October 24, 2024 • 9 mins
In this episode, expert Jake Nichols who has dedicated his career to serving persons with SUD discusses how shame and stigma impact a patients journey and actionable ways pharmacists can support them.
Each month, APhA will release two podcast episodes offering a fresh dose of education highlights, practice pearls, and insights to inform your pharmacy practice and advance patient care. Listen to new episodes at your convenience! Both members and nonmembers can log into their APhA pharmacist.com Learning Library account to successfully complete a short assessment at the end of each month to earn 0.5 hours of CE credits (.05 CEU).
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
Welcome to the First and happyAmerican Pharmacists Month.
My name is KatieMeyer and I serve as a Senior Director of Content
Creation here at APhA,and I'll be the host for this episode.
With American Pharmacists Month,
this month, we thought it was really importantto focus on the critical role
that pharmacies play in improving outcomesin public health from serving as a vital community
(00:23):
resource, helping patients navigatetheir insurance for access to medications, to
ensuring patients are on the correct medicationsupon discharge to the hospital.
You as pharmaciesplay such an essential role for your patients.
So thank you for all that you do.
And from a guest perspective today, boydo I have a treat for you.
In part one, we discussed recent guidelinespublished for Community Pharmacists about MOUD.
(00:47):
And today, I'm joined by JakeNichols, a pharmacist and friend of mine
who's dedicated his career to serving patientsand educating pharmacists
about how to care for patients with substanceuse disorder.
Welcome, Jake.
Why don't you introduce yourselfand tell listeners a little bit about yourself
and your story?
Hey, Katie, Great to be here, as always.
So my journey has been interesting,I guess to say the least, but ended up working
(01:11):
in a field specifically substance use disordersthat I had never planned on working in.
I found myself in treatment after a 15 yearhistory of substance use back in 2010.
Fell in love with this fieldand have been working at it for the past 15 years
for the time that I've been in recovery.
I've done many things from academiato managed care
(01:33):
to working with pharmaceutical industryand recently started my own company
called Ignite Biomedical,where we developed blood based biomarker tests
that will determine whether or notsomebody will respond to certain drug therapies.
Thanks, Jake, for that introduction.
Really happy to have you here today with us.
As I was reflecting on the discussionthat I had with guests from last week,
(01:57):
one of the recommendationsin the Pharm OUD guidelines that we spoke about
was related to stigma,
which is really so important to considerwhen we're speaking to a person with SUD.
Jake I've listened to your talk on Shame,which is related to stigma,
at the institute on substance use disorders,and it's just so very impactful.
So why don't you tell listeners a little bitabout how
(02:18):
Shame has impacted your journey with SUD?
Yeah, sure.
Shame has been a massive part of my journey
in both a positive and a negative fashion.
And as many individualsthat struggle with substance use disorder
beyond our own professional experience earlyon, shame is extremely debilitating.
You find yourself in a situationthat you would never possibly
(02:42):
imagined yourself to be in,where you start to feel inferior,
you feel worthless, you feel small,you feel helpless.
Especially as it relates to your own peersand other pharmacists.
And we'll talk about stigma later.
But, you know, they do go hand-in-hand.
And both of those together
can have really one of two,it can have two distinct effects.
(03:07):
And unfortunately, many folks, their reactionto shame or what we refer to as toxic shame
tends to be more of the retreat aspect.
And again, this isn't just pharmaciststhis anybody that's that's
found to have this diseasewhereby the shame causes you to retreat from
your social circle,your family, your own profession.
(03:28):
A lot of pharmacists that end up struggling
with SUD never go back to workwithin the pharmacy profession.
They seek other career opportunitiesand that's primarily because of shame.
And the
second effect that it can haveand the effect that it had on me is
is more of a motivating factorin terms of wanting to address
(03:48):
this shame, understanding where it comes fromand utilizing it to a degree
to motivate yourself, to want to do better,to want to break out of this.
And for me, it was really just a reflectionon the quote unquote, damage
I had done in my ability to be able to repairthat and move forward and share my experience
(04:10):
with others, with the hopethat I could help some folks in the process.
