Naloxone Access: More states look to pharmacists to increase naloxone access

Objectives The objective of this study is to assess West Virginia (WV) pharmacists’ stocking and dispensing practices of opioid-related medications and to identify the educational needs relating to providing naloxone in community pharmacies. Design A cross-sectional, anonymous, 49-item survey was created and validated to assess the educational needs of WV community pharmacists. Setting and participants The data collection instrument was administered to 266 pharmacists currently licensed in WV at six continuing education events throughout the state from March 1st, 2016 to June 15th, 2016. Outcome measures Pharmacists’ educational needs were determined using the Extended Parallel Process Model, which has four main constructs: perceived severity, perceived susceptibility, response efficacy, and self-efficacy. Pharmacists’ stocking and dispensing of opioids and related medications were also assessed. Results Pharmacists completed 157 surveys. They were mostly male (56.1%), full-time employees (67.5%), worked mostly in community pharmacies (69.4%), and had a mean age of 50.19 years (SD=13.62). The newly-adapted opioid perceived efficacy and perceived severity of opioid adverse events scales were tested for reliability and validity. Only 20.4% of the community pharmacists surveyed felt comfortable selling naloxone over-the-counter. As for the other opioid-related medications, only 53.3% stocked buprenorphine and 74.8% stocked buprenorphine/naloxone. Conclusion As the most accessible health care providers, community pharmacists are acutely aware of how the opioid epidemic affects their communities. Some pharmacists in WV are hesitant to stock and dispense opioids and opioid-dependence medications. Although this may decrease the flow of potentially abused drugs into the community, it may also restrict access to necessary therapy from patients with opioid use disorder. Furthermore, pharmacists in WV are not yet comfortable stocking and dispensing naloxone. Tailored educational materials can help in controlling the pharmacists’ fear and reinforce the benefits of over-the-counter naloxone use.

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“…8 To maximize pharmacists’ effort in this regard states have expanded pharmacists’ legal abilities to furnish naloxone. 8,12-15 …”

Section: Introductionmentioning

confidence: 99%

Pharmacists' readiness to provide naloxone in community pharmacies in West Virginia

Thornton¹,

Lyvers²,

Scott³

et al. 2017

Journal of the American Pharmacists Association

105

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“…10 Effective clinical, policy, and community responses to solve the opioid epidemic focus on a continuum beginning with appropriate initiation of opioids and ending with harm reduction efforts. [11][12][13][14][15][16][17] The first step is the appropriate initiation of opioids because as many as 46% of adults who were initiated on opioids transition into chronic opioid users. 18 Chronic opioid therapy (COT) can exacerbate current conditions and lead to development of new chronic physical and mental health conditions, and other opioid-related adverse effects including overdose.…”

Section: James Douglas Thorntonmentioning

confidence: 99%

“…harm reduction). [11][12][13][14][15][16][17] Naloxone has been approved in many forms (e.g. intranasal, intravenous) and can completely reverse the immediate risks of opioid overdose and prevent deaths due to opioid overdose.…”

Section: Background and Need For Studymentioning

confidence: 99%

“…52 Pharmacists are providing naloxone to the community in unique ways and their legal responsibilities are in a state of change. 16,17,52,63,64 West Virginia (WV) is an appropriate state to evaluate the capacity of community pharmacies to provide naloxone due to its reliance on community pharmacies to provide access to healthcare and its current high levels of opioid abuse and deaths. 47,65 In 2015, WV led the US with 35.5 deaths per 100,000 inhabitantstwice the national average.…”

Section: Background and Need For Studymentioning

confidence: 99%

“…66 States which have been most burdened by the opioid epidemic have used community pharmacists to increase access to naloxone. 17,67,68 For example, Kentucky (24.7 drug overdose deaths per 100,000 inhabitants) passed legislation for pharmacists to provide naloxone in the community in 2015 and the state agencies provide education materials tailored to pharmacists in their state. 64 Despite the anecdotal successes, 46,53 the true societal impact of naloxone in a community will be determined in the coming months and years.…”

Section: Background and Need For Studymentioning

confidence: 99%

See 2 more Smart Citations

Transitions Within Opioid Therapy and Their Impact on Morbidity, Healthcare Utilization, and Costs

Thornton¹

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Association between state Medicaid expansion status and naloxone prescription dispensing

Sohn

Talbert

Delcher

et al. 2020

Health Services Research

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Objective To test whether Medicaid expansion is associated with (a) a greater number of naloxone prescriptions dispensed and (b) a higher proportion of naloxone prescriptions paid by Medicaid. Data Sources/Study Setting We used the IQVIA National Prescription Audit to obtain data on per state per quarter naloxone prescription dispensing for the period 2011‐16. Study Design In this quasi‐experimental design study, the impact of Medicaid expansion on naloxone prescription dispensing was examined using difference‐in‐difference estimation models. State‐level covariates including pharmacy‐based naloxone laws (standing/protocol orders and direct authority to dispense naloxone), third‐party prescribing laws, opioid analgesic prescribing rates, opioid‐involved overdose death rates, and population size were controlled for in the analysis. Principal Findings Medicaid expansion was associated with 38 additional naloxone prescriptions dispensed per state per quarter compared to nonexpansion controls, on average (P = .030). Also, Medicaid expansion resulted in an average increase of 9.86 percent in the share of naloxone prescriptions paid by Medicaid per state per quarter (P < .001). Conclusions Our study found that Medicaid expansion increased naloxone availability. This finding suggests that it will be important to consider naloxone access when making federal‐ and state‐level decisions affecting Medicaid coverage.

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Naloxone Access: More states look to pharmacists to increase naloxone access

Cited by 3 publications

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Pharmacists' readiness to provide naloxone in community pharmacies in West Virginia

Pharmacists' readiness to provide naloxone in community pharmacies in West Virginia

Transitions Within Opioid Therapy and Their Impact on Morbidity, Healthcare Utilization, and Costs

Association between state Medicaid expansion status and naloxone prescription dispensing

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