Thousands more doses of the overdose treatment drug naloxone are in the hands of opioid users and their family members, thanks to a Utah order that let pharmacies dispense the life-saving drug without a prescription.
The Utah Department of Health (DOH) issued the standing order in late 2016, giving pharmacists legal authority to provide naloxone to anyone with a higher risk of an overdose. The drug — delivered via a nasal spray or syringe — reverses overdoses from opiates or heroin minutes after they occur.
Through 2017, pharmacies doled out 4,275 naloxone doses in Utah as a result of the order, health department officials announced, for an average of about 12 doses dispensed each day. The drug is covered by most health insurance plans, often with a copay of about $20.
“Every dose of naloxone we get out in our communities represents a potential life saved,” Joseph Miner, DOH executive director, said in a statement. “I urge all pharmacies across the state to enroll in the standing order and help Utahns access this life-saving medication.”
Angela Stander, a Department of Health opioid overdose prevention coordinator, acknowledged that Utah is still only “scratching the surface” on pharmacy participation.
Officials said 165 Utah pharmacies enrolled in the program last year, about a fifth of the more than 800 traditional licensed retail pharmacies, as well as hospital and clinic pharmacies, in the state.
Rural pharmacies make up only 30 percent of all pharmacies enrolled in the standing order, but they dispensed nearly 70 percent of all the naloxone doses dispensed last year.
Stander said pharmacies operated by large urban health care providers such as University of Utah Health and Intermountain Healthcare have their own naloxone standing orders, so are not counted in the numbers.
The Health Department did not track the number of overdose reversals resulting from the state’s standing order, Stander said. But officials said there were 99 confirmed overdose reversals attributed to about 2,800 naloxone doses that were doled out in other ways, including outreach providers funded by the Health Department and syringe exchange programs.
Often, those seeking naloxone from a pharmacy are family members of someone at risk of overdosing on heroin, Stander said. In other cases, it’s someone picking up a large prescription of opioids for severe pain, who may be at an elevated risk of addiction to pills.
Greg Jones, pharmacy director for Harmons and a member of the Utah Pharmacy Licensing Board, said the standing order has “definitely increased access” to the drug at the grocery chain’s 17 pharmacies. It also has led to more conversations between pharmacists and patients about the risks of opioids.
But he said there’s still a misconception among patients about who is at risk of overdosing.
“People think overdose deaths are for people using heroin,” Jones said. “People still don’t understand the potential risk of [prescription] opioids.”
Those interested can locate a participating Utah pharmacy online, and pharmacies seeking to join the standing order can do so at naloxone.utah.gov.