Pharmacists increase naloxone access in communities

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State laws vary, but pharmacists can be integral to naloxone access

Pharmacists in New Mexico were some of the first in the nation to prescribe naloxone—an antidote for opioid overdose. Naloxone is covered under Medicaid in New Mexico. But in 2014, only 87 naloxone Medicaid claims came from 23 unique pharmacies across the state. That number has grown to 808 claims for naloxone from 100 unique outpatient pharmacies in just the first two quarters of 2016.

The increase in naloxone access can be attributed in large part to a novel pharmacist-initiated naloxone program. Since April, a group of pharmacists who are part of a nonprofit HIV/Hepatitis C clinic in New Mexico have been traveling onsite to pharmacies in the state and training pharmacists to operate a naloxone program.

“Even though we have this law in New Mexico, we didn’t see claims increase for naloxone so we felt we needed hands-on training for pharmacists and technicians,” said Kate Morton, PharmD, director of Pharmacy Services of Southwest CARE Center, the nonprofit that provides the onsite training.

She said many pharmacists intended to take advantage of the law but didn’t know how to develop a program, or they were too strapped for time to get one started. Providing hands-on, peer-to-peer training seemed like the most effective tactic, according to Morton.

Pharmacists across the country see an increased need for access to naloxone in their communities.

Collaborative practice agreements (CPAs) provide another pathway to respond to this need. Pharmacists’ authority to dispense naloxone without a prescription varies by state, and most can dispense naloxone through CPAs if standing orders or other prescribing laws are not in place.

Pharmacists at Riverside Village Pharmacy in Nashville began noticing more prescriptions for naloxone in early 2016. This prompted them to look into working with a local physician to be able to prescribe naloxone. Their CPA with a physician, who is also an addiction treatment specialist, became official in September. Now Riverside Village pharmacists can assess a patient’s overdose risk and dispense naloxone, as well as educate patients and caregivers on what to do in an overdose situation.

For pharmacists interested in a CPA for naloxone prescribing, Bryant Cary, PharmD, a pharmacist at Riverside Village Pharmacy who developed the program, recommends first understanding the law in one’s practicing state since it is different everywhere. Otherwise, exercising patience can help.

“[Our CPA] started with an idea 8–9 months ago and took all that time to get it going as far as putting together a protocol and figuring out what the laws are in Tennessee and getting it approved,” said Cary.

But it’s all worth it, he said, because of how much it’s benefiting the entire community.

Visit www.pharmacytoday.org for the full article in the upcoming December 2016 issue of Pharmacy Today.

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