Impact of a statewide community pharmacy approach to opioid harm reduction

The past several years have seen sharp increases in opioid overdose mortality. Harm reduction resources, such as nonprescription syringes and naloxone, are used to save lives.

To develop a statewide approach to increase the use of opioid harm reduction services through community pharmacies.

The North Carolina Association of Pharmacists was awarded a grant to address opioid mortality across the state, using community pharmacies to address opioid use disorder.

A statewide, standardized approach was implemented to increase knowledge and use of opioid harm reduction resources in the community pharmacy setting.

Pharmacies were offered training related to harm reduction. Participating pharmacies provided monthly updates related to staff training, syringe access status, naloxone kits distributed, and comments about how the training was changing their practice. At the project conclusion, pharmacies provided retrospective naloxone dispensing data along with naloxone dispensing during the intervention period. Pharmacies shared the greatest benefit of the program, a potential change to make implementation simpler, and the biggest change in the pharmacist(s) as a result of the project. Descriptive statistics were used to analyze data.

A total of 58 pharmacies across 33 counties participated in the harm reduction project. Of the 100 North Carolina counties, 15 counties were identified as high-need, and 14 of the 15 high-need counties (93%) participated in this project. Of the 58 participating pharmacies, 40 pharmacies (69%) had or implemented a nondiscriminatory nonprescription syringe policy within their pharmacy. During the baseline period (January 1, 2018, to June 15, 2018), 177 prescriptions for naloxone were dispensed by participating pharmacies. During the intervention period (January 1, 2019, to June 15, 2019), 639 prescriptions for naloxone were dispensed, representing a 361% increase in naloxone dispensing.

The successful implementation of a standardized, statewide approach increased access to harm reduction services.