Pharmacists Offer Patients Lifelines as Opioid Misuse Challenge Persists

November 19, 2025

As one of several defining public health crises of the 21st century, the opioid epidemic in the United States continues to claim tens of thousands of lives annually. Efforts to curb prescription opioid abuse have yielded positive results, but the rise of black market heroin laced with fentanyl, a synthetic opioid that can be deadly even in small doses, has added new challenges in recent years.

Pharmacists have become an essential part of the country’s strategy to combat opioid overdoses. In particular, the expanded role of pharmacists in opioid use disorder (OUD) treatment, overdose prevention, and misuse mitigation reflects the broader changes in opioid regulations and pharmacy practice that have expanded since 2023. With prescription monitoring programs (PMPs), the increasing availability of life-saving interventions like naloxone, and new federal action, pharmacists are more directly involved in patient care than ever before.

Current State of the Opioid Epidemic

During the COVID-19 pandemic, a disruption in access to treatment and recovery services, as well as increased social isolation and stress, contributed to a surge of overdose deaths. This trend culminated in 2023, when an estimated 110,037 people died from drug overdoses. However, provisional Centers for Disease Control and Prevention (CDC) data indicated a sharp 26.9% decline in overdose rates in 2024. If these numbers prove accurate, 2024 will have had the lowest overdose death toll since 2019. Almost all states shared in this improvement; many, including Michigan, Ohio, and West Virginia, experienced declines exceeding 35%. A few states, including Nevada and South Dakota, saw slight increases.

Despite this encouraging data, the annual number of lives lost to opioid overdoses remains high, and ending the opioid crisis is a top priority in improving and protecting public health. While illicit opioid use is now a greater driver of the overdose crisis than prescription opioid misuse, prescription misuse remains a significant contributor to opioid addiction and fatalities. In 2023, CDC reported approximately 13,000 deaths involving prescription opioids, including oxycodone, hydrocodone, and fentanyl, that were prescribed for medical use. Pharmacy regulators continue to refine policies aimed at preventing the misuse and diversion of prescription opioids while also balancing the needs of patients who have a legitimate need for these medications.

Pharmacists’ Expanding Role in Treating OUD

For many years, pharmacists have played an increasingly integral role in addressing the opioid epidemic, and most recently, more pharmacists are providing services related to helping patients manage OUD medication treatment.

Buprenorphine is now widely recognized as a key component in medication treatment for OUD. DEA’s elimination of the X-waiver requirement was intended to make buprenorphine more accessible to patients, especially in underserved or rural areas where there are often fewer health care providers available to assist patients. This change also paved the way for pharmacists to become more involved in direct patient care for individuals with OUD, offering a crucial support option for those in treatment.

Since nearly 90% of the US population lives within 5 miles of a pharmacy, pharmacists’ ability to engage in OUD treatment provides significant access for patients seeking help. For example, a pilot study demonstrated that when pharmacists managed buprenorphine therapy for patients, they were more likely to remain in treatment, showing an 89% retention rate after 1 month compared to just 17% for patients receiving standard care through clinics.

Pharmacy-Based Overdose Prevention

Overdose prevention is another critical area where pharmacists have proved to be effective. With illegally manufactured fentanyl being involved in more than 70% of overdose deaths, naloxone has become a key tool in preventing death. Watch our video to learn more about naloxone:

In most states, pharmacists distribute naloxone to anyone at risk of overdose, including patients who are prescribed high doses of opioids or benzodiazepines. This may also include individuals with a history of OUD in their families. Pharmacies have also implemented naloxone distribution programs, making the drug widely available.

Pharmacists have also helped to distribute fentanyl test strips in states that have eliminated them as drug paraphernalia. As a harm reduction tool, these strips can help individuals determine whether illicitly purchased drugs contain fentanyl. Several states have also authorized pharmacies to provide these tools to individuals who are at elevated risk.

How Pharmacists Help Protect Patients from the Opioid Crisis

Pharmacists engage with prescribers to verify the authenticity and appropriateness of the prescriptions if they suspect prescription misuse. In certain circumstances, pharmacists can refuse to fill questionable prescriptions. Pharmacists assess each situation carefully to avoid preventing legitimate access to pain relief.

Pharmacists also educate patients on the dangers of the opioid crisis. Educating yourself and your loved ones about opioid safety is an important step to combat the opioid crisis. Learn about the risks of opioid overdose, how naloxone works, and when it should be used on the Prevent Misuse section of our website.