Acceptability of Naloxone Co-Prescription Among Primary Care Providers Treating Patients on Long-Term Opioid Therapy for Pain

Behar, Emily; Rowe, Christopher; Santos, Glenn-Milo; Coffa, Diana; Turner, Caitlin; Santos, Nina C.; Coffin, Phillip O.

doi:10.1007/s11606-016-3911-z

Cited by 35 publications

(35 citation statements)

References 16 publications

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“…Identification and recognition of key facilitators and barriers to increasing naloxone access were the predominant themes of this category (11/15), unlike the patient and bystander results [ 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ]. Seven of these studies were in the form of discussion groups and interviews, and the remaining four were surveys.…”

Section: Resultsmentioning

confidence: 99%

Stakeholders’ Perceptions of Factors Influencing the Use of Take-Home-Naloxone

et al. 2020

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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. After a series of screening processes, 51 articles were included for analysis. Two key stakeholder perspectives emerged: patients and bystanders (n = 36), and healthcare professionals (n = 15). Within the patient and bystander group, a strong consensus arose that there were positive outcomes from increased access to take-home naloxone and relevant training programs. Despite these positive outcomes, some healthcare professionals were concerned that take-home naloxone would encourage high-risk opioid use. Conclusion: Take-home naloxone is slowly being introduced into community practice, with a sense of enthusiasm from patients and bystanders. There are still a number of barriers that need to be addressed from healthcare professionals’ perspective. Future research should be aimed at emergency care professionals outside of the US, who are most experienced with naloxone and its potential impact on the community.

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Section: Resultsmentioning

confidence: 99%

Stakeholders’ Perceptions of Factors Influencing the Use of Take-Home-Naloxone

et al. 2020

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“…In contrast, acceptability by primary care providers for coprescription of naloxone with long-term opioid therapy for pain in adults has been demonstrated to be relatively high (79-83 percent). 18,19 The overall low risk to benefit ratio of home prescription of naloxone must be considered in light of the opioid epidemic and prevention of morbidity. Nevertheless, guidelines regarding the dosing of naloxone in the pediatric setting have yet to be established and the majority of our clinicians did not report prescribing naloxone when prescribing opioids.…”

Section: Discussionmentioning

confidence: 99%

Clinician opioid prescribing practices and patient utilization of prescribed opioids in pediatrics

Huang¹,

Kuelbs²

2018

J of Opioid Management

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Objective: Little is known regarding clinician prescribing of opioid medications and of patient use of prescribed opioid medications in pediatrics. The authors sought to learn more about pediatric clinician opioid prescribing practices and patient utilization and disposal of prescribed opioids.Design: Cross-sectional, observational study.Setting: Tertiary care pediatric healthcare center.Participants: Pediatric clinicians who prescribe opioid medications and parents of children prescribed an opioid medication.Main Outcome Measures: Clinicians were surveyed about opioid prescribing practices for acute pain management in children, and parents were asked about utilization and disposal of prescribed opioids.Results: Most clinician respondents (64 percent) reported prescribing opioid medications to manage acute pain. The typical length of opioid prescriptions was limited to 7 days (93 percent). Parents reported a high prevalence of leftover opioid medications (86 percent). Most (59 percent) did not dispose of the remaining medication.Conclusions: Targets for intervention to reduce unnecessary opioid exposure in youth are identified.

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“…Some of the earliest efforts in naloxone co-prescription were made by Project Lazarus in Wilkes County, North Carolina, which saw a 70% decrease in prescription opioid-related overdose death rates during the implementation phase of the project from 2009 to 2010 (Albert et al, 2011). Naloxone co-prescribing was found to be acceptable to clinicians and it was associated with reductions in emergency department visits for opioid-related adverse events (Behar et al, 2016; Coffin et al, 2016). …”

Section: Introductionmentioning

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

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249

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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Acceptability of Naloxone Co-Prescription Among Primary Care Providers Treating Patients on Long-Term Opioid Therapy for Pain

Cited by 35 publications

References 16 publications

Stakeholders’ Perceptions of Factors Influencing the Use of Take-Home-Naloxone

Stakeholders’ Perceptions of Factors Influencing the Use of Take-Home-Naloxone

Clinician opioid prescribing practices and patient utilization of prescribed opioids in pediatrics

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

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