Faculty Collaboration Database

Factors associated with naloxone availability and dispensing through Michigan's pharmacy standing order. Am J Drug Alcohol Abuse 2022 Jul 04;48(4):454-463

Date

04/12/2022

Pubmed ID

35405078

DOI

10.1080/00952990.2022.2047714

Scopus ID

2-s2.0-85129160996 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

Background: Pharmacy standing order policies allow pharmacists to dispense naloxone, thereby increasing access to naloxone. Objectives: To describe pharmacy standing order participation and associations of pharmacy and community characteristics that predict naloxone availability and dispensing across eight counties in Michigan. Methods: We conducted a telephone survey of 662 standing order pharmacies with a response rate of 81% (n = 539). Pharmacies were linked with census tract-level demographics, overdose fatality rates, and dispensing data. County maps were created to visualize pharmacy locations relative to fatality rates. Regression models analyzed associations between pharmacy type, neighborhood characteristics, fatality rates, and these outcomes: naloxone availability, having ever dispensed naloxone, and counts of naloxone dispensed. Results: The prevalence of standing order pharmacies was 54% (n = 662/1231). Maps revealed areas with higher fatality rates had fewer pharmacies participating in the standing order or lacked any pharmacy access. Among standing order pharmacies surveyed, 85% (n = 458/539) had naloxone available and 82% had ever dispensed (n = 333/406). The mean out-of-pocket cost of Narcan_® was $127.77 (SD: 23.93). National chains were more likely than regional chains to stock naloxone (AOR = 3.75, 95%CI = 1.77, 7.93) and to have ever dispensed naloxone (AOR 3.02, 95%CI = 1.21,7.57). Higher volume of naloxone dispensed was associated in neighborhoods with greater proportions of public health insurance (IRR = 1.38, 95%CI = 1.21, 1.58) and populations under 44 years old (IRR = 1.24, 95%CI = 1.04, 1.48). There was no association with neighborhood overdose fatality rates or race in regression models. Conclusion: As deaths from the opioid epidemic continue to escalate, efforts to expand naloxone access through greater standing order pharmacy participation are warranted.

Author List

Dahlem CH, Myers M, Goldstick J, Stevenson JG, Gray G, Rockhill S, Dora-Laskey A, Kellenberg J, Brummett CM, Kocher KE

Author

Aaron Dora-Laskey MD Adjunct Assistant Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Drug Overdose
Humans
Michigan
Naloxone
Narcotic Antagonists
Opioid-Related Disorders
Pharmacies
Pharmacy
Standing Orders