Co-prescribing naloxone in primary care settings may reduce ER visits

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Research funded by the National Institute on Drug Abuse (NIDA) found that patients taking opioids for long-term chronic pain, who were given prescriptions for naloxone in a primary care setting, had 63 percent fewer opioid-related emergency department visits after one year compared to those who did not receive prescriptions for naloxone.

This study presents the first large published data regarding co-prescribing naloxone for primary care patients on long-term opioid therapy for pain. Primary care providers were more likely to give naloxone prescriptions to patients on higher opioid doses and with prior opioid-related emergency department visits. The findings suggest that prescribing naloxone in primary care settings is feasible and may offer an additional benefit to reducing opioid-related adverse events.

Study authors indicate they do not know how many patients filled their prescriptions, and their analyses suggests a behavioral impact of naloxone co-prescription, as patients become more aware of the hazards of these medications and may engage in efforts to improve medication safety.

Study Update:

The researchers conducted a follow-up study to evaluate chronic pain patients’ attitudes toward being offered a naloxone prescription. Results showed that 82% successfully filled the prescription and 97% believed that patients prescribed opioids for pain should be offered naloxone. Most patients had a positive (57%) or neutral (22%) response to being offered naloxone, and 37% reported safer opioid use behaviors after receiving the prescription; there were no harmful behavior changes reported. The authors concluded that primary care patients on opioids found it acceptable to receive a prescription for naloxone, the prescription reached patients who had not had access to naloxone, and having naloxone may be associated with beneficial changes in opioid use behaviors.

For a copy of the abstract, "Nonrandomized Intervention Study of Naloxone Coprescription for Primary Care Patients Receiving Long-Term Opioid Therapy for Pain," published in the Annals of Internal Medicine, go to http://annals.org/article.aspx?articleid=2531366&resultClick=3.

For a copy of the abstract, "Primary Care Patient Experience with Naloxone Prescription," published September 12 in Annals of Family Medicine, go to: http://www.annfammed.org/content/14/5/431.full.

For more information about prescription opioids, go to: https://www.drugabuse.gov/drugs-abuse/opioids. For more information on naloxone, go to: https://archives.drugabuse.gov/news-events/news-releases/2015/11/fda-approves-naloxone-nasal-spray-to-reverse-opioid-overdose.

For more information, contact the NIDA press office at media@nida.nih.gov or 301-443-6245. Follow NIDA on Twitter and Facebook.