Pharmacy Students' Perceptions and Stigma Surrounding Naloxone Use in Patients with Opioid Use Disorder: A Mixed Methods Evaluation.

Alina Cernasev,Kenneth C Hohmeier,Michael P Veve,Taylor Talbott,Elizabeth A Hall

doi:10.3390/pharmacy8040205

Alina Cernasev, Kenneth C Hohmeier + Show 3 more

Open Access

https://doi.org/10.3390/pharmacy8040205

Copy DOI

Abstract

Pharmacists represent a key group of healthcare professionals that can increase awareness and destigmatize naloxone use. The objective of this study was to investigate pharmacy student perceptions of the use, dispensing, and stigma surrounding naloxone. An electronic survey was administered to pharmacy students that included questions about demographics, work history, naloxone use, and naloxone stigma. Separate qualitative interviews were performed to identify themes surrounding naloxone use. Two-hundred sixty-two participants completed the survey. The majority of participants were “highly willing” (74%) to fill a naloxone prescription for a patient and “somewhat comfortable” (38%) in counseling on naloxone; most were “somewhat comfortable” (38%) administering naloxone. Naloxone is “very rarely” (87%) recommended in community workplace settings, and the majority (64%) reported that patients never request information about naloxone availability. Seventy-six percent of respondents reported that naloxone-associated interactions have an influence on the way they communicate with patients in community pharmacy settings. Thematic analyses found that pharmacy students identify the importance of naloxone as a life-saving medication and the need for naloxone training, but patient-perceived stigma and limited access to naloxone remain prevalent. Pharmacy students are generally well-versed and inclined toward distributing, counseling on, and administering naloxone. Naloxone is rarely dispensed and patient conversations involving naloxone are infrequent in community settings. Future efforts focused on approaches toward difficult patient conversations and normalization of naloxone are needed to destigmatize and facilitate use.

Highlights

Over the past two decades, the United States (U.S.) has experienced an evolving public health crisis: the opioid epidemic
There may be some limitations to external validity when compared to where naloxone training is provided in other U.S College of Pharmacy curricula. The results of this mixed methods study found that pharmacy students display comfort, willingness to dispense, and confidence in administering naloxone to patients
A small portion of pharmacy students report that they change their behavior when responding to a patient encounter related to naloxone

Summary

Introduction

Over the past two decades, the United States (U.S.) has experienced an evolving public health crisis: the opioid epidemic. What started as an effort to provide adequate pain management transformed into widespread opioid overuse, overdose-related deaths, and other significant detrimental societal effects [1]. In 2000, prescribers increased their use of opioids as a result of Joint Commission pain management standards; pharmaceutical companies subsequently began heavily promoting their highly addictive opioid products [1]. From 1999 to 2018, almost 450,000 people died from a prescription or illicit opioid overdose [2]. While the introduction of naloxone products into the U.S market and in pharmacies has helped to curtail the prevalence of opioid-related overdoses across the country, several barriers remain in obtaining access to naloxone and decreasing the negative stigma surrounding its use, from both a population and healthcare provider perspective.

Objectives

Methods

Discussion

Conclusion