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Opioid Prescribing with Take-Home Naloxone: Rationale and Recommendations

Abstract

Purpose of Review

Although take-home naloxone is available for prescribing, recommended for certain high-risk patients, and can prevent overdose-related deaths, access to naloxone remains a challenge. This review describes the high-risk population on opioids that benefit from naloxone co-prescription, guidelines, and the current trends in naloxone prescribing, and the barriers faced by all the stakeholders.

Recent Findings

Opioid-related overdoses and deaths still occur at critically high numbers. Short-acting opioid antagonists like naloxone can reverse the effect of an overdose in a few minutes. The US Food and Drug Administration (FDA) approved naloxone nasal spray, and auto-injectable kits are both effective and easy to administer. An increasing number of states in the USA mandate the co-prescription of naloxone for patients on chronic opioid therapy, irrespective of the presence of other underlying risk factors. The lack of provider education is one of the significant barriers for co-prescribing naloxone with opioids.

Summary

Naloxone can be lifesaving in patients experiencing an opioid overdose. Providers are encouraged to co-prescribe take-home naloxone for high-risk patients on chronic opioid therapy. Understanding the barriers, creating awareness, and providing education can increase the prescription of take-home naloxone and help prevent opioid overdose-related deaths.

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Amaram-Davila, J., Mallipeddi, T. & Reddy, A. Opioid Prescribing with Take-Home Naloxone: Rationale and Recommendations. Curr Anesthesiol Rep 10, 428–435 (2020). https://doi.org/10.1007/s40140-020-00419-0

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Keywords

  • Naloxone
  • Opioid use
  • Opioid overdose
  • Overdose-related death
  • Opioid epidemic