Bottom Line: Two studies looked at the availability of naloxone, an antidote for opioid overdoses, from pharmacies in two states that have passed legislation to allow pharmacists to dispense the medication without a physician's prescription.
What: Having access to naloxone can reduce the risk of death from an opioid overdose. Legislation in California has allowed trained pharmacists to provide naloxone without a physician's prescription since 2016. In this study, an anonymous telephone survey of some California community pharmacies was conducted in 2018 with interviewers posing as potential customers who asked pharmacy staff if they could get naloxone without a prescription. Less than 25 percent of about 1,150 retail pharmacies said they were giving naloxone to patients without a physician prescription. Of the pharmacies providing the medication, only about 50 percent had nasal naloxone in stock. Limitations of the study include a lack of data on the reasons why pharmacies weren't providing the naloxone.
Authors: Talia Puzantian, Pharm.D., BCPP, Keck Graduate Institute School of Pharmacy and Health Sciences, Claremont, California, and James J. Gasper, Pharm.D., BCPP, University of California, San Francisco
(doi:10.1001/jama.2018.12291)
What: A second study evaluated naloxone accessibility from chain pharmacies in Texas under a standing order from prescribers almost three years after Texas enacted legislation. Under a standing order, prescribers may authorize pharmacists to dispense naloxone without a prescription. In this study, interviewers posed as customers and spoke to pharmacists about wanting to purchase naloxone to have on hand in the event they had to respond to an opioid overdose. Among about 2,300 pharmacies, 84 percent indicated they would dispense the naloxone and 69 percent of pharmacies had the medication in stock. The study was limited by interviewing only one pharmacist per pharmacy and including only Texas chain pharmacies.
Authors: Kirk E. Evoy, Pharm.D., BCACP, BC-ADM, CTTS, the University of Texas at Austin, and coauthors
(doi:10.1001/jama.2018.15892)
Related Material: The editorial, "Overcoming Inertia to Improve Medication Use and Deprescribing," by Michael A. Steinman, M.D., University of California San Francisco, California, and C. Seth Landefeld, M.D., University of Alabama at Birmingham, is available on the For The Media website.
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To Learn More: The full studies are available on the For The Media website.
Editor's Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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Puzantian study: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.12291
Evoy study: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.15892
Journal
JAMA