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Chatterjee A, Yan S, Xuan Z, et al. Broadening access to naloxone: Community predictors of standing order naloxone distribution in Massachusetts. Drug Alcohol Depend. 2021;230:109190doi: 10.1016/j.drugalcdep.2021.109190.
Chatterjee, A., Yan, S., Xuan, Z., Waye, K. M., Lambert, A. M., Green, T. C., Stopka, T. J., Pollini, R. A., Morgan, J. R., & Walley, A. Y. (2022). Broadening access to naloxone: Community predictors of standing order naloxone distribution in Massachusetts. Drug and alcohol dependence, 230109190. https://doi.org/10.1016/j.drugalcdep.2021.109190
Chatterjee, Avik, et al. "Broadening access to naloxone: Community predictors of standing order naloxone distribution in Massachusetts." Drug and alcohol dependence vol. 230 (2022): 109190. doi: https://doi.org/10.1016/j.drugalcdep.2021.109190
Chatterjee A, Yan S, Xuan Z, Waye KM, Lambert AM, Green TC, Stopka TJ, Pollini RA, Morgan JR, Walley AY. Broadening access to naloxone: Community predictors of standing order naloxone distribution in Massachusetts. Drug Alcohol Depend. 2022 Jan 01;230:109190. doi: 10.1016/j.drugalcdep.2021.109190. Epub 2021 Nov 27. PMID: 34864356; PMCID: PMC8714703.
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Drug Alcohol Depend. 2022 Jan 01;230:109190. doi: 10.1016/j.drugalcdep.2021.109190. Epub 2021 Nov 27.

Broadening access to naloxone: Community predictors of standing order naloxone distribution in Massachusetts.

Drug and alcohol dependence

Avik Chatterjee, Shapei Yan, Ziming Xuan, Katherine M Waye, Audrey M Lambert, Traci C Green, Thomas J Stopka, Robin A Pollini, Jake R Morgan, Alexander Y Walley

Affiliations

  1. Boston Medical Center and Boston University School of Medicine, Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, 801 Massachusetts Ave, 2nd Floor, Boston, MA 02118, USA. Electronic address: [email protected].
  2. Boston Medical Center and Boston University School of Medicine, Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, 801 Massachusetts Ave, 2nd Floor, Boston, MA 02118, USA.
  3. Boston University School of Public Health, Department of Community Health Sciences, 801 Massachusetts Ave, Crosstown Building 4th Floor, Boston, MA 02118, USA.
  4. The Heller School for Social Policy and Management at Brandeis University, Institute for Behavioral Health, 415 South St, MS 035, Waltham, MA 02453, USA.
  5. Tufts University School of Medicine, Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave, Boston, MA 02111, USA.
  6. West Virginia University School of Medicine, Department of Behavioral Medicine and Psychiatry and West Virginia University School of Public Health, Department of Epidemiology and Biostatistics, 1 Medical Center Dr, Morgantown, WV 26506, USA.
  7. Boston University School of Public Health, Department of Health Law, Policy and Management, 715 Albany St, Talbot Building Floor 2 West, Boston, MA 02118, USA.

PMID: 34864356 PMCID: PMC8714703 DOI: 10.1016/j.drugalcdep.2021.109190

Abstract

BACKGROUND: Naloxone is a prescription medication that reverses opioid overdoses. Allowing naloxone to be dispensed directly by a pharmacist without an individual prescription under a naloxone standing order (NSO) can expand access. The community-level factors associated with naloxone dispensed under NSO are unknown.

METHODS: Using a dataset comprised of pharmacy reports of naloxone dispensed under NSO from 70% of Massachusetts retail pharmacies, we examined relationships between community-level demographics, rurality, measures of treatment for opioid use disorder, and overdose deaths with naloxone dispensed under NSO per ZIP Code-quarter from 2014 until 2018. We used a multi-variable zero-inflated negative binomial model, assessing odds of any naloxone dispensed under NSO, as well as a multi-variable negative binomial model assessing quantities of naloxone dispensed under NSO.

RESULTS: From 2014-2018, quantities of naloxone dispensed under NSO and the number of pharmacies dispensing any naloxone under NSO increased over time. However, communities with greater percentages of people with Hispanic ethnicity (aOR 0.91, 95% CI 0.86-0.96 per 5% increase), and rural communities compared to urban communities (aOR 0.81, 95% CI 0.73-0.90) were less likely to dispense any naloxone by NSO. Communities with more individuals treated with buprenorphine dispensed more naloxone under NSO, as did communities with more opioid-related overdose deaths.

CONCLUSION: Naloxone dispensing has substantially increased, in part driven by standing orders. A lower likelihood of naloxone being dispensed under NSO in communities with larger Hispanic populations and in more rural communities suggests the need for more equitable access to, and uptake of, lifesaving medications like naloxone.

Copyright © 2021 Elsevier B.V. All rights reserved.

Keywords: Analgesics, opioid; Harm reduction; Naloxone; Pharmacy; Standing orders

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