State legal innovations to encourage naloxone dispensing

Davis, Corey S.; Carr, Derek

doi:10.1016/j.japh.2016.11.007

Cited by 116 publications

(97 citation statements)

References 26 publications

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“…We found that the naloxone dispensing rate and third-party payer One of the most widely discussed strategies to prevent fatal opioid overdose is to increase naloxone access. 34,[40][41][42] As demand for naloxone has increased, the cost of naloxone has also increased.…”

Section: Discussionmentioning

confidence: 99%

“…We focused on two particular provisions of naloxone access laws that were widely adopted during the observation period and that were intended to increase naloxone dispensing from retail pharmacies: (a) pharmacy-based naloxone laws and (b) third-party prescribing laws. 34 In this study, pharmacy-based naloxone laws referred to standing orders, protocol orders, and direct authority to dispense naloxone. Through these laws, a person at risk for opioid overdose can obtain naloxone from a retail pharmacy without first seeing a prescriber, and furthermore, these interventions were previously shown to decrease opioid-related overdose deaths.…”

Section: Variables and Data Sourcesmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Variables and Data Sourcesmentioning

confidence: 99%

Association between state Medicaid expansion status and naloxone prescription dispensing

Sohn

Talbert

Delcher

et al. 2020

Health Services Research

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“…Liability risks associated with naloxone were not greater than any with other medications, and some states provided additional protection from civil liability or criminal action to pharmacists to encourage naloxone prescription and dispensing. 16 It is evident that potential pharmacist roles in opioid overdose prevention have been recognized by a majority of states with efforts promoting the role of pharmacists in naloxone dispensing.…”

Section: Recognition Of Pharmacist Services By Statesmentioning

confidence: 99%

“…12 Specific protocols are pursuant to individual state regulations, but overall they have increased access to naloxone by eliminating the previously necessary patientephysician interaction and written prescription. [14][15][16] As a result, pharmacists have expanded their roles in screening patients at risk for overdose and dispensing naloxone alongside opioid medications as appropriate. 17,18 This expansion of naloxone access and pharmacist roles has been supported by national pharmacy associations and federal agencies through the dissemination of toolkits, guidelines, and other resources.…”

mentioning

confidence: 99%

Pharmacist roles, training, and perceived barriers in naloxone dispensing: A systematic review

Thakur¹,

Frey²,

Chewning³

2020

Journal of the American Pharmacists Association

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“…Since October 2015, UK pharmacies providing supervised opioid substitution treatment can supply THN without prescription to individuals likely to witness an opioid overdose provided "the [naloxone] supply is suitably recorded" (PHE, 2015). As of August 2016, US pharmacists can prescribe naloxone in 5 states and dispense naloxone via standing orders in forty-two states (Davis and Carr, 2017). Pharmacy-based provision has been piloted as a strategy to promote naloxone access in rural areas (Green et al, 2015b) and increased dramatically in the US since 2013 (Jones et al, 2016).…”

Section: Pharmacy-based Provisionmentioning

confidence: 99%

Twenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids—Conception and maturation

McDonald

Campbell

Strang

2017

Drug and Alcohol Dependence

110

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Highlights Deaths from opioid overdose can be prevented by prompt administration of naloxone  It has been 20 years since take-home naloxone provision was first proposed  Take-home naloxone programs have recently overcome legal barriers in many countries  Take-home naloxone provision remains low compared to evident growing clinical need  The 'opt-out' model of required pre-provision may achieve wider naloxone coverage Abstract Background: Opioid overdose is a major cause of mortality, but injury and fatal outcomes can be prevented by timely administration of the opioid antagonist naloxone. Pre-provision of naloxone to opioid users and family members (take-home naloxone, THN) was first proposed in 1996, and WHO Guidelines were issued in 2014. While widespread in some countries, THN is minimally available or absent elsewhere. This review traces the development of THN over twenty years, from speculative harm reduction proposal to public health strategy.Method: Medline and PsycINFO were searched for peer-reviewed literature using Boolean queries: 1) "naloxone OR Narcan"; 2) "(opioid OR opiate) AND overdose AND prevention". Grey literature and specialist websites were also searched. Data were extracted and synthesized as narrative review, with key events presented as chronological timeline. Results Conclusions:Framed as a public health tool for harm reduction, THN has overcome social, clinical, and legal barriers in many jurisdictions. Nonetheless, the rising death toll of opioid overdose illustrates that current THN coverage is insufficient, and greater public investment in overdose prevention will be required if THN is to achieve its full potential impact.

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State legal innovations to encourage naloxone dispensing

Abstract: Pharmacists are key members of the health care team and are uniquely situated to reduce potential opioid overdose risk. Pharmacists should be aware of and utilize innovative state laws designed to increase access to naloxone.

Cited by 116 publications

References 26 publications

Association between state Medicaid expansion status and naloxone prescription dispensing

Association between state Medicaid expansion status and naloxone prescription dispensing

Pharmacist roles, training, and perceived barriers in naloxone dispensing: A systematic review

Twenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids—Conception and maturation

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