Pharmacists' attitudes toward dispensing naloxone and medications for opioid use disorder: A scoping review of the literature.

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Background: Pharmacists are on the frontline caring for patients at risk of an opioid overdose and for patients with an opioid use disorder (OUD). Dispensing naloxone and medications for OUD and counseling patients about these medications are ways pharmacists can provide care. Key to pharmacists' involvement is their willingness to take on these practice responsibilities. Methods: The purpose of this scoping review is to identify, evaluate, and summarize published literature describing pharmacists' attitudes toward naloxone and medications for OUD, i.e., methadone, buprenorphine, and naltrexone. All searches were performed on December 7, 2018, in 5 databases:,, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost, Cochrane Central Register of Controlled Trials via Wiley, and Clarivate Web of Science. Articles included original research conducted in the United States, described attitude-related language toward naloxone and medications for OUD, and pharmacists. Results: A total of 1323 articles were retrieved, 7 were included. Five studies reported on pharmacists' attitudes toward naloxone dispensing, 1 study reported on attitudes toward naloxone, buprenorphine, and buprenorphine/naloxone, and 1 reported on attitudes toward buprenorphine/naloxone. Respondents were diverse, including pharmacists from different practice specialties. Studies found that pharmacists agreed with a naloxone standing order, believed that naloxone should be dispensed to individuals at risk of an opioid overdose, and were supportive of dispensing buprenorphine. A minority of pharmacists expressed negative attitudes. Barriers cited to implementation included education and training, workflow, and management support. Conclusions: Pharmacists were positive in their attitudes toward increased practice responsibilities for patients at risk of an opioid overdose or with an OUD. Pharmacists must receive education and training to be current in their understanding of OUD medications, and they must be supported in order to provide effective care to this patient population.





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Muzyk, Andrew, Zachary PW Smothers, Kathryn Collins, Mark MacEachern and Li-Tzy Wu (2019). Pharmacists' attitudes toward dispensing naloxone and medications for opioid use disorder: A scoping review of the literature. Substance abuse. pp. 1–8. 10.1080/08897077.2019.1616349 Retrieved from

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Andrew Muzyk

Associate Professor of the Practice of Medical Education

Dr. Andrew Muzyk is an Associate Professor of the Practice of Medical Education at Duke University School of Medicine in Durham, NC and an Associate Professor in the Department of Pharmacy Practice at Campbell University College of Pharmacy and Health Sciences in Buies Creek, NC. Dr. Muzyk also holds a Clinical Associate appointment in the Duke University School of Nursing. Dr. Muzyk's responsibilities include teaching students across numerous health professions programs, rounding as a clinical pharmacist at Duke University Hospital, and conducting educational research.

Dr. Muzyk is the director of pharmacology content and the course co-adminstrator for the Foundations of Patient Care II course, a semester long course that includes pharmacology, pathology, microbiology, immunology, and clinical medicine content. He teaches pharmacology to first-year medical students at Duke University School of Medicine with a focus on CNS medications. For five years, Dr. Muzyk served as the director for the Biological Psychiatry course for psychiatry residents in the Duke Department of Psychiatry and Behavioral Sciences.

At Campbell University College of Pharmacy and Health Sciences, he teaches pharmacy students about the treatment of psychiatric and substance use disorders and men's health. Dr. Muzyk is the course co-coordinator for the pharmacoepidemiology, health informatics, and neurology-psychiatry modules. He precepts fourth-year pharmacy students completing an internal medicine or psychiatry clerkship at Duke University Hospital.

He teaches students in other health professions programs at Duke and Campbell including doctor of osteopathy, physician assistant, and nursing. His teaching in these programs focuses on the management of psychiatric and substance use disorders. Dr. Muzyk serves as a mentor for graduate students enrolled in the University of Michigan Master of Health Professions Education program.

Dr. Muzyk's clinical responsibilities include rounding at Duke University Hospital on the Medicine-Psychiatry inpatient service and providing consultation to the inpatient psychiatry unit and the opioid use disorder consult service. He is a clinical pharmacist in the Duke University Hospital Department of Pharmacy.

Dr. Muzyk has over 70 publications from research projects focused on health professions student education and hospital based medication outcomes. His work has been published in journals including Academic Medicine, Substance Abuse, Psychosomatics, Academic Psychiatry, American Journal of Pharmaceutical Education, CNS Drugs, and Pharmacotherapy. He has received approximately $170,000 in grants to support his educational research developing an interprofessional substance use disorder course for health professions students and continuing education programs for healthcare professionals. Educational research support has come from Duke Academy for Health Professions Education and Academic Development, Duke Division of Addiction Medicine, Duke Bass Connections, the Josiah Charles Trent Memorial Foundation Endowment Fund, Duke-Southern Regional Area Health Education Center, and Campbell University College of Pharmacy and Health Sciences. Dr. Muzyk has given numerous presentations throughout the United States on topics related to psychiatric and substance use disorders and health professions education. He is a speaker for the North Carolina Area Health Education Centers (AHEC).

