The Iowa Pharmacy Recovery Network...Making a Difference

A friend of ours was walking down a deserted Mexican beach at sunset. As he walked along, he began to see another man in the distance. As he grew nearer, he noticed that the local native kept leaning down, picking something up and throwing it out into the water. Time and again he kept hurling things out into the ocean.

As our friend approached even closer, he noticed that the man was picking up starfish that had been washed up on the beach and, one at a time, he was throwing them back into the water.

Our friend was puzzled. He approached the man and said, "Good evening, friend. I was wondering what you are doing."

"I’m throwing these starfish back into the ocean. You see, it’s low tide right now and all of these starfish have been washed up onto the shore. If you don’t throw them back into the sea, they’ll die up here from lack of oxygen."

"I understand," my friend replied, "but there must be thousands of starfish on this beach. You can’t possibly get to all of them. There are simply too many. And don’t you realize this is probably happening on hundreds of beaches all up and down this coast. Can’t you see that you can’t possibly make a difference?"

The local native smiled, bent down and picked up yet another starfish, and as he threw it back into the sea, he replied, "Made a difference to that one!"¹

The Iowa Pharmacy Recovery Network is seeking to make a difference. There are pharmacists, pharmacy students, and pharmacy technicians who are falling out of the profession due to chemical and/or mental impairments. The profession of pharmacy can’t afford to lose valuable people because of a disease that is manageable. Caring volunteers who understand the disease are willing to help provide a second chance to those who need it.

Estimates place the incidence of chemical dependency in the pharmacy profession at about 15%. If this estimate is accurate, Iowa potentially has 350 impaired pharmacists, in addition to pharmacy students and technicians. IPRN has been designed to deal with impaired pharmacy professionals in a compassionate and non-punitive manner by providing confidential assistance in locating appropriate rehabilitative services and serving as an advocate for their re-entry into the profession.

Chemical Dependency as a Disease

In order to understand what the Iowa Pharmacy Recovery Network was designed to accomplish, it is first important to understand chemical dependency as a disease. Over 40 years ago, the general population did not accept those with chemical dependency as people who needed to be treated; they simply saw it as a character flaw. Then, in 1956, the American Medical Association formally recognized alcoholism as a disease. If you understand this concept, you will understand the mission of the Iowa Pharmacy Recovery Network.

As Vernon Johnson outlines in his book, Intervention, you would not blame your child for coming down with the flu. Instead, you would take your child to the doctor, have the disease properly diagnosed, and do whatever you could to speed your child on the way to recovery. Similarly, you cannot blame the chemically dependent person for being chemically dependent. What you can do is help him or her to get the care that is needed.²

What is IPRN?

The Iowa Pharmacy Recovery Network is a monitoring and advocacy peer-review program administered by the Iowa Pharmacists Association for the purpose of assisting impaired pharmacists, pharmacy students, and pharmacy technicians, whose dependency and or disability is potentially threatening to professional performance and public safety. Services provided by IPRN are intended to be in the best interest of the pharmacist, technician, or student, and the public. IPRN’s activities are designed to preserve the involved pharmacy professional’s reputation and ability to render competent and quality patient care.

The goals of IPRN are to:

• identify and approach the impaired pharmacist, pharmacy technician, or pharmacy student with their problem;
• recommend facilities for evaluation and referral;
• persuade the pharmacy professional to enter appropriate treatment; and
• monitor the pharmacy professional’s rehabilitation and reentry into the profession.

How Does IPRN Work?

The Iowa Pharmacy Recovery Network serves as a confidential resource to assist impaired pharmacists, pharmacy students and pharmacy technicians obtain an evaluation, treatment, aftercare, support, and as a mechanism for reentry into the profession of pharmacy. IPRN receives names of potentially impaired pharmacy professionals through the impaired person; a concerned family member, friend or co-worker; a college of pharmacy; or the board of pharmacy.

