Naloxone availability in independent community pharmacies in Georgia, 2019

Abstract

Background Increasing the availability of naloxone among people who use opioids, and friends and family of past and present people who use opioids 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 community pharmacies in Georgia. Secondary objectives include determining pharmacists’ knowledge regarding the standing order and ability to counsel regarding naloxone. Methods A cross-sectional study using a secret shopper approach with phone contact was conducted over a period of 10 months. The study was population based and was conducted at all independent pharmacies in the state of Georgia. All independent community pharmacies in the state of Georgia were contacted and asked the naloxone questions with a 96% response rate (n = 520). Results Five hundred fifty-eight independent community 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 prescription was required. The mean (SD) cash price was $148.02 (27.40), with a range of $0 to $300. Of 237 pharmacists asked who had naloxone in stock or who stated they could get naloxone in stock, 212 stated that they could demonstrate how to use it, 8 stated they could not, and 17 said that they possibly could or were unsure how to use it. Conclusions This study provided insight into the limited availability of naloxone at independent community pharmacies in Georgia after the standing order was issued. The majority of pharmacists at independent pharmacies in Georgia were not using the publicly available state naloxone standing order. Additionally, the low availability of naloxone and its high cost for uninsured individuals are significant structural barriers for reducing opioid-related mortality.

Attitude changes following short-form opioid overdose video education: a pilot study

“…It is worth considering whether the lengthy training required to explain IM naloxone administration is still necessitated, since naloxone has shifted from IM to primarily IN administration (Narcan) in recent years. The transition has both increased ease of administration and decreased risk of needlestick injury [13]. Additionally, participants in this study identifying as either a healthcare provider, or a family member or friend of a person with an OUD scored significantly higher than other participants.…”

“…With these considerations, measuring the impact of a brief video education provided virtually on participants' attitudes toward overdose could be a significant step toward future mitigation of opioid use morbidity and mortality. Decreasing financial burden of educational programs while increasing scalability has become ever more significant as opioid fatalities and the demand for naloxone continue to rise [7,13].…”

“…There is a body of research that points to the effectiveness of in-person opioid overdose education [7,8,12,13]. However, there is a recognition that virtual education and telemedical interventions have the potential to also be an effective means of delivering OORT [15].…”

Research and scholarly methods: Audit studies

“…Many recent audit studies have been conducted in the community pharmacy setting, 7,[10][11][12][13][16][17][18][19][20][21][22][23][24] which resembles secret shopper methodology commonly conducted in consumer settings unrelated to healthcare, such as investigating differing experiences in vehicle purchase negotiations based on race and gender. 25 Audit studies in community pharmacies may be easier to conduct, as compared to other healthcare settings, because they typically do not require an appointment or an encounter fee to be paid.…”

Stayin’ Alive in Little 5: Application of Sentiment Analysis to Investigate Emotions of Service Industry Workers Responding to Drug Overdoses

“…The overwhelming driver of increased deaths due to opioid use is the contamination of the drug supply with synthetic opioids, such as fentanyl, that are 50 times more potent than heroin [ 5 ]. One of the most important steps that the State of Georgia has taken to reduce the number of deaths from opioid overdose is the implementation of standing orders, which allow pharmacists and other healthcare professionals to distribute naloxone, an opioid antagonist, to laypersons without the need for a provider’s prescription [ 6 ]. The implementation of naloxone standing orders has been shown to increase community availability of this life saving medication [ 7 , 8 ] and decrease opioid-related mortality [ 9 ].…”