SAFE GC Coalition: CDC Sees Variation in Naloxone Prescriptions

The Centers for Disease Control and Prevention (CDC) reports approximately 48,000 U.S. drug overdose deaths involved opioids in 2017. Naloxone (also known as narcan) is a life-saving medication that can reverse the effects of an opioid overdose.

Pharmacists and other healthcare providers play a critical role in ensuring patients receive naloxone. Many states have laws that allow pharmacists to dispense naloxone without a prescription (called standing orders), which have contributed to lowering deaths.

Dispensing has increased in recent years, but more work needs to be done, particularly in rural counties. According to the CDC, the number of prescriptions for naloxone doubled from 2017 to 2018. Only one naloxone prescription is dispensed for every 70 high-dose opioid prescriptions and rural counties are nearly three times more likely to be ranked low dispensing than metropolitan counties.

This wide variation in prescribing and dispensing across the U.S. despite consistent state laws and recommendations indicates people who may need naloxone are not all getting it. Dispensing naloxone in areas hardest hit by the opioid overdose epidemic can increase the number of overdose reversals and the opportunity to link overdose survivors into treatment. Actions needed to improve access locally include reducing insurance co-pay for patients, increasing provider training and education and targeting distribution especially in rural areas.

Going forward, the CDC recommends pharmacists and other healthcare providers monitor patients for risk of overdose, prescribe or dispense naloxone when overdose risk factors are present, and counsel patients on how to use it, ensure naloxone is always available in pharmacies and participate in and offer naloxone training and education.

Health insurers can reduce patient out-of-pocket costs and cover naloxone prescriptions without prior approval. Additionally, States and communities can work with healthcare providers to expand naloxone access, especially in rural areas, promote the benefits of prescribing, dispensing, and carrying naloxone and create harm reduction programs and improve access to medication-assisted treatment for opioid use disorder.

Improvements could also be made by physicians by following the CDC Guidelines for Prescribing Opioids for Chronic Pain, considering offering naloxone to patients receiving high opioid dosages (greater than or equal to 50 morphine milligram equivalents per day).

The CDC recommends asking your doctor or pharmacist for a naloxone prescription if you or a loved one are taking high-dose opioids or have a substance use disorder. Keeping naloxone in stock in pharmacies and educating patients, caregivers, and the community about the benefits of having naloxone readily available to more people can decrease overdoses.

The CDC is a federal agency that conducts and supports health promotion, prevention and preparedness activities in the United States, with the goal of improving overall public health. To learn more about the CDC please visit www.cdc.gov.

The SAFE Glen Cove Coalition is conducting an opioid prevention awareness campaign entitled, "Keeping Glen Cove SAFE," in order to educate and update the community regarding opioid use and its consequences. To learn more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencove or visit SAFE’s website to learn more about the Opioid Epidemic at www.safeglencove.org