According to the surgeon general of the United States, the number of overdose deaths from prescription and illicit opioids doubled from 21,089 in 2010 to 42,249 in 2016. This steep increase is attributed to the rapid proliferation of illicitly made fentanyl and other highly potent synthetic opioids. These are being mixed with heroin, sold alone as super-potent heroin, pressed into counterfeit tablets to look like commonly misused prescription opioids or sedatives (such as Xanax), and being mixed (often unknowingly) with other illicit drugs. This is dramatically increasing the risk for fatal overdoses.
Another contributing factor to the rise in opioid overdose deaths is an increasing number of individuals receiving higher doses of prescription opioids for long-term management of chronic pain. Even when taking their pain medications as prescribed, these patients are at increased risk for accidental overdose as well as drug-alcohol or drug-drug interactions with sedating medications, such as benzodiazepines.
Can naloxone be prescribed for a family member or friend of a person at risk for an opioid overdose?
Yes. Kentucky and Indiana laws allow for health care providers to prescribe naloxone (Narcan) to anyone who requests a prescription and has, in the clinical judgment of the prescriber, the ability to administer the drug in the event of an opioid overdose. This includes family members or friends of persons at risk for opioid overdose. Prescribers are specifically exempted from any legal liability or disciplinary/adverse action.
Is naloxone available without a prescription?
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Yes. Kentucky and Indiana pharmacists may dispense naloxone, however it is always best to provide a prescription. The pharmacist will provide education on how to administer naloxone and information on recognizing the signs of opioid overdose. Naloxone is covered by most insurance.
What is coprescribing?
Naloxone saves lives, and prescribers should consider prescribing naloxone with the opioid prescription to any patients at risk for opioid adverse events, including overdose; patients on higher doses of opioids; patients on opioids in combination with benzodiazepines or alcohol; and patients with an underlying mental health illness that could make them more likely to overdose. The surgeon general recommends coprescribing naloxone when a patient is considered to be at high risk of an overdose as an essential element of our national effort to reduce overdose deaths. It should be practiced widely.
Continuing education on opioid abuse
Continuing medical education (CME) credits are available through online learning at NortonHealthcare.com/CME. Click on “CME Activities” and then “Online Activities.” In the search field, type in “HB1” to see available learning opportunities about opioids or view here.
Physicians now can access convenient continuing medical education through the monthly “MedChat” podcast. “MedChat” fills a unique professional gap and is structured around a conversation addressing key issues for each topic. “MedChat” episodes last 30 minutes, so you can listen on your way to work, while walking the dog, eating your lunch or another convenient time for you.