Role of Pharmacists in Addiction Medicine in Canada's Publicly Funded Health Care Systems: A Qualitative Study.

Background: Canadians face unprecedented substance-related harms, affecting their health, livelihoods, and relationships. While medications are commonly used for withdrawal, harm reduction, and treatment, the role of pharmacists in addiction medicine care settings remains unclear. Objective: To explore the roles, activities, facilitators, barriers, and value added of pharmacists working in the area of substance use disorder in Canada's publicly funded health care systems. Methods: This qualitative study was based on virtual interviews conducted from January 26 to February 14, 2024, with 15 pharmacists practising in Canada. Participants were included if they provided direct patient care within a publicly funded system with a component of their focus in addiction medicine. Interviews were transcribed and analyzed using NVivo 12 software, and thematic analysis was employed to identify key themes. Narratives were developed to demonstrate the wide variety of workplaces, roles, and responsibilities of the participants. Results: The 15 participating pharmacists, from 7 provinces, described diverse activities, including provision of education, gathering of information, assessment, prescribing and administration of medications, harm reduction, support of care transitions, policy development, and strengthening of therapeutic alliances. Areas of focus included being surprised by working in "grey" areas, experiencing barriers relating to the scope of their positions, and adding value by having specialized knowledge about medications. Conclusions: Pharmacists in Canada play diverse roles in substance use disorder care, with the potential to expand system capacity and improve medication management. However, systemic support and innovation are needed to encourage their increased involvement, and further research is needed to evaluate outcomes associated with implementation of these roles.