A nationwide pharmacy chain responds to the opioid epidemic

Shafer, Emily Fitzgibbons; Bergeron, Nyahne Q.; Smith-Ray, Renae L.; Robson, Chester; O’Koren, Rachel

doi:10.1016/j.japh.2016.12.075

Cited by 20 publications

(16 citation statements)

References 8 publications

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“…High risk venues and populations include people leaving settings where tolerance is reduced (incarceration, hospital, detoxification programs, residential treatment). Pharmacies are ripe for scale up because they are the most common and community-based health facilities with longer hours of operation than many other health care facilities (Bounthavong et al, 2017; Jones, Lurie, & Compton, 2016; Shafer, Bergeron, Smith-Ray, Robson, & O'Koren, 2017; Stopka, Donahue, Hutcheson, & Green, 2017). Many states have instituted policies to encourage wider provision of naloxone through pharmacies.…”

Section: Overdose Response In the Synthetic Opioid Eramentioning

confidence: 99%

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic

Fairbairn

Coffin

Walley

2017

International Journal of Drug Policy

251

192

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Community-based overdose prevention programs first emerged in the 1990's and are now the leading public health intervention for overdose. Key elements of these programs are overdose education and naloxone distribution to people who use opioids and their social networks. We review the evolution of naloxone programming through the heroin overdose era of the 1990's, the prescription opioid era of the 2000's, and the current overdose crisis stemming from the synthetic opioid era of illicitly manufactured fentanyl and its analogues in the 2010's. We present current challenges arising in this new era of synthetic opioids, including variable potency of illicit drugs due to erratic adulteration of the drug supply with synthetic opioids, potentially changing efficacy of standard naloxone formulations for overdose rescue, potentially shorter overdose response time, and reports of fentanyl exposure among people who use drugs but are opioid naïve. Future directions for adapting naloxone programming to the dynamic opioid epidemic are proposed, including scale-up to new venues and social networks, new standards for post-overdose care, expansion of supervised drug consumption services, and integration of novel technologies to detect overdose and deliver naloxone.

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Section: Overdose Response In the Synthetic Opioid Eramentioning

confidence: 99%

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic

Fairbairn

Coffin

Walley

2017

International Journal of Drug Policy

251

192

View full text Add to dashboard Cite

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“…Increases in opioid abuse can be attributed at least in part to changes in medication prescribing habits, changes in drug formulations, increased ease of access to drugs illegally (including over the internet), and an overall massive increase in the number of opioid prescriptions filled [ 4 ]. While opioid analgesic use in acute pain management seems benign, it often results in long-term use of opioids for pain management, which is associated with significant burden and addiction [ 4 , 5 ]. Furthermore, the scant evidence for the long-term efficacy of opioids does not support their widespread use in the management of chronic pain and raises concerns for patients’ greater physical and psychosocial problems [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Opioid Use Disorders in Adult Postsurgical Patients

Burcher¹,

Suprun²,

Smith³

2018

Cureus

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The use of opioids in the treatment of chronic pain is one of the most controversial topics in medicine today. Many studies have proposed that the postoperative period is a vulnerable time for patients at risk for developing an opioid use disorder. Many patients are prescribed opioids for management of their postsurgical pain and continue using them for prolonged amounts of time following their surgeries. Some populations are more likely to develop an opioid use disorder following exposure to opioid medications than others. In this review, the authors discuss the patient-level risk factors for the abuse of these drugs in postsurgical patients.

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“…The increasing number of opioid overdoses in Australia include pharmaceutical opioids as well as heroin. As the primary distributers of pharmaceutical opioids in our communities, pharmacists are increasingly being recognised as potential educators and distributers of naloxone (4,5,11,12). The down-scheduling enables members of the public to request naloxone from pharmacies but also for pharmacists to initiate naloxone supply.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…In most cases, these deaths are accidental and preventable and population level responses are required to reverse these concerning trends. The rescheduling of naloxone in Australia recognises the potential role of pharmacists in overdose prevention including as educators and distributers of naloxone (4,5,11,12).…”

Section: Introductionmentioning

confidence: 99%

How prepared are pharmacists to provide over-the-counter naloxone? The role of previous education and new training opportunities

Chun

Olsen

Taing

et al. 2019

Research in Social and Administrative Pharmacy

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Introduction and Aims: Opioid overdose can be reversed with timely administration of naloxone. In Australia, naloxone was rescheduled from prescription only (S4) to pharmacist only over-the-counter (OTC, S3) in February 2016, increasing access for the general public. A key barrier to naloxone supply by pharmacists is a lack of knowledge, highlighting the role of pharmacist education. Community pharmacists' education, experience, and training preferences related to naloxone provision, overdose, and substance use disorder were examined. Methods: Online survey data from a national sample of Australian pharmacists on their educational preferences regarding naloxone and overdose prevention, and prior training on substance use disorder (n = 595) was analyzed using bivariate and multivariate regression analysis. Data from qualitative semi-structured telephone interviews with pharmacists about OTC naloxone provision (n=21) was analyzed using thematic analysis. Results: Most pharmacists (81%, n = 479) were willing to be trained in opioid overdose prevention, with greater willingness to attend training associated with younger age, being female, fewer years of practice, not having attended previous education on substance use disorder, and higher confidence in issues relating to substance use disorder. Qualitative interviews confirmed community pharmacists' willingness to attend training but analysis revealed low awareness, knowledge, and confidence about naloxone and preventing opioid overdose. Most pharmacists preferred online training or webinars. Discussion and Conclusion: Most community pharmacists in Australia are willing to attend training on providing naloxone and preventing opioid overdose. There are opportunities to develop and expand the online presence of training, guidelines, and education materials to facilitate the expanded supply of OTC naloxone.

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A nationwide pharmacy chain responds to the opioid epidemic

Abstract: The availability of safe drug-disposal kiosks, naloxone dispensing at pharmacies, and patient education are key prevention initiatives to address the opioid epidemic and reduce the increasing national burden of opioid overdose. Early results are quantitatively and qualitatively promising.

Cited by 20 publications

References 8 publications

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic

Risk Factors for Opioid Use Disorders in Adult Postsurgical Patients

How prepared are pharmacists to provide over-the-counter naloxone? The role of previous education and new training opportunities

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