FRIDAY, May 10, 2019 (Pharmacist's Briefing) -- Only state naloxone access laws (NALs) allowing direct dispensing of naloxone by pharmacists appear to be useful in cutting fatal overdose rates, according to a study published online May 6 in JAMA Internal Medicine.
Rahi Abouk, Ph.D., from William Paterson University in Wayne, New Jersey, and colleagues compared fatal and nonfatal overdoses in states that adopted NALs to those in states that did not adopt NALs from 2005 to 2016.
The researchers found that NALs granting direct authority to pharmacists were associated with significant reductions in fatal overdoses. However, these NALs may also increase nonfatal overdoses seen in emergency department visits. Relative to adoption of the NALs, the effect sizes for fatal overdoses grew over time. It is estimated that these policies reduced opioid-related fatal overdoses by 0.387 per 100,000 people in three or more years after adoption (95 percent confidence interval, 0.119 to 0.656; P = 0.007). There was no significant association for indirect authority to dispense (increase by 0.121; 95 percent confidence interval, −0.014 to 0.257; P = 0.09) and other NALs (increase by 0.094; 95 percent confidence interval, −0.040 to 0.227; P = 0.17) with reducing fatal overdoses.
"Communities in which access to naloxone is improved should prepare for increases in nonfatal overdoses and link these individuals to effective treatment," the authors write.