August 8, 2019

Naloxone prescriptions are booming—but still lag far behind opioid prescriptions, CDC finds

Daily Briefing

    The number of U.S. pharmacies dispensing prescriptions for the opioid overdose reversal drug naloxone doubled from 2017 to 2018, but there is still only one naloxone prescription dispensed for every 69 high-dose opioid prescriptions, according to a CDC report released Tuesday.

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    Report details

    For the report, CDC researchers examined U.S. naloxone dispensing patterns from 2012 to 2018 using pharmacy retail data from IQVIA, a health care, data science, and technology company. The data included more than 50,000 pharmacies across the United States and reflected prescriptions filled under standing orders and written by physicians.

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    While the data offers a glimpse into naloxone dispensing patterns, AP reports that it does not provide a full picture: The data represent only about 2,900 of the nation's 3,100 counties and parishes, and it focuses exclusively on retail pharmacies, which dispensed about 20% of naloxone prescriptions in 2017, according to AP.

    Findings

    Overall, the researchers found the number of naloxone prescriptions dispensed from retail pharmacies increased dramatically from fewer than 1,282 prescriptions in 2012 to 556,847 prescriptions in 2018. From 2017 to 2018, the number of prescriptions dispensed increased by 106%.

    However, the researchers said retail pharmacy prescriptions for high-dose opioids continue to outpace those for naloxone. According to CDC, one naloxone prescription was dispensed for every 69 high-dose opioid prescription dispensed in 2018. CDC currently recommends patients with high-dose opioid prescriptions receive naloxone prescriptions to prevent overdose.

    Anne Schuchat, the principal deputy director of the CDC, said, "We may never get to 1-to-1 … but we think that ratio of 1-to-70 is too low."

    The researchers also found geographic disparities in naloxone dispensing rates. For instance, they found naloxone is most commonly dispensed in cities and in the South. The researchers attributed the higher dispensing rates in these areas to factors including higher opioid use and policies requiring access to naloxone.

    However, Schuchat emphasized that people who overdose in rural areas may have to wait longer for an ambulance, and therefore could benefit more from having the opioid reversal drug readily available. 

    The researchers did note that the number of high-dose opioid prescriptions dispensed decreased from about 49 million in 2017 to 38 million in 2018.

    The researchers said the increase in naloxone prescriptions being dispensed and the decrease in high-dose opioid prescriptions being dispensed may have contributed to the decline in opioid overdose deaths in 2018 (AP/New York Times, 8/6; Joseph, STAT News, 8/6; Stobbe, AP/Los Angeles Times, 8/6).

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