CDC Guidance on Ensuring Availability of Naloxone
According to the U.S. Centers for Disease Control and Prevention (CDC) there is wide variation in prescribing and dispensing Naloxone persists across the Unites States. In 2017, there was approximately 48,000 deaths related to drug-overdose involving opioids in the United States. In response to this epidemic, many states have enacted laws permitting standing orders that allow pharmacists to dispense naloxone without a prescription. While laws have contributed to lowering death rates and dispensing of naloxone has increased in recent years, more work needs to be done, particularly in rural counties. Because of the high numbers of drug overdose deaths involving opioids, 36% of which in 2017 involved prescription opioids, the CDC states that improving access to naloxone is a public health priority. Additional efforts from pharmacists, healthcare providers, and health insurers are needed to improve naloxone access at the local level, including prescribing and pharmacy dispensing.
The CDC is underscoring the following key information for clinicians:
- Dispensing naloxone in areas most affected by the opioid overdose epidemic can increase the number of overdose reversals and the opportunity to link overdose survivors to treatment.
- Clinicians can help by:
- Following CDC Guideline for Prescribing Opioids for Chronic Pain to consider offering naloxone to patients receiving high opioid dosages (greater than or equal to 50 morphine milligram equivalents per day).
- Recent studies show that primary care providers only prescribed about two naloxone prescriptions for every 100 high-dose opioid prescriptions. The CDC recommend co-prescribing nalonone for patients at risk for opioid overdose.
- Monitor patients for risk of overdose, prescribe or dispense naloxone when overdose risk factors are present, and counsel patients on how to use it.
- Ensuring naloxone is always available in pharmacies.
- Participate in and offer naloxone training and education.
- Keeping naloxone in stock in pharmacies.
- Educating patients, caregivers, and the community about the benefits of having naloxone readily available to more people.
Despite substantial increases in naloxone dispensing, the rate of naloxone prescriptions dispensed per high-dose opioid prescription remains low. Efforts to improve naloxone access and distribution work most effectively with efforts to improve opioid prescribing, implement other harm-reduction strategies, promote linkage to medications for opioid use disorder treatment, and enhance public health and public safety partnerships.
Included with today’s notice is an example policy related to opioid training and education and clinical tips for prescribing opioids.
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