By Tom Flanagan, MMS Media
Relations Manager
A pharmacist demonstrates how to use Narcan (naloxone) nasal spray in the current episode of
Physician Focus .
It’s a message as jarring as it is factual: A patient cannot receive proper clinical treatment for substance use disorder if that patient is not alive to receive it. This is why access to naloxone, and effective and efficient deployment of the drug, are growing more critical by the day.
“Unfortunately, overdose is no longer a rare event,” said Alexander Y. Walley, MD, MSc, director of the Addiction Medicine Fellowship at the Clinical Addiction Research and Education Unit, Boston University School of Medicine/Boston Medical Center.
To be effective, naloxone needs to be distributed broadly. “It’s important to have naloxone available not only to people who themselves are at risk for overdose, but also to those who have someone in their lives who is at risk,” says Dr. Walley, who is also associate professor of medicine at Boston University School of Medicine. “Access is also critical in other areas of society; for example, to someone who owns a restaurant, where the bathroom could potentially be a place where drugs are ingested.”
Increased access to naloxone is a priority in MMS advocacy. At the 2017 Interim Meeting, the House of Delegates adopted a resolution that the Society will encourage efforts to ensure all health care professional students in Massachusetts receive training in the administration of
naloxone.
Which Patients Need to Hear This
Messaging about how to get and use naloxone should be just as broadly disseminated. Key venues include physicians’ practices. Prescribing an opioid pain medication requires screening the patient for substance use disorder — and regardless of the patient’s risk, providers should always discuss overdoses.
“It’s important for all patients to be educated about the potential risk, and to ask them if they have a plan in place in the event of an overdose,” says Dr. Walley, who practices at the Grayken Center for Addiction at Boston Medical Center. “Any time we’re prescribing an opioid, the patient should hear that it’s a good idea to think about having a naloxone rescue kit.” Their families also need that information.
The public’s heightened awareness of the opioid crisis may facilitate provider-patient discussions. “These conversations have become more normalized as part of the broader conversation on public health. It’s about safety; it’s not accusatory,” says Dr. Walley. “When we talk to patients about wearing seat belts, we’re not accusing them of being a bad driver or of driving drunk.”
Key Messages for Patients
- Go to the pharmacy: Since 2014, all Massachusetts retail pharmacies licensed by the Board of Pharmacy must obtain a standing order and maintain a continuous supply of naloxone.
- Talk to the pharmacist: Pharmacists at locations that recognize standing orders are required to complete naloxone training approved by the Massachusetts Department of Public Health (MDPH), including how to advise customers on when and how to deploy naloxone.
- Insurance covers it: MassHealth, and most insurers in the state, cover naloxone with affordable co-pays, according to the MDPH.
- Other options: The state has a variety of resources that can provide “safety-net” access to naloxone; for example, the
Overdose Education and Naloxone Distribution (OEND) pilot program, administered by the MDPH, is aimed at those most at risk of experiencing an opioid overdose, and has 21 locations statewide.
- Educational tools: The MDPH has
online and print resources for patients, families, communities, providers, and state municipalities and agencies.
