Vital Signs: Pharmacy-Based Naloxone Dispensing - United States, 2012-2018

Area of Science:

• Public Health
• Epidemiology
• Pharmacology

Background:

• The CDC Guideline for Prescribing Opioids for Chronic Pain advises naloxone prescription for patients with overdose risk factors.
• Opioid overdose deaths are a major public health concern, with prescription opioids involved in 36% of deaths in 2017.
• Improving access to naloxone is a critical public health priority.

Purpose of the Study:

• To analyze trends and characteristics of naloxone dispensing from U.S. retail pharmacies.
• To assess national and county-level dispensing patterns.
• To identify factors influencing naloxone accessibility.

Main Methods:

• Analysis of 2012-2018 retail pharmacy data from IQVIA.
• Assessment of naloxone dispensing by U.S. Census region, urban/rural status, and prescriber specialty.
• Examination of recipient characteristics and county-level dispensing factors.

Main Results:

• Naloxone prescriptions dispensed from retail pharmacies increased substantially, with a 106% rise from 2017 to 2018.
• In 2018, one naloxone prescription was dispensed for every 69 high-dose opioid prescriptions nationally.
• Significant regional variations in dispensing were observed, with lowest rates in rural counties and wide variation by prescriber specialty.

Conclusions:

• Despite increased dispensing, naloxone prescriptions per high-dose opioid prescription remain low, with substantial geographic disparities.
• Naloxone distribution is a key component of the public health response to the opioid overdose epidemic.
• Improving naloxone access requires integrated efforts in opioid prescribing, harm reduction, treatment linkage, and public health partnerships.