Addiction medicine takes personal turn at APhA Institute


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APhA Institute on Alcoholism and Drug Dependencies hosts inaugural session

Though major medical associations have identified alcoholism and substance use disorder as diseases since the early 1950s, the science of treating people with addictions has taken a long and varied road. 


Pharmacy’s contribution to the treatment of drug dependencies took a large step forward in 1983, when APhA staff members Richard P. Penna and Ronald L. Williams established a Pharmacy Section at an existing well-regarded program known as the University of Utah School on Alcoholism and Other Drug Dependencies. Pharmacist presence at the school’s important conference, held yearly in June, was consistent and strong. The conference incorporated health professionals from a wide range of practices, including physicians, dentists, nurses, and social workers.


APhA hosts inaugural session


Because of scheduling conflicts, the University of Utah announced that the broad-ranging conference would cease after its 63rd session in 2014. APhA, however, saw the event’s value to both pharmacists in recovery and pharmacists interested in the treatment of drug dependencies and created its own conference at the same location to continue the message. This new event, the APhA Institute on Alcoholism and Drug Dependencies, hosted its inaugural session from June 5 to 8, 2015, at the University of Utah in Salt Lake City.


“There are very few conferences in the profession of pharmacy that make as strong an impact on the lives of the attendees as the APhA Institute,” said Keith Marciniak, BSPharm, APhA Senior Director of Student and New Practitioner Development.


Marciniak served for 12 years as a Pharmacy Section Co-Leader at the previous Utah School with volunteer APhA members Charles Broussard, BSPharm, and Melissa Skelton Duke, PharmD, MS, BCPS.


“Having had the opportunity to help lead this transformative experience at the Utah School for so many years, I witnessed how detrimental the disease of addiction, and the stigmas related to addiction, can be,” said Marciniak. “The Utah School offered our pharmacist and student pharmacist members in recovery with a supportive environment to learn and mentor those interested in addiction. APhA wanted to make sure that we continued this benefit for our members with the new Institute.” 


The conference ran 4 days, from Friday to Monday, with a town hall–style 12-step meeting at the end of every day, following sessions ranging from prescription drug abuse to medical marijuana. The first day featured an Alcoholics Anonymous meeting, the second a Narcotics Anonymous meeting, the third an Al-Anon meeting, and the fourth a general 12-step meeting with sharing open even to those without addiction issues. Participants were eligible to receive up to 17.75 hours of continuing pharmacy education credit.


Pharmacists in recovery


All the individuals interviewed for this story supported the idea that focusing the conference on pharmacy and including only APhA members afforded them better abilities to connect with colleagues and to learn on topics relevant to their practice.


One pharmacist in recovery who has been sharing his story at the conference for more than 25 years is Jeffrey Baldwin, PharmD, FAPhA, FASHP, Professor of Pharmacy Practice and Pediatrics at the University of Nebraska Medical Center.


“In 1982, I realized I was an alcoholic, entered treatment, and got sober,” said Baldwin. “I had no related legal charges or professional violations that would have necessitated licensure review, but I decided right away that I was going to be open about my disease and my sobriety. When I first got a chance to attend the Utah School in 1985, it gave me a chance to share my story.”


Baldwin said there are about 30 to 50 pharmacists in recovery in attendance at the Utah School/APhA Institute each year, many of whom share their stories of finding recovery after long periods of suffering the consequences of addiction. Those who have attended for more than 5 years are affectionately known as “dinosaurs,” similar to the way that veterans of Alcoholics Anonymous are termed “old-timers.”


“Often, students attending the Institute are amazed at how open attendees who are in recovery are about sharing the ‘experience, strength, and hope’ of their personal journeys, whether during Institute presentations, personal conversations, or open 12-step meetings. Such openness is a fundamental part of 12-step meetings, whether it occurs in a small meeting with a few people or at a meeting as large as the approximately 300 people at the Institute,” said Baldwin. 


Jarrod Grossman, PharmD, who serves as the Executive Director of the Pharmacists Rehabilitation Organization for the state of Ohio, said he entered recovery after an intervention from the Board of Pharmacy in 2003. He found the opportunity to be open about his recovery but also got valuable training for his career. “I swapped a lot of information about best practices in pharmacist rehabilitation with my colleagues,” said Grossman. “I also got to share my story, which we sometimes call a case study.”


Changing views on addiction


Other attendees, though they did not suffer from the disease of addiction themselves, said that they were particularly moved by the proceedings.


New practitioner Rachel Barenie, PharmD, has attended the conference three times and shared that learning in-depth about the subject allowed her to change her views on her father’s struggle with alcoholism. “The first year I went, I was so naive,” said Barenie. “I believed that [addiction] was a choice, and that my dad chose the bottle over me. I learned that alcoholism is a disease. This process encouraged me to have a conversation with my father to build back that relationship. It’s because of this conference that I got my family back.”


Barenie continued, “There was not a lot of that disease state in our curriculum. Now I function so much better in my family unit at home. If we don’t see addiction as a disease, how will be able to recognize and care for those people as our patients? Now I’m better off as a daughter and health care provider.”


Dominick Curry, a student pharmacist at the University of Florida College of Pharmacy, attended this year for the first time to represent the national award that his school won for the APhA Academy of Student Pharmacists’ Generation Rx program. “I went into the conference expecting it to be like any other conference—it caught me by surprise how much I was affected emotionally by it,” he said. “I didn’t realize that so many of the presenters would be people recovering from substance use disorders. Once they shared their stories, it created this amazingly open, nonjudgmental atmosphere.”


Curry said that this spirit of candor encouraged both recovering users and those struggling with other issues to speak up. “At the meetings, people in the audience would stand up and tell their story. It was stories about terrible things that have happened to them. Their fears, anxieties, struggles, emotional events, deaths in the family; things that people don’t usually talk about. This made everyone feel very connected to one another.”


“Usually, when you first meet someone, you put up the facade or conference version of yourself,” added Curry. “Here, we were all very real and very honest with each other.”


‘Being sober brought a purpose’


When asked about the difference between alcohol and other psychoactive substance use disorders, Baldwin said they are the same, except for the stigma. “Alcohol is one of the deadliest drugs we have out there,” he said. “But socially, it’s less stigmatic to be a person recovering from alcoholism than being in recovery from other drug use disorders, such as meth or heroin.”


Baldwin said that real-life consequences can help get people into recovery. “If they’ve done something like being arrested for driving while intoxicated, stealing narcotics, or forging prescriptions,” he said, “they may have to suffer some consequences of that, such as actions against their license(s) or jail time or fines. We shouldn’t get a ‘get out of jail free’ card just because we have alcoholism or other substance use disorders.”


Grossman added that his recovery included so much more than just eliminating the use of drugs from his daily routine. “Being sober brought a purpose to my life,” he said. “Before I got clean, everything was about using drugs and living in active addiction. Recovery has taught me to do the right thing for the right reason; that I could better myself for the right reason. I’m lucky that I picked a profession where I could help a lot of people who need help. I’m free from what had enslaved me previously.”


“Like so many other people in recovery,” concluded Grossman, “I’ve finally found some serenity.”


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