Pharmacy Service Logic Model Could Improve Opioid Optimization Services

With the use of a pharmacy service logic model, using a detailed road map to highlight specific health care strategies to policymakers, pharmacy leaders can improve and scale up opioid optimization services, according to a study in Research in Social and Administrative Pharmacy.¹

“Pharmacy practice has expanded greatly in the past decade with pharmacists taking on new and creative approaches to addressing the opioid crisis,” wrote the authors of a study published in Substance Abuse and Rehabilitation.² “Collaborative and interdisciplinary approaches to addressing the root causes of opioid misuse and opioid overdose are still desperately needed.”

The necessity for these structured approaches is underscored by the global burden of chronic pain, which affects nearly 20% of adults in some regions and more than one-third of the global population overall. Although opioids remain essential for severe acute pain, their application in chronic nonmalignant pain (CNMP) remains a subject of intense clinical debate due to the high risks of dependence, tolerance, and misuse.³

READ MORE: US Controlled Substance Market Expected to Grow $21 Billion by 2035

In many low- and middle-income settings, such as Pakistan, a dual dilemma exists, including a lack of access to potent opioids for legitimate pain relief and the unsupervised over-prescription of weaker, unregulated opioids like tramadol. This opioid access crisis demonstrates that without safe, clinically supervised pathways within community pharmacies, patients often resort to informal and potentially fatal sources for relief.¹

The implementation research logic model (IRLM) serves as a bridge between theoretical knowledge and practical application, addressing the gap between what is known about opioid safety and what is actually done in the pharmacy. By organizing core elements of care into a visual framework, logic models allow diverse stakeholders, from government policymakers to local pharmacists, to work from a shared conceptual foundation.^1,4

In the Netherlands, for example, such models have been used to shift the professional focus from traditional product-oriented dispensing to patient-centered pharmaceutical care, which prioritizes the patient’s ability to cope and self-manage their condition.⁴

Despite the clear benefits of pharmacy-led interventions, significant barriers often hinder the transition from theory to practice. Research across various settings identifies a persistent lack of reimbursement for a pharmacist’s counseling time as a top-tier obstacle.^2,5

Without sustainable payment models, even well-intentioned programs struggle to maintain the necessary staffing, space, and time for complex patient reviews. Furthermore, many pharmacists report a lack of specialized knowledge or clinical confidence in managing advanced opioid cases, alongside a perceived lack of autonomy when facing pressure from corporate policies or unsupportive pharmacy management.^1,2,5

Stigma also remains a formidable barrier, with some practitioners expressing discomfort in providing harm reduction services or medication-assisted treatment for individuals with opioid use disorder.²

To overcome these hurdles, a comprehensive logic model proposes multilevel strategies starting at the system level. These include formal regulatory reforms that define the pharmacist’s role in specialized clinical services and the implementation of digital health systems to improve record-keeping and interprofessional communication.¹

Clinically, this translates to a multimodal approach where pharmacists work within an interdisciplinary team to monitor therapeutic plans, adjust dosages gradually, and integrate non-pharmacological therapies like behavioral or physical rehabilitation.³

Successful implementation also requires a shift in public and professional perception. Large-scale awareness campaigns are needed to reposition the pharmacist as a critical health care provider in the eyes of a public that may still view the pharmacy primarily as a retail outlet.^1,2

Simultaneously, addressing the friction between physicians and pharmacists is essential for creating a collaborative environment where shared decision-making can thrive.⁵

As the role of the pharmacist continues to evolve to meet the challenges of the opioid crisis, the use of structured logic models provides a life-saving commitment to ensuring that pain management remains equitable, safe, and accountable.^1,2

“This study presents a novel approach to the development of a pharmacy service logic model using a theory of change-inspired approach to provide a road map to policy makers,” concluded authors of the current study.¹ “It can help facilitate knowledge transfer and provide a logic model that can help develop and implement future community pharmacy opioid medication optimization services in Pakistan.”

READ MORE: Pain Management Resource Center

REFERENCES

1. Iqbal A, Knaggs RD, Anderson C, et al. An implementation research logic model of a novel community pharmacy opioid optimisation service for people with chronic pain. Res Soc Adm Pharm. 2026;22(9):870-891. doi:10.1016/j.sapharm.2026.05.002

2. Kosobuski L, O'Donnell C, Koh-Knox Sharp CP, et al. The role of the pharmacist in combating the opioid crisis: an update. Subst Abuse Rehabil. 2022 Dec 28;13:127-138. doi: 10.2147/SAR.S351096.

3. Cordero-Pérez FJ, Pérez-Baena MJ, Pina-Ruviralta N, et al. Optimizing opioid use in pain management: a comprehensive review of clinical benefits, risks, and dependence. Healthcare (Basel). 2026 Feb 11;14(4):457. doi: 10.3390/healthcare14040457.

4. Moltó-Puigmartí C, Vonk R, van Ommeren G, et al. A logic model for pharmaceutical care. J Health Serv Res Policy. 2018 Jul;23(3):148-157. doi: 10.1177/1355819618768343.

5. Simmons RG, Baayd J, Tak C, et al. A stakeholder-developed logic model to improve utilization of pharmacy-prescribed contraception in Utah. Implement Sci Commun. 2023 Oct 11;4(1):124. doi: 10.1186/s43058-023-00503-6.