In the event IPRN receives information about an impaired professional from the actual professional, a concerned person, or a college of pharmacy, the case is handled completely confidentially. IPRN works to verify the concerns and then takes steps to assist the professional in receiving an evaluation and the subsequent treatment and aftercare support needed to remain a viable member of the profession of pharmacy. IPRN will work with an impaired professional’s family and co-workers for a period of at least five years to assure successful recovery and reentry into the profession.

In the event a pharmacy professional has already been disciplined by the Iowa Board of Pharmacy Examiners, the Iowa Pharmacy Recovery Network may get involved in the professional’s aftercare process through a stipulation of their probation or suspension status.

What is IPRN’s relationship with the Iowa Board of Pharmacy?

In 1997, legislation was passed which allowed the Iowa Board of Pharmacy Examiners to increase the licensure and re-licensure fees of pharmacists, in order to support the Iowa Pharmacy Recovery Network. This was implemented in 1998, with a $10 increase in pharmacists’ fees. In September, 1998, a contract was signed between the board and IPRN which recognized IPRN as a peer assistance program.

IPRN’s activities are completely confidential. The only cases which are required to be reported to the board of pharmacy are those where there is imminent danger to the public or to the IPRN volunteers, or the pharmacy professional has diverted controlled substances for reasons other than their own use. The board is typically involved only to the extent of knowing the situations anonymously, by case number. (Details can be found in Iowa Code 155A.39 and 657 Iowa Administrative Code (I.A.C.) chapter 30)

What are Future IPRN Plans?

To establish a 24-hour toll-free telephone number so that issues can be addressed on a more urgent level.

To develop peer support groups throughout the state for pharmacy professional in recovery.

To provide education to the pharmacy profession in Iowa on chemical dependency.

To expand IPRN’s services to include mental and physical impairments which are potentially threatening to professional performance and public safety.

How Do I Get Involved?

The Iowa Pharmacy Recovery Network is in need of volunteers throughout the state of Iowa. There are four ways to get involved in IPRN:

• IPRN Committee Member. IPRN committee meetings are held quarterly. The committee oversees and coordinates the functions of the IPRN program throughout the state of Iowa.
• Regional Coordinator There are 5 regional coordinators throughout the state who serve to receive notice regarding an impaired professional and carry through with the IPRN procedure.
• Monitor. Monitors serve to “monitor” impaired professionals for compliance with their IPRN contract. Their responsibilities include carrying out the IPRN procedure to have the impaired professional sign a contract with IPRN, developing a treatment plan in conjunction with the professional’s treatment center, monitoring the impaired professional’s progress throughout their contract, submitting reports to the IPRN committee, and working with the regional coordinator to coordinate a support group in their region of the state.
• Advocate Advocates serve to provide peer support and assistance to impaired professionals as they enter treatment and recovery. Their responsibilities may include being involved in IPRN activities, accompanying the recovering professional or technician to board hearings, writing letters on behalf of recovering professionals, or helping recovering professionals re-enter into the profession by helping with job searches or serving as a reference.

Even if you are not interested in becoming involved in this process, all pharmacy professionals can assist this effort by being aware of the signs and symptoms of chemical dependency and contacting the Iowa Pharmacy Recovery Network when you are suspicious of an issue that could be handled by IPRN. This effort can only be successful if we are all involved and concerned about our colleagues.

It is difficult to take an initiative and get help for someone you care about. But it is more difficult to watch a colleague’s personal and professional life fall apart. We need your help to make a difference to each and every pharmacy professional with a chemical dependency problem. IPRN can only be successful if we all work together to recognize chemical dependency as a disease and know that each intervention will positively affect a persons’ life.

Please contact Jennifer Moulton, IPRN staff, or Bruce Alexander, IPRN Chair, if you are interested in serving as a volunteer or know someone who needs IPRN’s assistance. The profession needs you to make a difference!

¹Jack Canfield and Mark V. Hansen. One at a time. In Canfield J, Hansen MV, eds. Chicken Soup for the Soul. Deerfield Beach, FL. Health Communications, Inc., 1993:22-3.

²Vernon E. Johnson. Intervention - How to Help Someone Who Doesn’t Want Help. Johnson Institute Books. Minneapolis. 1986:3.