Abstract from chapter in O'Donnell's Drug Injury :

Opioids are a class of drugs that affect the central and peripheral nervous systems. These drugs are prescribed for the management of moderate-to-severe pain due to their ability to reduce the intensity of pain transmission. However, they demonstrate high abuse liability, and their overusage has been characterized as an epidemic. Excessive overprescribing of these drugs led to rampant misuse and abuse of these drugs. Opioid toxicity can lead to serious adverse effects including respiratory depression and death. In the event of overdose and toxicity, the opioid antidote and antagonist naloxone are used and have saved countless lives. Opioid withdrawal is debilitating and often contributes to continued drug use and relapse. The relapse and addictive nature of these drugs have been challenging to address; however, multiple agents have now been approved for opioid use disorder. Providers should ensure appropriate prescribing and good faith dispensing and also should educate patients on the abuse liability and exercise cautious use with these drugs. Legal case reports related to opioid toxicity are provided.

Abstract from chapter in O'Donnell's Drug Injury :
The pharmacist plays a key role in ensuring the safe and effective use of medications. Pharmacists can improve medication safety and efficacy by aligning with the National Patient Safety Goals (NPSGs), which were established by The Joint Commission (TJC) in 2002. This chapter will focus on NPSGs related to anticoagulation therapy and medication information in the hospital setting. Due to complex dosing and pharmacodynamics, anticoagulants have the potential to cause adverse events in the absence of monitoring. The NPSGs detail problems and best practices for the use of warfarin, direct oral anticoagulants (DOACs), and anticoagulation reversal agents. With regard to medical information, NPSGs advise on best practices for the recording and transfer of drug information as well as for medical reconciliation. Medical reconciliation is especially critical for ensuring safety in the setting of polypharmacy and otherwise complex drug regimens. The importance of patient education is also emphasized in NPSG recommendations.

Controlled substance medication diversion is on the rise in healthcare. Reports indicate that drug diversion costs the healthcare industry more than $70 billion per year, and up to 10 percent of healthcare providers will divert drugs at some point in their careers. However, most provider personnel do not receive adequate training to prevent and report drug diversion. Does your team know what to do if they suspect diversion at your facility?

Despite consensus recommendations from the American College of Emergency Physicians (ACEP), the Centers for Disease Control and Prevention, and the surgeon general to dispense naloxone to discharged ED patients at risk for opioid overdose, there remain numerous logistic, financial, and administrative barriers to implementing "take-home naloxone" programs at individual hospitals. This article describes the recent collective experience of 7 Chicago-area hospitals in implementing take-home naloxone programs. We highlight key barriers, such as hesitancy from hospital administrators, lack of familiarity with relevant rules and regulations in regard to medication dispensing, and inability to secure a supply of naloxone for dispensing. We also highlight common facilitators of success, such as early identification of a "C-suite" champion and the formation of a multidisciplinary team of program leaders. Finally, we provide recommendations that will assist emergency departments planning to implement their own take-home naloxone programs and will inform policymakers of specific needs that may facilitate dissemination of naloxone to the public.

Splawski J, Intranasal Medications Focus on Sedation, Pain and Seizures. Pharmacology Updates. Vituity’s Online CME program. 2018

For an emergency medicine pharmacist to become a well-integrated multidisciplinary team member, his or her services need to be accepted by the emergency department (ED) staff. There have been 2 published studies attesting the value of the emergency medicine pharmacist by ED staff: at an academic medical and trauma center in 2007 and a large academic medical center in 2011. The aim of this study is to determine whether the emergency medicine pharmacist's value, as perceived by ED staff, would be similarly accepted at a smaller community hospital with limited clinical pharmacist services.

Involving pharmacists in the process of comparing the medications that should be ordered for a patient with the new medications that are currently ordered and resolving differences improves accuracy, decreases mortality, and improves transitions of care.

If you are involved with the healthcare system as a practitioner or attorney, you know that cases involving drug-induced injury are as complex as they are common. While the injury to the patient might seem obvious, in reality that has very little effect on the course that the litigation will take. This makes it especially important to accurately evaluate the case.

Givone D, Splawski J, Duckworth K. Ask The Psychiatric Pharmacist #16: Part of my mental illness makes me hear voices. I started to take an antipsychotic to help with my symptoms. The medication helps, but sometimes I still hear the voices. Does this mean the medication is not working anymore? NAMI and CPNP July 2010.

Splawski J. My Summer as a VALOR Intern. KeePosted (Loves Park, IL). September 2008: volume 34, No. 8