Thanks so much for sharing that, Jake.
You mentioned stigma.
Let's focus on that a little bit more.
So how does shame differ from stigma and what arethe potential results of both shame and stigma?
Yeah, So so shame is,you know, again, can be a positive
(04:31):
or a negative factor to some degree is healthyshame and it's unhealthy shame.
And I talked about how those can motivateyou either way, but shame
is also an individualized internal factor.
And in many cases it's a reactionto what I call the perceived audience.
You perceive that people are judging you
or they're making assumptions about youthat may or may not be true.
(04:55):
And nobody likes being judged.
Stigma is a mark of infamy.
It's a little bit more permanent.
It's a little more universal.
It's something that is usually carriedover from generations for decades.
And it's really a judgmentthat people make instantaneously, in many cases,
they're not afraid to display their stigma,But there is still a tremendous amount of stigma
(05:19):
for individualsthat are found to have substance use issues.
It has certainly gotten better in the 15 years
that I have been working in this field,
but it's still, in my opinion,the primary factor as to why
we're facing the scope of this epidemicthat we have been for decades now.
Our audience is a bunch of pharmacists that reallywant to help and support these patients.
(05:42):
Thinking along those lines,what can pharmacists do
as that community resource to recognize that shame
and support people in a way that's free of stigma,that kind of are experiencing it?
Yeah, this is a relatively common question.
I get, Katie, and
you know, the answer is actually pretty simple.
It's being more self-aware,meaning how you carry yourself, your expressions,
(06:08):
the language that you use when you're interactingwith somebody who's in recovery
or still struggling with substanceuse disorder really goes a long way.
Because if you take into account the stigmaand the shame that these individuals
have experienced and are experiencing
when they come up to our countersor we encounter them in the clinic or whatever
(06:30):
setting we work in, they are in most cases
expecting that degree of judgmentthat in many cases
other health care providers have,you know, put upon them.
And when you are able to break down that
barrier instantly and with these individuals,you have a much more optimal
(06:52):
therapeutic interaction, as I like to say.
So again, the language that we use,you know, staying away
from terms like addict or drug abuse,you know, talking about,
you know, your role as a pharmacistand really just emphasizing to folks
that you are here to help them in any way possibleas they take their journey through recovery.
(07:13):
You know, don't assume that people knowhow to take buprenorphine the right way.
And that's always a tough topic for
for pharmacistsor any medications, for any SUD for that matter.
Don't be afraid to offer counselingas it relates to that.
But it's really just comes downto showing interest.
Trying to reserve our judgment and how we againdisplay ourselves and carry our selves and
(07:36):
and be very conscious of their body languageas well.
In many cases, you can see almost instantly
how somebody is feeling about this interactionin terms of how they carry themselves.
They may be coming up to the counteror again to your desk
or to your office with their head down.
They may be avoiding looking at you.
They may be scratching their faceor other areas of their body
(07:58):
that signs of of nervousness,that signs of concern.
And with any patient,the sooner we can belay those concerns,
the better off we'll be in interacting with them.
Thanks, Jake, for really driving homethe importance of the pharmacies
and just what they can doand how they can interact with patients
with OCD to support themthrough their journey and really promote trust.
(08:20):
All right.
Let's summarize major takeaways from our time heretoday.
Shame is a primary factorthat influences the ability of a person
with substanceuse disorder to achieve and maintain recovery.
As pharmacists, it's important that we communicatein a manner that avoids stigma, ensuring
that we're self aware during our encounterswith people who suffer from SUD.
(08:42):
Remember, your patients are expecting judgment,and by breaking down barriers
and walls, your interactionswill be all the more impactful and effective.
If you haven't listened to partone of this month's first full podcast yet,
it was released one week ago and that episodeI hosted APhA’s Executive Education
Fellows and reviewed the recent PhARM OUDguidelines released by an NABP and the NCPA.
(09:04):
Definitely check those out for any listenerswho practice in states
that have authority to prescribeMOUD, APhA has an eight hour
training program on initiating buprenorphinethat meets MATE Act training requirements.
Definitely check it out
if you're looking to renew your licenseor become a provider to support persons with SUD.
And last but not least, don'tforget to head over to the Learning Library
(09:26):
at learn.pharmacist.comto earn your CE for this month's podcast.
We'd love to hear your feedbackon how you like the new set up.
Take care.
Welcome to the First and happyAmerican Pharmacists Month.
My name is KatieMeyer and I serve as a Senior Director of Content
Creation here at APhA,and I'll be the host for this episode.
With American Pharmacists Month,
this month, we thought it was really importantto focus on the critical role
that pharmacies play in improving outcomesin public health from serving as a vital community
(00:23):
resource, helping patients navigatetheir insurance for access to medications, to
ensuring patients are on the correct medicationsupon discharge to the hospital.
You as pharmaciesplay such an essential role for your patients.
So thank you for all that you do.
And from a guest perspective today, boydo I have a treat for you.
In part one, we discussed recent guidelinespublished for Community Pharmacists about MOUD.
(00:47):
And today, I'm joined by JakeNichols, a pharmacist and friend of mine
who's dedicated his career to serving patientsand educating pharmacists
about how to care for patients with substanceuse disorder.
Welcome, Jake.
Why don't you introduce yourselfand tell listeners a little bit about yourself
and your story?
Hey, Katie, Great to be here, as always.
So my journey has been interesting,I guess to say the least, but ended up working
(01:11):
in a field specifically substance use disordersthat I had never planned on working in.
I found myself in treatment after a 15 yearhistory of substance use back in 2010.
Fell in love with this fieldand have been working at it for the past 15 years
for the time that I've been in recovery.
I've done many things from academiato managed care
(01:33):
to working with pharmaceutical industryand recently started my own company
called Ignite Biomedical,where we developed blood based biomarker tests
that will determine whether or notsomebody will respond to certain drug therapies.
Thanks, Jake, for that introduction.
Really happy to have you here today with us.
As I was reflecting on the discussionthat I had with guests from last week,
(01:57):
one of the recommendationsin the Pharm OUD guidelines that we spoke about
was related to stigma,
which is really so important to considerwhen we're speaking to a person with SUD.
Jake I've listened to your talk on Shame,which is related to stigma,
at the institute on substance use disorders,and it's just so very impactful.
So why don't you tell listeners a little bitabout how
(02:18):
Shame has impacted your journey with SUD?
Yeah, sure.
Shame has been a massive part of my journey
in both a positive and a negative fashion.
And as many individualsthat struggle with substance use disorder
beyond our own professional experience earlyon, shame is extremely debilitating.
You find yourself in a situationthat you would never possibly
(02:42):
imagined yourself to be in,where you start to feel inferior,
you feel worthless, you feel small,you feel helpless.
Especially as it relates to your own peersand other pharmacists.
And we'll talk about stigma later.
But, you know, they do go hand-in-hand.
And both of those together
can have really one of two,it can have two distinct effects.
(03:07):
And unfortunately, many folks, their reactionto shame or what we refer to as toxic shame
tends to be more of the retreat aspect.
And again, this isn't just pharmaciststhis anybody that's that's
found to have this diseasewhereby the shame causes you to retreat from
your social circle,your family, your own profession.
(03:28):
A lot of pharmacists that end up struggling
with SUD never go back to workwithin the pharmacy profession.
They seek other career opportunitiesand that's primarily because of shame.
And the
second effect that it can haveand the effect that it had on me is
is more of a motivating factorin terms of wanting to address
(03:48):
this shame, understanding where it comes fromand utilizing it to a degree
to motivate yourself, to want to do better,to want to break out of this.
And for me, it was really just a reflectionon the quote unquote, damage
I had done in my ability to be able to repairthat and move forward and share my experience
(04:10):
with others, with the hopethat I could help some folks in the process.
Thanks so much for sharing that, Jake.
You mentioned stigma.
Let's focus on that a little bit more.
So how does shame differ from stigma and what arethe potential results of both shame and stigma?
Yeah, So so shame is,you know, again, can be a positive
(04:31):
or a negative factor to some degree is healthyshame and it's unhealthy shame.
