Pharmacists in Kentucky Can Now Dispense Naloxone Without Prescriptions

The Kentucky Board of Pharmacy has passed an emergency regulation permitting the state’s pharmacists to dispense the opioid overdose antidote naloxone without a prescription.

“This is a great opportunity for pharmacists to be involved in helping save lives,” Michael Burleson, RPh, executive director of the Kentucky Board of Pharmacy, told Pharmacy Times.

The emergency regulation was catalyzed by Kentucky’s SB 192, which was recently amended to allow certified pharmacists to prescribe and dispense the medication. It also permits naloxone to be given to “persons, agencies, or school employees capable of administering the medication in emergency situations,” including first responders.

Thanks to the bill’s passage, the state pharmacy board was able to develop the naloxone regulation, and an e-mail blast about it was sent out to 8000 pharmacists in Kentucky. Burleson said he has already heard from a number of interested pharmacists in the past week or so since the regulation went into effect.

According to the regulation, pharmacists who desire to dispense naloxone must submit an application to the board, and if accepted, they can achieve certification in 30 days. However, pharmacists will have to take a training course the board is developing on topics such as risk factors for opioid abuse and overdose, drug overdose prevention, and naloxone administration.

In addition, pharmacists will be required to have a physician-approved protocol related to naloxone dispensing. This protocol will include specific education patients will receive when dispensed naloxone and identify criteria for why a patient is eligible to receive it.

Burleson said naloxone may be dispensed to a customer who comes in with concerns that a friend has the potential to overdose.

“We need to be aware of what’s going on and try to make sure we’re getting this drug to the individuals who need it,” he explained.

Patients who enter a pharmacy for naloxone will receive verbal counseling and written materials about ways to prevent overdose, spot signs of an overdose, steps for responding to an overdose, and information on naloxone related to its administration and storage.

Pharmacists will have to document their naloxone dispensing in the pharmacy management system, as well.

Trish Freeman, RPh, PhD, a Kentucky Pharmacists Association (KPhA) member and clinical associate professor at the University of Kentucky College of Pharmacy, told Pharmacy Times that this is an important milestone for public health in her state.

She noted Kentucky had the second-highest age-adjusted overdose mortality rate in United States in 2013, and the state’s rate was almost double that of the country’s overall rate. Increased access to naloxone, however, can prevent overdoses that result in death.

“Pharmacists have unparalleled access to individuals in a community who may be at risk, or know someone at risk, for opioid overdose and are poised to make a significant impact on our overdose deaths by fulfilling this new role,” said Dr. Freeman, who is also the chairwoman of KPhA’s Provider Status Workgroup.

Dr. Freeman thinks it is “only a matter of time” until other states pass similar regulations.

Kentucky is not the only state where pharmacists can dispense naloxone without a prescription. For example, since January 1, 2015, California pharmacists have been permitted to dispense the drug after taking a continuing education course developed by the California Pharmacists Association.

Dr. Freeman saw Kentucky’s move as a potential step toward pharmacists achieving provider status, and she remarked it was a “fairly easy sell” to propose increasing access to naloxone through pharmacist protocols.

“Whether you consider immunizations, overdose prevention, chronic disease prevention, or health and wellness promotion, the pharmacist can significantly improve public health when provided the opportunity to do so,” Dr Freeman told Pharmacy Times. “We are excited that pharmacists have been given the opportunity to increase access to naloxone and prevent overdose deaths in Kentucky.”