reduction, and appropriate opioid use. <b>Methods:</b> Six databases were searched (MEDLINE, EMBASE, Scopus, PsycINFO, CENTRAL and Cochrane Methodology Register) from inception to March 2023. The protocol was registered in PROSPERO (CRD42023401895). <b>Results:</b> Twenty-nine studies identified five key areas of pharmacist interventions in opioid management—naloxone programs and opioid de-escalation, patient and primary healthcare providers' education and motivational interview, prescription monitoring and opioid risk screening, clinical pharmacy interventions (pharmacotherapy, medication review, prescribing, adherence monitoring), and collaborative healthcare approaches to promote optimal opioid use. Outcomes assessment indicated harm reduction, improved safety, increased non-opioid analgesic use, decreased opioid consumption, and enhanced pain management. <b>Conclusion:</b> This review underscores pharmacists' vital role in tackling opioid misuse, overuse and abuse, providing a foundation for evidence-based policies to minimize harm and promote optimal opioid use. This study investigated the scope of services provided by pharmacists and their impact on patient outcomes, harm reduction, and appropriate opioid utilization. This review identified five key areas of contributions made by pharmacists in rational opioid prescribing and use and demonstrated a positive impact on core outcomes. These results emphasize the critical role of pharmacists in addressing the complex issues surrounding opioid use, misuse and abuse. Pharmacists' services significantly reduce opioid-related harm, including through naloxone programs and opioid de-escalation. Educational interventions by pharmacists improve patient adherence and knowledge regarding opioid safety. Collaborative care approaches between pharmacists and other healthcare professionals enhance patient outcomes and reduce opioid misuse. There is a critical gap in addressing misuse of other opioid substances beyond naloxone.