Naloxone prescribing by psychiatric clinical pharmacists for patients receiving opioid agonist treatment

Abstract

Take-home naloxone is an important intervention for addressing opioid overdoses. Patients with a history of a substance use disorder are at an elevated risk of experiencing an overdose, and even in substance-abuse treatment, they may continue to witness peer overdoses. The purpose of this innovative practice was for psychiatric clinical pharmacists to improve access to intranasal naloxone and provide opioid overdose prevention training for patients receiving opioid agonist treatment (OAT). This program took place at a San Francisco Department of Public Health pharmacy that provides OAT (buprenorphine and methadone) to approximately 200 patients with opioid use disorders as part of an integrated treatment program. During the 17-month study period, 47 intranasal naloxone kits were prescribed. Patients reported 3 successful opioid overdose reversals using intranasal naloxone. Based on these findings, psychiatric clinical pharmacists can improve patient safety by increasing access to intranasal naloxone and opioid overdose prevention training for patients receiving OAT.