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January 4, 2019

Naloxone should be prescribed alongside opioids, HHS recommends

Daily Briefing

    HHS last month released new guidelines that encourage health care providers to prescribe the overdose-reversal drug naloxone to patients taking prescription opioids who are at a high risk of overdosing on the drugs.

    Jan. 24 webconference: How to tackle the opioid crisis and drug diversion

    The new guidance is likely to increase the number of providers who prescribe naloxone, and could help to curb the number of deaths caused by opioid drug-related overdoses. HHS released the guidance one day after an FDA advisory panel voted to recommend that opioid drug labels recommend providers prescribe naloxone whenever they prescribe the opioids.

    Guidance details

    HHS said the new guidance expands on earlier guidance issued by CDC. HHS in the new guidance recommended that providers prescribe naloxone to patients at high risk of overdosing on prescription opioids, including those who:

    • Are being treated for an opioid use disorder;
    • Have a non-opioid substance use disorder;
    • Have a mental health condition;
    • Have a history of opioid use disorder;
    • Have respiratory issues;
    • Might be using heroin or other illicit drugs;
    • Take at least 50 morphine milligram equivalents of opioids per day;
    • Take benzodiazepines; or
    • Were recently incarcerated.

    HHS also suggests that providers talk to patients and patients' families about how naloxone works, how the drug is administered, and how others can help in the instance of an overdose. Brett Giroir, assistant secretary for health and senior advisor for opioid policy at HHS, said, "Given the scope of the opioid crisis, it's critically important that health care providers and patients discuss the risks of opioids and how naloxone should be used in the event of an overdose."

    The guidance is voluntary, meaning providers are not required to follow it. However, Giroir called the guidance "essential" to addressing the opioid epidemic. "We have begun to see some encouraging signs in our response to the opioid crisis, but we know that more work is required to fully reverse the decades-long epidemic," he said, adding, "Co-prescribing naloxone when a patient is considered to be at high risk of an overdose is an essential element of our national effort to reduce overdose deaths and should be practiced widely" (Raman, CQ News, 12/19/18 [subscription required]; Joseph/Mishra, Reuters, 12/18/18; Frieden, MedPage Today, 12/20/18).

    Access our new resources on the opioid epidemic

    The opioid epidemic is a complex, multi-dimensional public health problem. Use this list of helpful resources on how hospitals and health systems can play a role to treat opioid addiction and prevent further increase in opioid abuse.

    Access our Opioid Resources Here

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