Factors associated with naloxone availability and dispensing through Michigan's pharmacy standing order

Area of Science:

• Public Health
• Pharmacy Practice
• Opioid Epidemic Research

Background:

• Pharmacy standing order policies are crucial for expanding access to naloxone, an opioid overdose reversal medication.
• These policies empower pharmacists to dispense naloxone without a patient-specific prescription, addressing a critical public health need.
• The study investigates the landscape of naloxone availability and dispensing through these policies in Michigan.

Purpose of the Study:

• To determine the prevalence of pharmacy standing order participation for naloxone dispensing across eight Michigan counties.
• To identify pharmacy and community characteristics associated with naloxone availability and dispensing rates.
• To analyze factors influencing naloxone stock and dispensing by pharmacies operating under standing orders.

Main Methods:

• A telephone survey was conducted with 662 pharmacies operating under standing orders, achieving an 81% response rate (n=539).
• Pharmacy data were linked with census tract demographics, overdose fatality rates, and dispensing records.
• Regression models were employed to analyze associations between pharmacy type, neighborhood characteristics, and naloxone outcomes.

Main Results:

• Over half (54%) of surveyed pharmacies participated in standing order policies for naloxone.
• 85% of participating pharmacies had naloxone available, and 82% had dispensed it.
• National chain pharmacies were more likely to stock and dispense naloxone. Higher dispensing volumes correlated with neighborhoods having more public insurance and younger populations.

Conclusions:

• Despite the potential of pharmacy standing orders to increase naloxone access, geographic disparities exist, with higher fatality areas showing less pharmacy participation.
• National chains demonstrate greater engagement in stocking and dispensing naloxone.
• Further efforts are needed to enhance standing order pharmacy participation to combat the escalating opioid epidemic and improve naloxone accessibility.