Prescribe to Prevent: Overdose Prevention and Naloxone Rescue Kits for Prescribers and Pharmacists

Abstract

In March of 2015, the United States Department of Health and Human Services identified 3 priority areas to reduce opioid use disorders and overdose, which are as follows: opioid-prescribing practices; expanded use and distribution of naloxone; and expansion of medication-assisted treatment. In this narrative review of overdose prevention and the role of prescribers and pharmacists in distributing naloxone, we address these priority areas and present a clinical scenario within the review involving a pharmacist, a patient with chronic pain and anxiety, and a primary care physician. We also discuss current laws related to naloxone prescribing and dispensing. This review was adapted from the Prescribe to Prevent online continuing medical education module created for prescribers and pharmacists (http://www.opioidprescribing.com/naloxone_module_1-landing).

Predicting pharmacy naloxone stocking and dispensing following a statewide standing order, Indiana 2016

“…The rate of OOD quadrupled between 1999 and 2015 and reached a point where 91 Americans died daily ( CDC, 2017a ). Part of the federal government’s response was to identify access to the OOD reversal medication naloxone as part of a tripartite approach to reducing OOD ( Kim et al, 2016 ).…”

Retention of Student Pharmacists’ Knowledge and Skills regarding Overdose Management with Naloxone

“…Volunteers given up to 100 times the therapeutic dose of naloxone suffered no adverse effects, which demonstrates the safety of the agent and enables the public to administer naloxone even in the absence of extensive training. 14,15 Given the proper resources, such as integrated access to the prescription drug monitoring program with the dispensing software used to process and prepare prescriptions in community pharmacies, pharmacists have the opportunity to make a significant impact on community-level prescription substance use disorder prevention and treatment efforts. 16 Pharmacists have daily contact with patients who are either at risk for opioid overdose themselves or know someone at risk.…”

Beliefs Associated with Pharmacy-Based Naloxone: a Qualitative Study of Pharmacy-Based Naloxone Purchasers and People at Risk for Opioid Overdose

“…The goal of the qualitative analysis was to explore factors that influence likelihood of obtaining PBN. As such, the analysis was deductive, informed by the social contextual model [14], current literature on PBN [16,17], and preliminary readings of the transcripts. Author ED created an initial draft of a code book comprised of theorybased codes [14] with five major sections: individual, social, organization/pharmacy, community, and societylevel influencing factors.…”