Trends in naloxone co-prescriptions

The opioid epidemic remains a significant public health crisis in the United States. Naloxone has been identified as a critical component in combating this crisis. However, co-prescription rates among patients receiving opioids remain suboptimal, especially among certain high-risk populations. The purpose of the current study is to update and analyze recent trends in naloxone co-prescription rates in Iowa.

A retrospective analysis of de-identified prescription data from the Iowa Prescription Monitoring Program (PMP) was performed. Naloxone co-prescription rates per 1000 patients receiving opioids in the state of Iowa were calculated in 2019, 2020, 2021, and 2022 for nine categories, stratified by opioid dose, concurrent benzodiazepine use, and patient demographics. Exclusion criteria consisted of patients in a hospice or a non-ambulatory setting.

The study found a year-over-year increase in naloxone co-prescriptions from 2019 to 2022 across all examined categories. High-risk groups, including patients on higher opioid doses and those prescribed opioids and benzodiazepines concurrently, showed substantial increases in naloxone co-prescriptions. Geographical and age-related disparities in naloxone co-prescribing rates were also observed, with rural areas and older patient groups less likely to receive naloxone.

The observed increases in naloxone co-prescribing rates indicate progress in opioid overdose prevention efforts. Nonetheless, co-prescription rates remain suboptimal among high-risk groups, underscoring the need for continued education and policy efforts to enhance naloxone accessibility and encourage its co-prescription with opioids, particularly among older patients and geographical areas with lower co-prescription rates.