In 1976 the IPA formed the Impaired Pharmacist Committee. Its purpose was to support and assist pharmacists who were physically and/or emotionally handicapped with their right to work and/or to get appropriate help. Indiana was the first state association to have such a committee.
In the early 1980's, under the leadership of Tom Meier, the Impaired Pharmacist Committee with Board of Pharmacy sanction and the Indiana Pharmacists Association support, began focusing on the pharmacist with abuse or dependency to chemical substance problems.
The committee became known as the Peer Review and Assistance Committee. Other states were forming such committees and aggressively adding structure and process to their designs. Texas, Michigan and Illinois were becoming leaders and the American Pharmaceutical Association was setting a new tone of acceptance and concern for the problem. The IPA committee lacking funding, administration and visibility was becoming somewhat ineffective.
In February of 1994, the IPA committee lost Tom Meier as Co-Chairperson. The three remaining active members held a meeting at the IPA office in Indianapolis to talk about the future of the committee. Six pharmacists made a commitment to revitalize the process and renamed the committee the Indiana Pharmacist Recovery Network (I-PRN) to correspond to the APhA new concept.
Our purpose was defined to:
1. provide assistance to chemically dependent/abuser pharmacists through listening, or sharing, or confrontation or intervention/contracting
2. provide advocacy to the pharmacist before employers, the Board of Pharmacy or other official agencies
3. educate pharmacists and students concerning chemical dependency particularly as to what can lessen the consequences of the progression of the problem
Why all the fuss? The disease of chemical dependency or the problem of substance abuse is a serious and widespread affliction. It does not affect only the person who has the malady. Perhaps one of the most visible consequences are the multitude of losses incurred; from loss of respect to loss of job, from loss of friends to loss of children, from loss of money to loss of inventories, the progression of the problem continues to add to the losses. How many of you have been involved in such a situation and felt the disruption within a family or in the work place created by a substance abuser?
And what is the scope of the problem? It has been estimated that 5.5 million Americans need chemical dependency treatment. Forty-five percent or 78 million adults are exposed to alcoholism in the family. In 1988, 10.5 million U.S. residents showed signs of alcohol dependency and 7.2 million more abused alcohol. Estimates among the general population indicate that 6-12 % have a substance abuse problem. Estimates among pharmacist and other health care providers indicate 12-18% are addicted, chemically dependent or alcoholic (in recovery or actively using). That figure extrapolated to Indiana might reflect 200-300 chemically dependent Pharmacists. The Board of Pharmacy in August of 1994 had 9 discipline hearings, appearances or reports filed, most of which were abuse/dependency related. In September of 1994 the Board had 17 such cases. The I-PRN since 1979 has been involved with over 50 pharmacists and currently we are monitoring ten.
Why is there such a problem? Why is there glaucoma, or diabetes or cancer? Is it genetics, environmental, choices or some combination? The medical model for chemical dependency has its origin in a 1956 American Medical Association statement and was updated with the help of the American Psychiatric Association in 1972. In August of 1992 a further expanded definition for the disease was printed in the JAMA stating: "Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive, and fatal. It is characterized by impaired control over drinking preoccupation with the drug alcohol, use of alcohol despite adverse consequences and distortions of thinking, most notably denial. Each of these symptoms may be periodic or continuous". The drug alcohol has been the focus of research and study because of its availability, legality and length of connection to our western culture. Dr. E.M. Jellinek, in the mid 1940s established many of the fundamental principles describing the symptoms and the progression of the disease. His U shaped curve is used in many treatment centers today to illustrate the diseases progress. Other mood altering drugs such as cocaine, marijuana, meperidine, benzodiazepines and others have not been studied as much as alcohol for a variety of reasons. Each one of them could be substituted in the AMA definition of alcoholism. Alcoholism, chemical dependency and addiction are ALL THE SAME DISEASE. The disease is an equal opportunity affliction. No longer is it the skid row bum or a bad person who has the problem/disease.
Reprinted from INDIANA PHARMACIST, November 1994, Vol. 75., No. 11.