Pharm Sci grad finds many patients with alcohol use disorder not receiving recommended treatment

Nima Tourchian’s master’s research suggests need for interventions to support vulnerable populations

Nima Tourchian has spent the majority of his master’s degree at the Leslie Dan Faculty of Pharmacy working and studying from home due to the COVID-19 pandemic, but his short time in-person at the Faculty made a big impression.

“I actually really enjoyed my time at the Faculty, for the short period of time I was there before COVID,” he says.

“I met a lot of great people and learned a lot from my courses and professors. It was a great experience.”

As an undergrad student in psychology at York University, Tourchian became interested in working with vulnerable populations. After graduating in 2018, he began thinking about pursuing a master’s degree and applied to study with Tara Gomes, assistant professor at the Leslie Dan Faculty of Pharmacy and epidemiologist at the Ontario Drug Policy Research Network, who specializes in pharmacoepidemiology, drug safety and effectiveness, and drug policy.

Tourchian was interested in her research related to vulnerable populations and substance use disorders, and in September 2019, he began his Master’s in Pharmaceutical Sciences with Gomes, studying the use of naltrexone in Ontario.

Naltrexone, a first-line treatment for patients with alcohol use disorder, was added to the public formulary in 2018, making it a more accessible treatment option. Tourchian and Gomes decided to use population data from ICES to gain a better understanding of how the medication is used in Ontario.

Current treatment guidelines for naltrexone recommend patients use the drug for at least six months to see any benefit. But Tourchian’s results showed that naltrexone use was low overall; half of the population they studied received only one prescription of the drug, and only one in six patients actually continued the treatment for the recommended six months.

He also found that the setting where patients initiated the therapy influenced the duration of use. Patients who started therapy after a hospital emergency department visit were less likely to receive a second prescription compared to patients who started therapy through a primary care setting.

“This research suggests that interventions need to support and improve naltrexone use in primary care through strategies like frequent follow-up, patient education and improved communication,” says Tourchian. “But we also saw high naltrexone discontinuation after hospital-based interactions, meaning we need interventions that support people coming from these settings to improve their transition of care from the hospital to the community.”

Short time on campus still leads to strong connections

Tourchian was only on campus for about six months when the pandemic shutdown moved courses and his research online. He conducted most of his research from home using the ICES remote server and successfully defended his thesis online in September 2021 – which meant about three-quarters of his degree was done remotely. But he found he was still able to connect with his professors and fellow students.

“From my experience at the Leslie Dan Faculty of Pharmacy, I really enjoyed the small classes where we were together sitting at one table and could talk to the professor and other students,” he says. “Everyone – professors, graduate coordinators, staff and students ­– was helpful and approachable, and I enjoyed that.”

With his master’s degree now complete, Tourchian plans to continue working with vulnerable populations and gain more experience in research in his future career. And he says his degree from the Leslie Dan Faculty of Pharmacy will be a huge benefit.

“This is one of the leading pharmacy research centres in Canada with an excellent reputation,” says Tourchian. “I think that matters a lot, and my experience here will help me with any role I have in the future.”