Article Figures & Data
Figures
- Figure 1
Opioid safety and how to use naloxone. A guide for patients and caregivers.
Tables
- Table 1
Demographic and Behavioral Characteristics of Primary Care Patients Prescribed Naloxone (N = 60)
Characteristic No. (%) Sex, male 33 (55) Race/ethnicity White 16 (27) African American 33 (55) Hispanic 5 (8) Mixed/other 6 (10) Prescribed opioids for pain 52 (87) Ever taken opioids not as prescribed 32 (53) Opioids currently prescribed, mean (SD) 1.3 (0.8) Previously received take-home naloxone 6 (10) Previously had heard of naloxone (n = 52) 21 (40) Naloxone ever used on participant (n = 22) 6 (27) History of overdose/bad reaction 22 (37) Overdose 12 (20) Bad reaction 10 (17) Ever witnessed an opioid overdose 32 (53) Perceived personal risk of overdose (n = 47) Low (<3) 36 (77) Moderate (3–6) 10 (21) High (>6) 1 (2) Response No. (%) Attempted to fill naloxone prescription 56 (93) Able to fill naloxone prescription (n = 56) 49 (88) Naloxone prescription from study used on participant 3 (5) Site of storage for naloxone (n = 48) Store at home 39 (81) Carry with me 6 (13) Unsure of location/lost 3 (6) Person(s) trained by participant to use naloxone (n = 49) Family 18 (37) Roommate 12 (24) Friend 11 (22) Partner 8 (16) Neighbor 5 (10) Housing staff 5 (10) Nobody 15 (31) Participant confidence in ability to use naloxone (n = 49) Not at all confident 2 (4) A little confident 5 (10) Somewhat confident 13 (26) Very confident 29 (59) Participant confident person(s) they trained could use naloxone (n = 34) Not at all confident 3 (9) A little confident 1 (3) Somewhat confident 9 (26) Very confident 21 (62) - Table 3
Reactions to and Perceptions of Naloxone Prescription Among Primary Care Patients (N = 60)
Perception and Reaction No. (%) Reaction to naloxone prescription offer Positive 34 (57) Negative 13 (22) Neutral 13 (22) Reasons for positive reaction to naloxone prescription offer (n = 34) Benefits the community 18 (53) Appreciated it was offered 14 (41) Improved relationship with provider 10 (29) Reasons for negative reaction to naloxone prescription offer (n = 13) Prescription was undeserved 10 (77) Judged by clinician 9 (69) Scared 8 (61) Offended by the prescription 3 (23) Opioid-related behavior modification since receiving naloxone Positive 22 (37) Neutral 38 (63) Negative 0 (0) Type of positive behavior modification (n = 8) Improved dosing 7 (88) Improved timing 7 (88) Improved knowledge around opioids and overdose 5 (63) Decrease in polysubstance use 1 (12) Decrease in using alone 1 (12) Would want naloxone prescription in the future (n = 59) Yes 56 (95) No 1 (2) Do not know 2 (3) Naloxone should be available to patients prescribed opioids for pain (n = 59) Yes, all 47 (80) Yes, some 10 (17) No 0 (0) Do not know 2 (3)
Supplemental Appendix
Supplemental Appendix
Files in this Data Supplement:
- Supplemental data: Appendix - PDF file
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.
