FIP Calls for Expanded Pharmacist Role in Preventing Harm from Psychoactive Substance Use

The International Pharmaceutical Federation (FIP) has called for pharmacists to play a stronger role in preventing and reducing harm associated with the non-medicinal use of psychoactive substances, highlighting their accessibility and position within community and primary healthcare as important assets in addressing substance use disorder (SUD).

The call is contained in a new FIP Statement of Policy and Call to Action on the role of pharmacists in preventing and reducing harm associated with psychoactive substances, adopted on 30 August 2026. The statement replaces FIP’s 2018 policy statement on the role of pharmacists in reducing harm associated with drugs of abuse.

FIP said substance use disorder remains a significant public health challenge associated with morbidity, mortality and social disadvantage, and emphasised the importance of prevention, early intervention, treatment support and evidence-informed harm reduction.

Pharmacists positioned across the continuum of care

According to the statement, pharmacists are uniquely positioned to contribute because of their accessibility and regular contact with patients and communities.

Their potential contribution includes public health education, identification of substance-related risks, brief interventions, medicines review, referral to appropriate treatment services and support for harm reduction interventions.

FIP identified three principal areas of pharmacy practice: discouraging non-medicinal use of psychoactive substances obtained through medical pathways; preventing the development of SUD, including cases associated with inappropriate prescribing or medicine use; and supporting the prevention, early identification and management of SUD.

The federation also stressed that pharmacist involvement must operate within national legislation, regulatory frameworks and local health-system structures. Services should be integrated with primary care, mental health, addiction medicine, emergency care, infectious disease services, social care and community organisations.

Prevention and early identification

FIP recommends that pharmacists strengthen prevention-oriented services, including health education, brief interventions and medicines reviews that can identify patterns of risky or inappropriate medicine use.

The statement also highlights the potential use of validated screening approaches, including the Screening, Brief Intervention and Referral to Treatment (SBIRT) tool and the World Health Organization’s Alcohol, Smoking and Substance Involvement Screening Test (ASSIST).

However, FIP notes that implementation should reflect local capacity, including available time, training, remuneration mechanisms and referral infrastructure.

This approach places pharmacists not only at the point where medicine-related problems are identified, but also earlier in the care pathway, where potentially harmful patterns can be recognised and appropriate interventions initiated.

Harm reduction among recommended pharmacy interventions

The statement gives significant attention to evidence-informed harm reduction.

Depending on national legal frameworks and healthcare capacity, FIP says pharmacies and pharmacists may contribute to services such as education on safer use, overdose awareness and response, vaccination, infectious disease prevention and provision of certain harm reduction equipment.

In jurisdictions where such services are permitted, this could include sterile injecting equipment, low dead-space syringes, alcohol swabs, sterile water, tourniquets and wound-care supplies.

FIP also recognises that pharmacy-based harm reduction has evolved beyond traditional exchange programmes in some settings, with pharmacies potentially providing equipment directly or working with specialised services through referral and collaboration.

The federation's position is that harm reduction should be delivered through respectful, non-judgemental and non-discriminatory approaches, while recognising the broader social, economic and environmental factors that influence substance use and related harms.

Greater pharmacist involvement in treatment support

FIP also identifies opportunities for pharmacists to contribute to treatment programmes for people experiencing SUD.

These include support for opioid agonist therapy and medication-assisted treatment programmes, with pharmacists potentially involved in supervised administration, adherence support and patient counselling.

Where national frameworks authorise such practice, pharmacists could also participate in collaborative prescribing or dose adjustment.

The statement therefore links pharmacists' role in substance-use care to broader developments in collaborative and integrated healthcare, rather than positioning pharmacy services in isolation.

Overdose prevention and naloxone access

Another major area highlighted by FIP is overdose prevention.

The statement supports improved access to opioid antagonists such as naloxone, including pharmacist-initiated provision where permitted by national regulations.

FIP calls on governments and policymakers to reduce unnecessary regulatory barriers to naloxone access while maintaining appropriate training, safeguards and pharmacovigilance.

It also identifies affordability, supply-chain resilience, public awareness and workforce training as factors that need to be addressed to achieve equitable access.

Focus on vulnerable and underserved populations

The policy also calls for greater attention to populations that may experience barriers to prevention, treatment and harm reduction services.

These include people experiencing homelessness, people in custodial settings, migrants and refugees, adolescents and young adults, women, people with mental health conditions, and people living in rural or remote areas.

