Broadening Access to Naloxone: Community Predictors of Standing Order Naloxone Distribution in Massachusetts

Details

• Alternative Title:
  Drug Alcohol Depend
• Personal Author:
  Chatterjee, Avik ; Yan, Shapei ; Xuan, Ziming ; Waye, Katherine M. ; Lambert, Audrey M. ; Green, Traci C. ; Stopka, Thomas J. ; Pollini, Robin A. ; Morgan, Jake R. ; Walley, Alexander Y.
• Description:
  Background:
  
  Naloxone is a prescription medication that reverses opioid overdoses. Allowing naloxone to be dispensed directly by a pharmacist without an individual prescription under a naloxone standing order (NSO) can expand access. The community-level factors associated with naloxone dispensed under NSO are unknown.
  
  Methods:
  
  Using a dataset comprised of pharmacy reports of naloxone dispensed under NSO from 70% of Massachusetts retail pharmacies, we examined relationships between community-level demographics, rurality, measures of treatment for opioid use disorder, and overdose deaths with naloxone dispensed under NSO per ZIP Code-quarter from 2014 until 2018. We used a multi-variable zero-inflated negative binomial model, assessing odds of any naloxone dispensed under NSO, as well as a multi-variable negative binomial model assessing quantities of naloxone dispensed under NSO.
  
  Results:
  
  From 2014–2018, quantities of naloxone dispensed under NSO and the number of pharmacies dispensing any naloxone under NSO increased over time. However, communities with greater percentages of people with Hispanic ethnicity (aOR 0.91, 95% CI 0.86–0.96 per 5% increase), and rural communities compared to urban communities (aOR 0.81, 95% CI 0.73–0.90) were less likely to dispense any naloxone by NSO. Communities with more individuals treated with buprenorphine dispensed more naloxone under NSO, as did communities with more opioid-related overdose deaths.
  
  Conclusion:
  
  Naloxone dispensing has substantially increased, in part driven by standing orders. A lower likelihood of naloxone being dispensed under NSO in communities with larger Hispanic populations and in more rural communities suggests the need for more equitable access to, and uptake of, lifesaving medications like naloxone.
  
  
• Keywords:
  Analgesics Drug Overdose Harm Reduction Humans Massachusetts Naloxone Narcotic Antagonists Opioid Pharmacy Standing Orders
• Source:
  Drug Alcohol Depend. 230:109190
• Pubmed ID:
  34864356
• Pubmed Central ID:
  PMC8714703
• Document Type:
  Journal Article
• Funding:
  R01 DA046527/DA/NIDA NIH HHSUnited States/ ; P30 DA040500/DA/NIDA NIH HHSUnited States/ ; P20 GM125507/GM/NIGMS NIH HHSUnited States/ ; R01 CE002999/CE/NCIPC CDC HHSUnited States/ ; R01 DA045745/DA/NIDA NIH HHSUnited States/ ; R01 DA040807/DA/NIDA NIH HHSUnited States/ ; R01CE002999/ACL/ACL HHSUnited States/
• Volume:
  230
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d44f81979743f5a70dcda9f762f94bda1af149e4f3b5a8773156c205fdfa1844
• Download URL:
  https://stacks.cdc.gov/view/cdc/113012/cdc_113012_DS1.pdf
• File Type:
  [PDF - 755.95 KB ]