Naloxone availability in independent community pharmacies in Georgia, 2019

Lauren Gilbert,Ekene Oranu,Kimberly Roth,Lauren Beasley,Jennifer Elliott,Jennifer Nguyễn

doi:10.1186/s13011-021-00402-w

Abstract

BackgroundIncreasing 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.MethodsA 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).ResultsFive 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.ConclusionsThis 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.

Highlights

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
Having naloxone on hand is useful for people who take high doses of opioid pain medications, people who use opioid medications along with benzodiazepines, and people who use opioids not as prescribed by a doctor or illicit opioid medications or substances alike in order to reduce the risk of overdose mortality [5]
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 [5]

Summary

Introduction

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 availability of naloxone, an opioid antagonist which rapidly reverses the effects of an opioidinduced respiratory depression, is a first line of defense in countering the incidence of opioid-related overdose deaths [3]. A single administration of a nasal spray or intramuscular injection of naloxone quickly competes for binding sites on opioid receptors within the nervous system, potentially saving an overdose victim’s life. Some people who use opioids may require a second or multiple doses of naloxone to reverse an overdose event [4]. Having naloxone on hand is useful for people who take high doses of opioid pain medications, people who use opioid medications along with benzodiazepines, and people who use opioids not as prescribed by a doctor or illicit opioid medications or substances alike in order to reduce the risk of overdose mortality [5]. In 2017, Surgeon General Jerome Adams encouraged widespread awareness of “knowing how to use naloxone and keeping it within reach [to] save a life” as a key part of the public health response to the opioid epidemic [6]

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