FIP says pharmacists should help maintain pharmacies as safe and trusted healthcare environments while advocating for equitable access to appropriate services.

The statement further recognises the frequent association between SUD and mental health conditions and recommends integrated care pathways linking pharmacists with mental health professionals and services.

Training identified as a critical requirement

FIP cautioned that expanded responsibilities require appropriate education and workforce development.

It recommends competency-based education covering the clinical pharmacology and toxicology of psychoactive substances, substance use disorders, identification of high-risk patterns and combinations, communication with vulnerable populations, stigma reduction, brief interventions, referral pathways, advocacy, cultural competence and management of challenging interactions.

Continuing professional development and, where appropriate, recognition of advanced pharmacy practice should also be promoted.

The federation also recommends quality assurance, monitoring and evaluation of pharmacist-led services. Suggested indicators include service uptake, referral success, patient safety, overdose events prevented and cost-effectiveness.

FIP calls for action from governments and pharmacy organisations

The statement places responsibilities across several stakeholder groups.

For governments and policymakers, FIP calls for engagement with pharmacists and pharmacy organisations to identify barriers and maximise pharmacists' contribution to nationally appropriate services. It also calls for certified training programmes, integration of relevant competencies into continuing professional development and reduced regulatory barriers to pharmacist provision of naloxone where appropriate.

FIP further calls for policies that enable pharmacists to participate in low-threshold interventions and facilitate access to shared digital patient records to support efforts to reduce harm associated with adult non-medicinal drug use.

For professional pharmacy organisations, the federation recommends advocacy for the resources, training, legal clarity and workplace protections required for pharmacists to provide prevention, treatment support and harm reduction services.

For academic institutions and education providers, FIP calls for the integration of harm reduction and SUD management into pharmacy education and early-career competency frameworks, alongside research that can strengthen the evidence base for policy and practice.

Pharmacists urged to strengthen prevention-focused practice

FIP also sets out specific actions for pharmacists themselves.

These include strengthening early identification and referral services, participating in competency-based education, contributing to quality and outcome measurement, and using digital health technologies such as electronic prescription monitoring systems where available to identify misuse, diversion, inappropriate prescribing and high-risk medicine combinations.

Pharmacists are also encouraged to engage with patients and people with lived experience when designing and delivering services and to establish integrated pathways with mental health professionals and other relevant healthcare providers.

Financing and industry responsibilities

The policy calls on payers and health-system funders to ensure appropriate remuneration for pharmacist-provided services related to prevention, early identification, intervention, referral, counselling and harm reduction.

FIP also calls on pharmaceutical manufacturers to support safer product designs that can reduce harm associated with non-medicinal use and diversion, as well as dosage forms and delivery devices that can facilitate safe administration of opioid antagonists such as naloxone by non-specialist users.

What the policy means for pharmacy

The new FIP position represents a broader conception of the pharmacist's contribution to substance-use care.

Rather than limiting pharmacy involvement to the supply and monitoring of medicines, the statement places pharmacists within a wider public health response encompassing prevention, early identification, referral, treatment support, overdose prevention and harm reduction.

For countries developing or strengthening responses to substance use, the practical application of these recommendations will depend on national legislation, regulatory capacity, workforce competencies, referral infrastructure and available financing.

FIP acknowledges these differences and deliberately avoids prescribing a single model for all countries. Instead, it calls for approaches that can be adapted to local health systems and sociocultural contexts while maintaining evidence-informed and person-centred principles.

The federation has committed to continuing advocacy for pharmacy-inclusive and evidence-informed public policy on non-medicinal psychoactive substance use. Its commitments include promoting standardised training and competency, ethical clarity around pharmacists' roles, evaluation frameworks, fair remuneration for harm reduction services and wider adoption of the recommendations.

FIP also says it will work with international organisations, including the United Nations and World Health Organization, as well as patient organisations and other stakeholders, to strengthen efforts towards patient safety, harm reduction and continuing professional education.

For pharmacy practice, the policy reinforces a clear message: pharmacists can contribute at multiple points in the substance-use care pathway, but meaningful expansion of that role requires appropriate training, legal frameworks, referral systems, remuneration and collaboration with other health professionals.

Source: International Pharmaceutical Federation (FIP), Statement of Policy and Call to Action: The role of pharmacists in preventing and reducing harm associated with psychoactive substances, adopted 30 August 2026.

Image credit: International Pharmaceutical Federation (FIP).