Barriers to and recommendations for take-home naloxone distribution: perspectives from opioid treatment programs in New Mexico (original) (raw)
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Over the past decade, opioid use has been at the forefront of a public health crisis throughout the United States. In response to the tremendous negative societal, personal, and economic impacts that the growing opioid crisis has caused, several governmental agencies began to respond. These efforts include declaration of a nationwide public health emergency, increased public health surveillance of the epidemic, research support for pain and addiction, and increased access to overdose-reversing drugs such as naloxone. Naloxone access, in particular, has become a priority. In the United States, pharmacists have had the opportunity to play a crucial role in promoting access to naloxone. Since initial approval by the Food and Drug Administration (FDA) in 1971 as an antidote to opioid agonist overdose, naloxone access has evolved significantly. Today many states have authorized standing orders for naloxone, allowing it to be dispensed by pharmacists without a patient-specific prescriptio...
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Background: Increasing the availability of naloxone among friends and family of past and present opioid users is a vitally important mission to reduce the occurrence of opioid-related overdose deaths. The purpose of this study was to determine the availability of naloxone in independent pharmacies in Georgia. Secondary objectives include determining pharmacists’ knowledge regarding the standing order and ability to counsel regarding naloxone.Methods: A cross-sectional study was conducted over a period of ten months. The study was population based and was conducted at all independent pharmacies in the state of Georgia. All independent pharmacies in the state of Georgia were contacted and asked the below questions with a 96% response rate (n=520). Results: 558 independent, retail pharmacies were called, with a 96% response rate (n=520 pharmacies). Two hundred-twenty pharmacies reported having naloxone in stock. Of the 335 pharmacists asked, 174 (51.9%) incorrectly said that a prescrip...
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To highlight New Mexico's multifaceted approach to widespread pharmacy naloxone distribution and to share the interventions as a tool for improving pharmacy-based naloxone practices in other states. New Mexico had the second highest drug overdose death rate in 2014 of which 53% were related to prescription opioids. Opioid overdose death is preventable through the use of naloxone, a safe and effective medication that reverses the effects of prescription opioids and heroin. Pharmacists can play an important role in providing naloxone to individuals who use prescription opioids. Not applicable. Not applicable. A multifaceted approach was utilized in New Mexico from the top down with legislative passage of provisions for a statewide standing order and New Mexico Department of Health support for pharmacy-based naloxone delivery. A bottom up approach was also initiated with the development and implementation of a training program for pharmacists and pharmacy technicians. Naloxone Medi...
Stakeholders’ Perceptions of Factors Influencing the Use of Take-Home-Naloxone
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Background and Aims: Opioid associated death and overdose is a growing burden in societies all over the world. In recent years, legislative changes have increased access to naloxone in the take-home setting for use by patients with a substance use disorder and bystanders, to prevent opioid overdose deaths. However, few studies have explored the factors influencing the uptake by its multiple stakeholders. The aim of this scoping review was to explore the factors influencing the use of take-home naloxone from the perspectives of different stakeholders. Methods: A scoping review methodology was adopted with a systematic search of databases EMBASE, MEDLINE and PubMed. A variation of the search words “naloxone”, “opioid” and “overdose” were used in each database. The articles were screened according to the predetermined inclusion/exclusion criteria and categorized based on their key perspective or target population. Results: The initial database search yielded a total of 1483 articles. A...
Annals of emergency medicine, 2016
Although the World Health Organization recommends take-home naloxone to address the increasing global burden of opioid-related deaths, few emergency departments (EDs) offer a take-home naloxone program. We seek to determine the take-home naloxone acceptance rate among ED patients at high risk of opioid overdose and to examine factors associated with acceptance. At a single urban ED, consecutive eligible patients at risk of opioid overdose were invited to complete a survey about opioid use, overdose experience, and take-home naloxone awareness, and then offered take-home naloxone. The primary outcome was acceptance of take-home naloxone, including the kit and standardized patient training. Univariate and multivariable logistic analyses were used to evaluate factors associated with acceptance. Of 241 eligible patients approached, 201 (83.4%) completed the questionnaire. Three-quarters of respondents used injection drugs, 37% were women, and 26% identified as "Indigenous." Of...
Opioid Prescribing with Take-Home Naloxone: Rationale and Recommendations
Current Anesthesiology Reports, 2020
Purpose of Review Although take-home naloxone is available for prescribing, recommended for certain high-risk patients, and can prevent overdose-related deaths, access to naloxone remains a challenge. This review describes the high-risk population on opioids that benefit from naloxone co-prescription, guidelines, and the current trends in naloxone prescribing, and the barriers faced by all the stakeholders. Recent Findings Opioid-related overdoses and deaths still occur at critically high numbers. Short-acting opioid antagonists like naloxone can reverse the effect of an overdose in a few minutes. The US Food and Drug Administration (FDA) approved naloxone nasal spray, and auto-injectable kits are both effective and easy to administer. An increasing number of states in the USA mandate the co-prescription of naloxone for patients on chronic opioid therapy, irrespective of the presence of other underlying risk factors. The lack of provider education is one of the significant barriers for co-prescribing naloxone with opioids. Summary Naloxone can be lifesaving in patients experiencing an opioid overdose. Providers are encouraged to co-prescribe take-home naloxone for high-risk patients on chronic opioid therapy. Understanding the barriers, creating awareness, and providing education can increase the prescription of take-home naloxone and help prevent opioid overdose-related deaths.
PHArmacists’ perspective oN the Take hOme naloxone prograM (The PHANTOM Study)
Canadian Pharmacists Journal / Revue des Pharmaciens du Canada, 2017
Objective: To evaluate pharmacists’ attitudes toward the Take Home Naloxone (THN) program and identify areas that could be improved to support pharmacists’ involvement. Methods: Pharmacists on the Alberta College of Pharmacists’ directory were invited to complete an online survey between July 10 and August 8, 2016. The survey consisted of 19 questions. Descriptive statistics were used to analyze the data. Results: Four hundred seventy pharmacists completed the survey (response rate = 11.2%). A total of 76.8% of respondents strongly agreed or agreed that pharmacists should be screening patients to identify those at risk of opioid overdose. Full-time pharmacists were more likely to agree ( p = 0.02). A total of 79.8% of respondents strongly agreed or agreed that pharmacists should be recommending THN kits. Pharmacists working in large population centres ( p = 0.008) and full-time pharmacists ( p = 0.02) were more likely to agree with this statement. Furthermore, 60.6% of pharmacists w...
Journal of Urban Health: Bulletin of the New York Academy of Medicine, 2003
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Harm Reduction Journal, 2015
The leading cause of adult injury death in the USA is drug overdose, the majority of which involves prescription opioid medications. Outside of the USA, deaths by drug overdose are also on the rise, and overdose is a leading cause of death for drug users. Reducing overdose risk while maintaining access to prescription opioids when medically indicated requires careful consideration of how opioids are prescribed and dispensed, how patients use them, how they interact with other medications, and how they are safely stored. Pharmacists, highly trained professionals expert at detecting and managing medication errors and drug-drug interactions, safe dispensing, and patient counseling, are an under-utilized asset in addressing overdose in the US and globally. Pharmacies provide a high-yield setting where patient and caregiver customers can access naloxone-an opioid antagonist that reverses opioid overdose-and overdose prevention counseling. This case study briefly describes and provides two US state-specific examples of innovative policy models of pharmacy-based naloxone, implemented to reduce overdose events and improve opioid safety: Collaborative Pharmacy Practice Agreements and Pharmacy Standing Orders.