Pharmacists Provide New Pathway to Naloxone

With Pennsylvania pharmacies now authorized to fill third-party naloxone prescriptions and California pharmacies set to dispense naloxone without any prescription at all, more and more pharmacists are providing a critical public pathway to the opioid overdose antidote.

“We see our naloxone access legislation as one more way California pharmacists are becoming primary care providers,” Jon Roth, CEO of the California Pharmacists Association (CPhA), told Pharmacy Times in an exclusive phone interview. “Dispensing naloxone is one more pathway for pharmacists to serve their communities.”

When the state’s new naloxone law takes effect on January 1, 2015, Roth said California pharmacists who wish to dispense the opioid reversal drug without a prescription must complete a 1-hour continuing education (CE) course that the CPhA is currently developing.

Well over 100 pharmacists in New Mexico have undergone similar training to dispense naloxone since last January, when the New Mexico Board of Pharmacy amended the Pharmacist Prescriptive Authority Act to include the opioid overdose reversal drug alongside vaccines and tobacco cessation therapy.

“One of the purposes of this new protocol was to address complaints that pharmacies were not stocking naloxone because prescribers were not prescribing it. So, it was believed that if pharmacists could prescribe it, then it would be in stock,” Dale Tinker, executive director of the New Mexico Pharmacists Association, told Pharmacy Times in a phone interview. “Now, other practitioners are now prescribing it definitely more than they were before…and we’re letting pharmacists who fill opioid prescriptions know that if a prescriber doesn’t co-prescribe naloxone, then the pharmacist can do that.”

In a policy statement issued in October 2014, the National Association of Boards of Pharmacy (NABP) said it “recognizes the value of pharmacists in assuring optimal medication therapy and promotes the pharmacist’s role in delivering opioid overdose reversal therapy.” In light of those sentiments, the NABP stated it “resolves to address the drug overdose epidemic crippling our nation by engaging with state and federal officials and representatives from national associations to support programs that involve an active role for pharmacists in expanding access to the opioid overdose reversal drug.”

Since November 5, 2014, a total of 25 states and the District of Columbia have passed naloxone access laws, according to The Network for Public Health Law. However, only New Mexico, Washington, New York, Rhode Island, and Vermont make the opioid overdose agent available from pharmacists without a prescription.

In Washington and Rhode Island, pharmacists are entering into collaborative practice agreements with physicians to gain prescriptive authority for naloxone. Through such agreements, pharmacists “work more closely with providers and their patients to increase awareness of overdose risk and to increase community protection from opioid overdose death by greatly increasing access to naloxone, particularly to those who do not know their risk,” Jeffrey Bratberg, PharmD, co-chair of the Rhode Island Pharmacists Association’s legislative committee, told Pharmacy Times in an email.

“I hope that with this increased knowledge of the problem and one solution to this problem, naloxone, literally in their hands, pharmacists will help reduce the stigma associated with opioid abuse and educate more and more people about their risk for overdose and how to prevent death as a result of overdose,” Dr. Bratberg added.