Naloxone coprescription in U.S. ambulatory care centers and emergency departments

Abstract

ObjectivesThe rise in both drug overdoses and deaths owing to opioids has been increasing for at least 2 decades in the United States. Naloxone-prescribing programs have been in use since the mid-2000s with a guideline to manage their use being published in 2012. This study seeks to determine the national prevalence of naloxone coprescribing within U.S. ambulatory care centers and emergency departments (EDs). MethodsThis study was a retrospective, cross-sectional, observational analysis of data collected by the Centers for Disease Control and Prevention (CDC) in the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey: Emergency Department Summary during the years 2012-2016. All survey participants aged 18 years or older with documented opioid use—with the exception of codeine, dihydrocodeine, and opioid-containing cough syrups—were included. Variables of interest that were available in the data were summarized. ResultsNaloxone was coprescribed with opioids in less than 0.1% of visits. Despite 5 years of data combined across 2 national surveys including 48,158 adults with documented opioid use, further analyses of naloxone coprescription could not be performed owing to the limited number of such coprescriptions. Among the factors previously documented to increase the risk of opioid overdose, concurrent benzodiazepine use (18.7%) was the most reported, followed by history of substance use disorder (1.6%) and history of overdose (< 0.1%). ConclusionUsing nationally representative data collected by the CDC from ambulatory care centers and EDs, we found that naloxone was coprescribed with opioids in only less than 0.1% of visits. Future research is warranted to determine whether current practices have adapted to meet the standards set by the 2016 CDC guidelines.