Still Not Enough Naloxone Where It’s Most Needed in Rural Areas

The overdose-reversing drug naloxone saves lives – but only if it’s readily available when an overdose occurs.

Despite a huge increase in naloxone prescribing in recent years, CDC researchers report in the latest Vital Signs study published today that far too little naloxone is being dispensed in many areas of the country that need it the most.

Moreover, too few doctors are prescribing naloxone to patients receiving high-dose opioids or opioids plus benzodiazepines or to those with a substance use disorder as recommended by CDC’s Guideline for Prescribing Opioids for Chronic Pain. Nearly 9 million more naloxone prescriptions could have been dispensed in 2018 if every patient with a high-dose opioid prescription were offered naloxone.

In 2017, 47,600 people in the U.S. died as a result of drug overdoses involving opioids. The prescribing and dispensing of naloxone is a critical part of the public health response to the opioid overdose epidemic.

Naloxone has been used for many years by emergency medical services, first responders, and community-based overdose prevention programs. Current efforts have focused on expanding access to naloxone through prescribing and pharmacy-based distribution.

Up-to-date information on pharmacy-based naloxone dispensing is needed. To address this gap and to inform future overdose prevention and response efforts, CDC examined trends and characteristics of how naloxone is dispensed from U.S. retail pharmacies at the national and county levels.

While the findings show an increase in naloxone dispensing from 2012 to 2018, study data confirm additional efforts are needed to improve naloxone access at the local level. Wide variations in dispensing in pharmacies exist, despite consistent state laws.

In 2018, rural counties had the lowest dispensing rates. Primary care providers wrote only 1.5 naloxone prescriptions per 100 high-dose opioid prescriptions – a marker for opioid overdose risk – and over half of naloxone prescriptions required a copay.

Key findings

  • The number of naloxone prescriptions dispensed doubled from 2017 to 2018.
  • Only one naloxone prescription is dispensed for every 70 high-dose opioid prescriptions nationwide.
  • Most (71%) Medicare prescriptions for naloxone required a copay, compared to 42% for commercial insurance.
  • Rural counties were nearly 3 times more likely to be a low-dispensing county compared to metropolitan counties.
  • Naloxone dispensing is 25 times greater in the highest-dispensing counties than the lowest-dispensing counties.

“It is clear from the data that there is still much needed education around the important role naloxone plays in reducing overdose deaths. The time is now to ensure all individuals who are prescribed high-dose opioids also receive naloxone as a potential life-saving intervention,” said CDC Director Robert R. Redfield, M.D. “As we aggressively confront what is the public health crisis of our time, CDC will continue to stress with healthcare providers the benefit of making this overdose-reversing medicine available to patients.”

Read more at CDC

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The Government Technology & Services Coalition's Homeland Security Today (HSToday) is the premier news and information resource for the homeland security community, dedicated to elevating the discussions and insights that can support a safe and secure nation. A non-profit magazine and media platform, HSToday provides readers with the whole story, placing facts and comments in context to inform debate and drive realistic solutions to some of the nation’s most vexing security challenges.

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