Naloxone Co-prescription in Chronic Opioid Therapy: Benefits, Pitfalls, and Lessons Learned

There has been a well-publicized epidemic of lethal and non-lethal prescription opioid overdose in the United States. Significant efforts have been made to alter this trajectory, both at the public health and direct medical care levels. One specific method of harm reduction has been the co-prescription of intranasal naloxone to all patients who are prescribed chronic opioids. In this editorial, we discuss our experience of instituting this quality improvement initiative within a large academic pain management center. After an adverse event of inadvertent administration of intranasal naloxone precipitating opioid withdrawal and emergency evaluation, we learned several lessons. These lessons include cultural sensitivity, being specific on prescription instructions, and how to best discuss naloxone co-prescription with our patients.