And I talked about how those can motivateyou either way, but shame
is also an individualized internal factor.
And in many cases it's a reactionto what I call the perceived audience.
You perceive that people are judging you
or they're making assumptions about youthat may or may not be true.
(04:55):
And nobody likes being judged.
Stigma is a mark of infamy.
It's a little bit more permanent.
It's a little more universal.
It's something that is usually carriedover from generations for decades.
And it's really a judgmentthat people make instantaneously, in many cases,
they're not afraid to display their stigma,But there is still a tremendous amount of stigma
(05:19):
for individualsthat are found to have substance use issues.
It has certainly gotten better in the 15 years
that I have been working in this field,
but it's still, in my opinion,the primary factor as to why
we're facing the scope of this epidemicthat we have been for decades now.
Our audience is a bunch of pharmacists that reallywant to help and support these patients.
(05:42):
Thinking along those lines,what can pharmacists do
as that community resource to recognize that shame
and support people in a way that's free of stigma,that kind of are experiencing it?
Yeah, this is a relatively common question.
I get, Katie, and
you know, the answer is actually pretty simple.
It's being more self-aware,meaning how you carry yourself, your expressions,
(06:08):
the language that you use when you're interactingwith somebody who's in recovery
or still struggling with substanceuse disorder really goes a long way.
Because if you take into account the stigmaand the shame that these individuals
have experienced and are experiencing
when they come up to our countersor we encounter them in the clinic or whatever
(06:30):
setting we work in, they are in most cases
expecting that degree of judgmentthat in many cases
other health care providers have,you know, put upon them.
And when you are able to break down that
barrier instantly and with these individuals,you have a much more optimal
(06:52):
therapeutic interaction, as I like to say.
So again, the language that we use,you know, staying away
from terms like addict or drug abuse,you know, talking about,
you know, your role as a pharmacistand really just emphasizing to folks
that you are here to help them in any way possibleas they take their journey through recovery.
(07:13):
You know, don't assume that people knowhow to take buprenorphine the right way.
And that's always a tough topic for
for pharmacistsor any medications, for any SUD for that matter.
Don't be afraid to offer counselingas it relates to that.
But it's really just comes downto showing interest.
Trying to reserve our judgment and how we againdisplay ourselves and carry our selves and
(07:36):
and be very conscious of their body languageas well.
In many cases, you can see almost instantly
how somebody is feeling about this interactionin terms of how they carry themselves.
They may be coming up to the counteror again to your desk
or to your office with their head down.
They may be avoiding looking at you.
They may be scratching their faceor other areas of their body
(07:58):
that signs of of nervousness,that signs of concern.
And with any patient,the sooner we can belay those concerns,
the better off we'll be in interacting with them.
Thanks, Jake, for really driving homethe importance of the pharmacies
and just what they can doand how they can interact with patients
with OCD to support themthrough their journey and really promote trust.
(08:20):
All right.
Let's summarize major takeaways from our time heretoday.
Shame is a primary factorthat influences the ability of a person
with substanceuse disorder to achieve and maintain recovery.
As pharmacists, it's important that we communicatein a manner that avoids stigma, ensuring
that we're self aware during our encounterswith people who suffer from SUD.
(08:42):
Remember, your patients are expecting judgment,and by breaking down barriers
and walls, your interactionswill be all the more impactful and effective.
If you haven't listened to partone of this month's first full podcast yet,
it was released one week ago and that episodeI hosted APhA’s Executive Education
Fellows and reviewed the recent PhARM OUDguidelines released by an NABP and the NCPA.
(09:04):
Definitely check those out for any listenerswho practice in states
that have authority to prescribeMOUD, APhA has an eight hour
training program on initiating buprenorphinethat meets MATE Act training requirements.
Definitely check it out
if you're looking to renew your licenseor become a provider to support persons with SUD.
And last but not least, don'tforget to head over to the Learning Library
(09:26):
at learn.pharmacist.comto earn your CE for this month's podcast.
We'd love to hear your feedbackon how you like the new set up.
Take care.
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