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Exploring the legalities behind prescription of naloxone

Exploring the legalities behind prescription of naloxone

12-05 | CDAH Team

As the opioid overdose deaths in the United States continue to rise, the need to implement an emergency solution has become indispensable. Naloxone, an opioid overdose antagonist is the need of the hour.

Naloxone, originally approved in 1971 help in reversing the lethal effects of an opioid overdose. Although naloxone can be administered intramuscularly, intravenously, subcutaneously and as a nasal spray, the intravenous form is preferred due to the quick scope of action and recovery.

In view of the opioid epidemic, pharmacists are beginning to realize the need for educating the public to empower everyone to prevent overdose situations. Since the administration and dispensation of naloxone requires additional training and education, it is necessary for both pharmacists and common masses to learn the basic techniques and rules.

As such, the rules pertaining to dispensation of naloxone differs from state to state. In some states, training is mandatory for pharmacists who can prescribe naloxone. While administering the drug to the patient, pharmacists are supposed to document all patients along with a training checklist acknowledging training in the administration techniques.

Some states allow patients to receive naloxone without a traditional written prescription. Also known as standing orders, physicians write prescriptions without mentioning the patient name. This allows nurses and other staff members in hospitals, health care facilities and even outpatient practices to administer naloxone.

As pharmacists play a pivotal role in counseling patients, some states allow them to dispense naloxone based on the Collaborative Drug Therapy Agreement. Although naloxone is a life-saving medication, it needs to be administered only in an emergency and the symptoms of an overdose are to be correctly identified before administration.

Moreover, the pros and cons of administering naloxone needs to be informed to patients, as well as his or her family members, caregivers and other third parties. The caregivers should know that the patient might wake up with irritability and aggressive behavior due to severe withdrawal after the administration of naloxone. This is primarily due to the role of naloxone in rapidly reversing opioid toxicity.

Community training necessary for increasing access to naloxone

The role of community training in preventing opioid overdoses is invaluable. Through the good Samaritan laws, the public have been empowered to participate in preventing opioid overdoses or reversing them quickly. The first state to amend the law pertaining to dispensation and administration of naloxone was New Mexico, wherein anyone possessing, prescribing, dispensing and administering naloxone are provide immunity vide this law. Since then every state has followed suit to broaden access to naloxone in varying degrees.

The number of people dying due to an overdose of prescription opioids between 1999 and 2015 has increased to about 183,000, and alarmingly, there seems to be no sign of abatement. Additionally, an increase in the abuse of heroin and other illicit opioids has further added to the death toll. Demographically, the highest overdose rates occur among non-Hispanic white Americans between the ages of 25 and 54. One out of four patients, receiving long-term opioids prescription for non-cancer pain in primary care settings grapple with addiction.

The most frequently abused opioids include methadone, oxycodone and hydrocodone. Despite the conscious efforts from all quarters to cut back on opioids, the Q4 2013 sales of OxyContin (oxycodone hydrochloride) manufactured by Purdue Pharma was $585,482.

The practice of overprescribing opioids has been prevailing in the United States for a long time now. As per the Centers for Disease Control and Prevention, opioid prescription increased fourfold between 1999 and 2015. In 2016, approximately 11.8 million people aged 12 or older misused opioids in the past year, including 948,000 users who misused heroin. Moreover, the total number of people in the same age range suffering from an opioid use disorder (OUD) was 2.1 million, including 153,000 adolescents. On an average, over 1,000 people are brought into emergency rooms (ERs) every day for misusing prescription opioids.

If you or your loved one is struggling with substance abuse or addiction, connect to the Colorado Drug Addiction Helpline to know about the addiction treatment centers in Colorado specializing in the best evidence-based intervention plans. Call at our 24/7 helpline number 866-218-7546 or chat online for further information on addiction treatment in Colorado.

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