Should You Hire a Pain Pharmacist?

Hey there! 👋🏻

As I talk with colleagues from various facilities since becoming more active on LinkedIn, I realized something:

Not every hospital has a pain management pharmacist.

I mean, if I were to ask you what a pain management pharmacist even is, what do you imagine we’re doing in the hospital or clinic?

So that got me thinking:

Why do some hospitals choose to invest in a pain management pharmacist—or perhaps more than one?

I’m not going to point out obvious reasons like the opioid crisis, because even countries without an opioid crisis may benefit from having such a valuable asset.

The question isn’t why should hospitals have one. The real question is, “What are hospitals not doing that a pain management pharmacist can fill in?”

If you’re a hospital administrator reading this, I’d like to share what I’m doing as a pain management pharmacist that brings value.

📝 Consults

You name it.

Titrate gabapentin. Switch gabapentin to pregabalin. Dose an opioid. Dose an opioid in an 83 year old. Dose an opioid in a 90 year old with end stage cancer.

Answering consults adds value to many departments because pain medication management often isn’t taught in depth during school or clinical training. There’s also huge value in answering consults:

The peace of mind.

📈 Opioid Stewardship

If you ask 10 clinicians about antimicrobial stewardship, I’m sure they’ll have something to say. But if you ask about opioid stewardship, I wonder if you’d get the same response.

You may ask, what’s different about opioid stewardship?

Truth is, the concept is the same.

IV to PO. Limit duration of opioid exposure. Choose pain medications wisely. They follow a similar framework, just like antimicrobial stewardship.

But if your pain management pharmacist can consistently apply these principles across departments, you’ll see results in as little as a year.

☎️ Drug Information

I call this the “side curb.” These aren’t formal consults. They’re not too technical, but some help would be nice.

Things I answer often:

1. Will oxycodone work if the patient is on Suboxone?

2. Can you double check the methadone dose from the methadone clinic?

3. How many lidocaine patches can the patient apply in a day?

   
   

🧑🏻‍🏫 Education

Education is my long-term investment in the hospital. Leveling up the knowledge base will pay dividends in the long run. And the goal isn’t to get everyone to my level of expertise. It’s to help clinicians recognize what’s reasonable and what’s not.

Since starting the inpatient pain management program, I’ve seen real improvement:

• Clinicians are more judicious with opioid dosing

• They’re more comfortable dosing non opioids on their own

• They’re more verbal about their concerns with pain regimens

  
  

This creates a feedback loop that continues to raise the standard.

---------------------------------------------------------------------------------------------------------------

So that’s what a pain pharmacist can bring to the table.

If you’re wondering where your facility stands with pain management, here are a few practice pointers to help gauge your program:

1. How often does your facility ACTUALLY monitor opioid use?

2. How often are non opioids used as adjuvants?

3. How is post surgical pain managed?

4. How is pain managed in patients with substance use disorder?

5. And most importantly, can you speak to your numbers and trends?

   
   

If you’re reading up to this point, I hope you take time to reflect on these questions.

They’re pointy, but honesty will help you grow.

See you next time.