Campbell University College of Pharmacy and Health Sciences Dean's Award for Excellence in Teaching; Association of American Medical Colleges (AAMC) Curricular Innovation Award (2020); Association for Multidisciplinary Education and Research in Substance use and Addiction (AMERSA), New Educator/Investigator award (2019); Campbell University College of Pharmacy and Health Sciences, Educator of the Year (2018); Duke University Hospital Department of Pharmacy, Educator and Researcher of the Year (2018); Duke Academy for Health Professions Education and Academic Development (Duke AHEAD), Interprofessional Excellence Award (2016); the Association of Academic Psychiatry (AAP), Psychiatric Education Award (2012); and, the North Carolina Association of Pharmacist (NCAP), Distinguished Young Pharmacist Award (2012).

Dr. Muzyk received his Doctor of Pharmacy (PharmD) degree from Mercer University College of Pharmacy in Atlanta, GA. He completed two years of post-doctorate pharmacy residency training at DCH Health System in Tuscaloosa, AL and at UNC Medical Center in Chapel Hill, NC. His second year of residency training was focused on psychiatric pharmacy practice. Dr. Muzyk obtained a Master of Health Profession Education degree from University of Michigan. In 2023, he completed a year long Climate Health Organizing Fellowship through the Center for Health Equity Education and Advocacy at Harvard Medical School and Cambridge Health Alliance.


Li-Tzy Wu

Professor in Psychiatry and Behavioral Sciences

Education/Training: Pre- and post-doctoral training in mental health service research, psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute on the Design and Conduct of Randomized Clinical Trials.

Director: Duke Community Based Substance Use Disorder Research Program.

Research interests: COVID-19, Opioid misuse, Opioid overdose, Opioid use disorder, Opioid addiction prevention and treatment, Pain and addiction, Chronic diseases and substance use disorders, diabetes, pharmacy-based care models and services, medication treatment for opioid use disorder (MOUD), Drug overdose, Polysubstance use and disorders, cannabis, alcohol, tobacco, hallucinogens, stimulants, e-cigarette, SBIRT (substance use Screening, Brief Intervention, Referral to Treatment), EHR-based research and intervention, data science, psychometric analysis (IRT), epidemiology of addictions and comorbidity, behavioral health care integration, health services research (mental health disorders, substance use disorders, chronic diseases), nosology, research design, HIV risk behavior. 

FUNDED Research projects (Principal Investigator [PI], Site PI, or Sub-award PI): 
R03: Substance use/dependence (PI).
R21: Treatment use for alcohol use disorders (PI).
R21: Inhalant use & disorders (PI).
R01: MDMA/hallucinogen use/disorders (PI).
R01: Prescription pain reliever (opioids) misuse and use disorders (PI).
R01: Substance use disorders in adolescents (PI).
R21: CTN Substance use diagnoses & treatment (PI).
R33: CTN Substance use diagnoses & treatment (PI).
R01: Evolution of Psychopathology in the Population (ECA Duke site PI).
R01: Substance use disorders and treatment use among Asian Americans and Pacific Islanders (PI).
UG1: SBIRT in Primary Care (NIDA, PI).
UG1: TAPS Tool, Substance use screening tool validation in primary care (NIDA, PI).
UG1: NIDA CTN Mid-Southern Node (Clinical Trials Network, PI).
UG1: EHR Data Element Study (NIDA, PI).
UG1: Buprenorphine Physician-Pharmacist Collaboration in the Management of Patients With Opioid Use Disorder (NIDA, PI).
PCORI: INSPIRE-Integrated Health Services to Reduce Opioid Use While Managing Chronic Pain (Site PI).
CDC R01: Evaluation of state-mandated acute and post-surgical pain-specific CDC opioid prescribing (Site PI).
Pilot: Measuring Opioid Use Disorders in Secondary Electronic Health Records Data (Carolinas Collaborative Grant: Duke PI).
R21: Developing a prevention model of alcohol use disorder for Pacific Islander young adults (Subaward PI, Investigator).
UG1: Subthreshold Opioid Use Disorder Prevention Trial (NIH HEAL Initiative) (NIDA supplement, CTN-0101, Investigator).
NIDA: A Pilot Study to Permit Opioid Treatment Program Physicians to Prescribe Methadone through Community Pharmacies for their Stable Methadone Patients (NIDA/FRI: Study PI).
UG1: Integrating pharmacy-based prevention and treatment of opioid and other substance use disorders: A survey of pharmacists and stakeholder (NIH HEAL Initiative, NIDA, PI).
UG1: NorthStar Node of the Clinical Trials Network (NIDA, Site PI).
R34: Intervention Development and Pilot Study to Reduce Untreated Native Hawaiian and Pacific Islander Opioid Use Disorders (Subaward PI, Investigator).
UG1: Optimal Policies to Improve Methadone Maintenance Adherence Longterm (OPTIMMAL Study) (NIDA, Site PI).
R01: Increasing access to opioid use disorder treatment by opening pharmacy-based medication units of opioid treatment programs (NIDA, PI)

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