Naloxone: Liability, regulatory concerns for pharmacists
As the epidemic of opioid abuse and heroin use in the United States continues, when it comes to dispensing naloxone to treat overdose, in many states pharmacists are on the front lines. So you need to be aware of the liability and regulatory considerations connected with naloxone.
Those concerns were the focus of a discussion at the meeting of the American Pharmacists Association held in Baltimore this year, moderated by Christopher Herndon, PharmD, BCPS, associate professor in the Department of Pharmacy Practice at Southern Illinois University, Edwardsville, School of Pharmacy.
Some states provide immunity to prescribers and dispensers of naloxone, Herndon said. Others allow a physician to issue standing orders for naloxone prescriptions, enabling pharmacists to dispense as needed to patients at risk of respiratory depression. Yet other states allow prescribing to a third party (e.g., a family member of a drug abuser).
Naloxone can be administered by intravenous, intramuscular, and subcutaneous injection; intranasal spray; and intramuscular autoinjection. Adverse reactions are minimal, although severe withdrawal symptoms may result from the overdose. If a long-acting opioid was taken, more than one dose of naloxone may be needed.
During the discussion, Anthony Tommasello, RPh, PhD, medical affairs manager with Indivior in Richmond, Va., advised pharmacists not think of naloxone only as a rescue drug to be used for a heroin overdose. “This is not just about heroin users … it is about the widespread use of opiates throughout the population,” Tommasello said. “[The] individuals at risk of overdose include people who are recipients of chronic high-dose opioid pain management in various forms.”