Providing Evidence to Support Pharmacists as Gatekeepers of Overdose Prevention

The incidence of overdoses is increasing, especially among young people, and patients with a history of overdoses are more likely to engage in subsequent suicidal behavior, even if their initial goal was self-harm. Drugs used in overdose cases include not only over-the-counter drugs but also prescription drugs, and, in many instances, the pharmacist dispenses the drug to the patient immediately before it is taken. Pharmacists working in insurance-affiliated pharmacies and drugstores should serve as gatekeepers to prevent overdose and suicide. This review aimed to generate concrete evidence to support pharmacists in preventing medication overdose and, ultimately, suicide. Specifically, we sought to (1) identify psychotropic drugs that may lead to tracheal intubation following an overdose, based on GC-MS analysis of samples of patients with drug overdose transported to emergency care facilities; (2) determine measures adopted by pharmacies to enable pharmacists and registered sales representatives to act as gatekeepers for medication overdose prevention; and (3) establish an OD score to rapidly identify overdose cases among patients transported to emergency care facilities and to characterize such patients based on the collected data. The abovementioned information may serve as concrete evidence to support the role of pharmacists as gatekeepers in overdose and suicide prevention.