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The Article in Brief
Primary Care Patient Experience With Naloxone Prescription
Emily Behar , and colleagues
Background Drug overdose, driven by opioids, is the leading cause of accidental death in the United States, but distribution of the opioid antagonist naloxone (which blocks or reduces the opioid's effects) has been associated with a reduction in opioid overdose mortality. This is the first study to evaluate patients' experiences receiving a co-prescription of naloxone with opioids.
What This Study Found Patients overwhelmingly responded positively to being offered a naloxone prescription, and having naloxone was associated with beneficial changes in their opioid use behaviors. Interviews with 60 patients who received naloxone prescriptions across 6 safety-net primary care clinics revealed that 90 percent of patients had never previously received a naloxone prescription, 88 percent successfully filled the prescription, 97 percent believed patients prescribed opioids should be offered naloxone, 79 percent had a positive or neutral response to being offered naloxone and 37 percent reported positive behavior change after receiving the prescription (safer dosing, safer timing and increased knowledge around opioids and overdose). Although 37 percent of patients described having previously overdosed, 17 percent of those patients described the events as ?bad reactions,? and 77 percent estimated their risk of overdose as low.
Implications
- The authors suggest that improved terminology is needed to describe opioid poisonings, as the term "overdose" may not reflect patients' perceptions.
- Since 90 percent of patients in this study had never previously received a naloxone prescription, the authors conclude that primary care prescribing appears to be reaching a population not served by community distribution. They call for future studies to investigate strategies to maximize the positive effects of on behavior change and to integrate naloxone prescribing with broader opioid stewardship efforts.