The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City

Morgan, Jake R.; Freibott, Christina E.; Jalali, Ali; Jeng, Philip J.; Walley, Alexander Y.; Chatterjee, Avik; Green, Traci C.; Nolan, Michelle L.; Linas, Benjamin P.; Marshall, Brandon D. L.; Murphy, Sean M.

doi:10.1016/j.dadr.2022.100083

Cited by 4 publications

(1 citation statement)

References 23 publications

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“…In NYC, OOPPs are any program registered with New York State as a source of naloxone distribution and training, which include a range of community-based organizations, healthcare facilities, syringe service programs, and other organizations. Compared to OOPPs, pharmacies play a smaller role in naloxone distribution in NYC (14). In 2018, NYC began collecting individual-level data to understand who receives naloxone kits from OOPPs and where kits are received (15).…”

Section: Introductionmentioning

confidence: 99%

Racial/Ethnic differences in receipt of naloxone distributed by opioid overdose prevention programs in New York City

Nolen

Trinidad

Jordan

et al. 2023

Preprint

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Introduction: We evaluated racial/ethnic differences in the receipt of naloxone distributed by opioid overdose prevention programs (OOPPs) in New York City (NYC). Methods: We used naloxone recipient racial/ethnic data collected by OOPPs from April 2018 to March 2019. We aggregated quarterly neighborhood-specific rates of naloxone receipt and other covariates to 42 NYC neighborhoods. We used a multilevel negative binomial regression model to assess the relationship between neighborhood-specific naloxone receipt rates and race/ethnicity. Race/ethnicity was stratified into four mutually exclusive groups: Latino, non-Latino Black, non-Latino White and non-Latino Other. We also conducted racial/ethnic-specific geospatial analyses to assess whether there was within-group geographic variation in naloxone receipt rates for each racial/ethnic group. Results: Non-Latino Black residents had the highest median quarterly naloxone receipt rate of 41.8 per 100,000 residents, followed by Latino residents (22.0 per 100,000), non-Latino White (13.6 per 100,000) and non-Latino Other residents (13.3 per 100,000). In our multivariable analysis, compared with non-Latino White residents, non-Latino Black residents had a significantly higher receipt rate and non-Latino Other residents had a significantly lower receipt rate. In the geospatial analyses, both Latino and non-Latino Black residents had the most within-group geographic variation in naloxone receipt rates compared to non-Latino White and Other residents. Conclusions: This study found significant racial/ethnic differences in naloxone receipt from NYC OOPPs. We observed substantial variation in naloxone receipt for non-Latino Black and Latino residents across neighborhoods, indicating relatively poorer access in some neighborhoods and opportunities for new approaches to address geographic and structural barriers in these locations.

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Section: Introductionmentioning

confidence: 99%

Racial/Ethnic differences in receipt of naloxone distributed by opioid overdose prevention programs in New York City

Nolen

Trinidad

Jordan

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

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Naloxone Access Laws and Opioid-Related Overdose Deaths in Youths

Toce,

Michelson,

Hadland

et al. 2024

JAMA Pediatr

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CTN-0138: adaptation, implementation, and cluster randomized trial of a Community Pharmacy-Based Prescription Drug Monitoring Program Opioid Risk Assessment Tool—a protocol paper

Cochran,

Brown,

et al. 2024

Addict Sci Clin Pract

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Background As the opioid epidemic continues to have a major negative impact across the US, community pharmacies have come under scrutiny from legal systems attempting to hold them accountable for their role in over dispensing and lack of patient intervention. While the most available tool for monitoring patients’ opioid use is Prescription Drug Monitoring Programs (PDMP), these do not provide pharmacists with actionable information and decision support. Our study addresses this gap through three objectives: [1] incorporate validated opioid risk metric thresholds into a PDMP platform to create the Opioid Risk Reduction Clinical Decision Support (ORRCDS) tool; [2] assess ORRCDS’ ability to reduce patient opioid risk; [3] assess ORRCDS’ sustainability and viability for broader dissemination in community pharmacy. Methods For objective 1, our team is partnering with leadership from the largest US PDMP organization and a top-five pharmacy chain to implement ORRCDS into the pharmacy chain’s workflow following the Guideline Implementation with Decision Support (GUIDES) framework. For objective 2, our team will conduct a type-1 implementation mixed methods study using a 2-arm parallel group clustered randomized design. We anticipate enrolling ~ 6,600 patients with moderate and high opioid use risk during the 6-month enrollment phase across 80 pharmacies. This sample size will provide 96.3% power to detect a 5% or greater difference in responder rate between the intervention and control arm. Responders are patients with moderate-risk at baseline who reduce to low-risk or those with high-risk at baseline who reduce to moderate or low-risk at 180 days post last intervention. To accomplish objective 3, we will use the Consolidated Framework for Implementation Research (CFIR) to develop and execute cross-sectional qualitative interviews with pharmacists (n = 15), pharmacy leaders (n = 15), and PDMP leaders (n = 15) regarding long term adoption and sustainability of the ORRCDS tool. Conclusions A PDMP tool that addresses moderate- and high-risk opioid use is not available in community pharmacy. This study will implement ORRCDS in a large retail pharmacy chain that will include additional screening and guidance to pharmacy staff to address risky opioid medication use. Our results will make critical advancements for protecting patient health and addressing the opioid epidemic.

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The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City

Cited by 4 publications

References 23 publications

Racial/Ethnic differences in receipt of naloxone distributed by opioid overdose prevention programs in New York City

Racial/Ethnic differences in receipt of naloxone distributed by opioid overdose prevention programs in New York City

Naloxone Access Laws and Opioid-Related Overdose Deaths in Youths

CTN-0138: adaptation, implementation, and cluster randomized trial of a Community Pharmacy-Based Prescription Drug Monitoring Program Opioid Risk Assessment Tool—a protocol paper

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