Expanding prescription naloxone. Alex Walley & Maya Doe- Simkins on behalf of prescribetoprevent.org. prescribetoprevent.org: Jenny Arnold, PharmD , BCPS Leo Beletsky , JD, MPH Alice Bell, LCSW Sarah Bowman, MPH Jef Bratberg , PharmD , BCPS Scott Burris, JD.
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Expanding prescription naloxone
Alex Walley & Maya Doe-Simkins on behalf of prescribetoprevent.org
Jenny Arnold, PharmD, BCPS
Leo Beletsky, JD, MPH
Alice Bell, LCSW
Sarah Bowman, MPH
JefBratberg, PharmD, BCPS
Scott Burris, JD
Maya Doe-Simkins, MPH
Traci Green, MSc, PhD
Alexander Y. Walley, MD, MSc
Modified Prescription Model
Nlx not dispensed from pharmacy
Records establish provider-pt relationship
Provider or on-site delegate gives nlx
No billing for nlx/svcs
Less legal gray area
Off site dr authorized nonmedical person to train/give nlx
“Prescribing naloxone in the USA is fully consistent with state and federal laws regulating drug prescribing. The risks of malpractice liability are consistent with those generally associated with providing healthcare, and can be further minimized by following simple guidelines presented.”
Burris S at al. “Legal aspects of providing naloxone to heroin users in the United States. Int J of Drug Policy 2001: 12; 237-248.
Opportunities for prescription naloxone
Where is the patient at as far as overdose?
Ask your patients whether they have overdosed, witnessed an overdose or received training to prevent, recognize, or respond to an overdose
Have you ever overdosed?
What were you taking?
How did you survive?
What strategies do you use to protect yourself from overdose?
How many overdoses have you witnessed an overdose?
Were any fatal?
What did you do?
What is your plan if you witness an overdose in the future?
Have you received a narcan rescue kit?
Do you feel comfortable using it?
What patients need to know:
Prevention - the risks:
Abstinence- low tolerance
Chronic medical disease
Long acting opioids last longer
Unresponsive to sternal rub with slowed breathing
Blue lips, pinpoint pupils
Response - What to do
Call for help
Continue rescue breathing for 3-5 minutes
Stay until help arrives
Good Samaritan provision: