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Helping people manage a range of health concerns is part of a pharmacist's role. Pharmacy students prepare for this by receiving a combination of hands-on practice and classroom learning.

Pharmacists play a key role in public health, often serving as an accessible point of care, particularly for people who may face barriers to obtaining health care in settings like hospitals or clinics. 

“Pharmacy professionals are not just dispensing medications,” says , a doctoral student in the School of Public Health who holds a master’s in pharmacy practice. “They are embedded in the community, they are part of our health-care system and they have an important role in public health.”

In particular, they have long been involved in harm reduction initiatives for people who use drugs, such as take-home naloxone programs. However, their role in this area has yet to be thoroughly catalogued, something a team of researchers sought to remedy with a .

A scoping review is a method used to broadly track what is happening in peer-reviewed (or grey) literature on a particular topic, explains Navarrete, first author on the paper.

“We wanted to create a map of all the ways pharmacy staff are caring for people who use drugs and how they are involved in harm reduction,” she adds. “A scoping review will let us capture different types of studies from different countries and build this big picture.” 

"The increasing scope of pharmacy practice worldwide and changes to education and training supports innovative services and models of care delivery to meet the needs of populations they serve, including people who use drugs,” says , dean of the Faculty of Pharmacy and Pharmaceutical Sciences and co-author on the scoping review. 

Navarrete explains that three main factors motivated the team of experts to turn their attention to this topic — the current toxic overdose crisis, the barriers people who use drugs face when accessing health care, and the expanding scope of pharmacy practice. 

From a public health perspective, the ongoing overdose crisis provided a sense of urgency for the researchers, who knew any insights they could provide would have potential benefit. 

“The street drug supply is unregulated and therefore unpredictable,” says Navarrete. “People don’t usually know what they’re consuming, and that increases the risks of harm, which is reflected in the numbers we can see at both the federal and provincial levels.” 

The decision to explore pharmacists’ roles within this context was prompted by their unique accessibility, particularly in settings where people may have limited contact with other health services. Navarrete cites provincial data from 2020 showing community pharmacies were the most visited health-care setting by people who experienced an unintentional opioid overdose within the 30 days before their death. 

“We know pharmacies are access points,” she says. “If we pair that with all the available literature internationally in terms of what’s possible in the profession, we can leverage that access point to support people and to contribute to the public health response to the drug overdose crisis.” 

Pharmacists provide a wide range of harm reduction services, including naloxone distribution and syringe exchange programs, as well as screening, testing and treatment for infectious diseases such as hepatitis C. They’re also often involved in interdisciplinary teams within mobile units that can go where they’re needed in communities.

The “big picture” view the scoping review provides will allow for the identification of potential gaps in education, practice and research that can then be addressed with targeted efforts and interventions, adds Navarrete.

“This evidence will also be available for others, so educators, policy makers or other health-care leaders can use this guide or map to consider expanding services, or consider barriers or challenges that maybe they haven’t thought about,” she says.

“Pharmacy-based harm reduction is possible and it can be consistent, sustainable and accessible in different communities,” she adds. “At the end of the day, that means expanding the safety net for people who use drugs. Pharmacy as a profession is ideally positioned to provide care when and where people need it, and people who use drugs should be no exception to that.”