Pharmacy personnel are under considerable stress. They are also surrounded by and work with substances of potential abuse. They have been known to become addicted, or ‘impaired’ at work due to substance abuse, including alcohol. This might or might not involve them illegally diverting abused medications for their own personal use. Many employers have an employee assistance program (EAP), usually an outside agency with trained professionals aimed to assist employees with any number of problems, including but not limited to personal problems, work stress problems, CNS disorders such as depression, and substance abuse. Additionally, many U.S. states have programs assisting pharmacists with substance use disorders.

Light et al reviewed the prevalence of state substance use disorder (SUD) programs aimed to help pharmacy professionals (including technicians and interns) return to active practice.¹ Their 2017 review found that 46 states have such programs. The authors provide the contact information and model structure used by those states with programs. They contend that frequent updating of program information is critical for those who might decide to seek assistance. They argue for the need of a central database that enables rigorous evaluation of outcomes and specific features. The authors also provide information about changes in program structure over the years. In the past (1990s), 25 programs were operated by state pharmacy associations; 5 were operated by the state board of pharmacy, 6 were operated by independent committees, 3 were operated by volunteer pharmacists, and 6 listed their operational model as “other.” This last category included collective health care groups, departments of professional regulation, hospital pharmacy associations, nursing programs, and nonprofit corporations. The trend over the years has been a marked decrease in the predominant structure of state association–based programs, with numbers declining from 25 to 8. The trend has been toward use of EAP consulting groups, specialized HMOs, and state boards of pharmacy.

Pharmacy managers will invariably be faced with employees suffering from various personal issues that require special attention and/or counseling. They could very well be faced with impaired professionals on the job. The manager must be aware of company policies if the SUD or other disorder is impacting the employee’s work and particularly if it may compromise patient safety. The manager also must be familiar with state law/regulations in this area. Guided by company policy and state law, the manager must show compassion and empathy, avail employees of resources, but also follow appropriate rules and regulations dealing with progressive discipline, if necessary. The manager must also consult company policy and state rules regarding confidentiality/privacy issues relating to employees facing such challenges and also in regard to hiring a new employee who was treated previously for an SUD and looking to regain employment.

Additional information about The Basics of Employment Law and Workplace Safety and Human Resources Management can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.

¹Light KE, Goodner K, Seaton VA, et al. State programs assisting pharmacy professionals with substance use disorders. J Am Pharm Assoc. 2017;57:704-710.

Authored by:

Shane P. Desselle, RPh, PhD, FAPhA, Professor of Social/Behavioral Pharmacy at Touro University California.