title: Orienting patients to greater opioid safety: models of community pharmacy-based naloxone.
abstract: The leading cause of adult injury death in the U.S.A. is drug overdose, the majority of which involves prescription opioid medications. Outside of the U.S.A., deaths by drug overdose are also on the rise, and overdose is a leading cause of death for drug users. Reducing overdose risk while maintaining access to prescription opioids when medically indicated requires careful consideration of how opioids are prescribed and dispensed, how patients use them, how they interact with other medications, and how they are safely stored. Pharmacists, highly trained professionals expert at detecting and managing medication errors and drug-drug interactions, safe dispensing, and patient counseling, are an under-utilized asset in addressing overdose in the U.S. and globally. Pharmacies provide a high-yield setting where patient and caregiver customers can access naloxone-an opioid antagonist that reverses opioid overdose-and overdose prevention counseling. This case study briefly describes and provides two US state-specific examples of innovative policy models of pharmacy-based naloxone, implemented to reduce overdose events and improve opioid safety: Collaborative Pharmacy Practice Agreements and Pharmacy Standing Orders.
authors.affiliation: Department of Emergency Medicine, Rhode Island Hospital, Injury Prevention Center, 55 Claverick St., 2nd Floor, Providence, Rhode Island, 02903, USA. traci.c.green@gmail.com.|Boston Medical Center, Injury Prevention Center, Boston University School of Medicine, 771 Albany St., Boston, Massachusetts, 02118, USA. traci.c.green@gmail.com.|The Warren Alpert Medical School at Brown University, 222 Richmond St, Providence, Rhode Island, 02903, USA. traci.c.green@gmail.com.|, 771 Albany St., Boston, Massachusetts, 02118, USA. traci.c.green@gmail.com.
authors.forename: Traci C
authors.initials: TC
authors.lastname: Green
authors.affiliation: The Warren Alpert Medical School at Brown University, 222 Richmond St, Providence, Rhode Island, 02903, USA. edauria@lifespan.org.
authors.forename: Emily F
authors.initials: EF
authors.lastname: Dauria
authors.affiliation: College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, Kingston, Rhode Island, USA. jefbratberg@uri.edu.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Bratberg
authors.affiliation: Network for Public Health Law, Carrboro, North Carolina, USA. cdavis@networkforphl.org.
authors.forename: Corey S
authors.initials: CS
authors.lastname: Davis
authors.affiliation: Clinical Addiction Research Education Unit, Boston University School of Medicine/ Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, Massachusetts, 02118, USA. awalley@bu.edu.
authors.forename: Alexander Y
authors.initials: AY
authors.lastname: Walley
mesh_terms: D003299:Cooperative Behavior; D003376:Counseling; D062787:Drug Overdose / Q000188:drug therapy* / Q000517:prevention & control*; D055030:Drug Users; D006801:Humans; D008404:Massachusetts; D017146:Models, Organizational; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000517:prevention & control*; D010593:Pharmaceutical Services; D010594:Pharmacies; D055553:Prescription Drugs; D012237:Rhode Island; D014481:United States
chemical_list: D009292:Narcotic Antagonists; D055553:Prescription Drugs; D009270:Naloxone