Emergency department physicians' and pharmacists' perspectives on take-home naloxone

Opioid overdose is an increasing burden world-wide and is a major cause of death in Australia. To reduce the number of opioid-related deaths, access to take-home naloxone has expanded in Australia and is now accessible without prescription. Emergency departments (ED) could be ideal settings for the distribution of take-home naloxone, due to regular encounters with patients who experience opioid overdoses. The aim of this study was to gain insight into ED physicians' and pharmacists' perspectives on take-home naloxone in the ED setting.

Semi-structured interviews were carried out with ED physicians and pharmacists about their perceptions of take-home naloxone. Participants were recruited through their involvement with professional bodies and through 'snowball' recruitment. Interviews were audio recorded and transcribed verbatim to be analysed using an inductive thematic approach.

Twenty-five interviews were conducted with 13 pharmacists and 12 physicians. Responses were categorised into three main themes: (i) Attitudes-the majority of participants supported take-home naloxone in principle, but had numerous concerns; (ii) Clinical Application-where challenges in terms of its patient use, implementation and pharmacological actions were raised; and (iii) Logistical Considerations-where many hindrances in relation to the distribution of take-home naloxone from the ED such as time considerations, education and resourcing were discussed.

Despite the majority supporting take-home naloxone, participants identified barriers to take-home naloxone in the ED. In the future, emphasis should be placed on educating and training staff in the ED about take-home naloxone and implementing standardised protocols.