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Addiction

11 July 2019

US pharmacies are often out of stock of opioid antidote

There is a law to encourage pharmacists to give naloxone to anyone who asked for it to curb the growing number of deaths from opioid overdoses.

Even though the drug naloxone can be a lifesaving antidote to an opioid overdose, researchers in Philadelphia report that only a third of drugstores in that city carried it.

What's more, although Pennsylvania's standing order law for naloxone (common brand name: Narcan) allows pharmacists to dispense the drug without a doctor's prescription, many pharmacies refused to give the nasal spray without a doctors' OK, the study authors said.

Laws not implemented

The intent of the law was to encourage pharmacists to give the drug to anyone who asked for it. The impetus for the law was to try to curb the growing number of deaths from opioid overdoses.

Not implementing these laws puts unnecessary barriers in the way of those who need this medicine most, said study co-author Dima Qato, an associate professor of pharmacy systems, outcomes and policy at the University of Illinois at Chicago College of Pharmacy.

"Efforts to strengthen the implementation of naloxone access laws, including statewide standing orders, which are considered the least restrictive, are warranted," Qato said in a university news release. "Particularly for pharmacies located in communities with the highest rates of death due to opioid overdose."

For the study, researchers surveyed Philadelphia drugstores by phone in 2017.

Of the more than 400 drugstores surveyed, only 34% had naloxone available. Chain pharmacies were more likely to stock it than independent ones.

Naloxone was also less likely to be found in minority neighbourhoods than in white neighbourhoods. It was also not likely to be found in areas with the highest number of drug overdose deaths, the researchers noted.

Pharmacies can be fined

In addition, of those stores that did stock naloxone, 40% asked for a doctor's prescription and many would not give the drug to those under 18.

Laws are not enough, according to Qato. "Policies need to be enforced and pharmacies need to be aware of and held accountable for implementing them," she said.

A new law now requires pharmacies to "stock naloxone and to post a sign notifying shoppers that it is stocked," said researcher Jenny Guadamuz, also from the University of Illinois.

"Pharmacies can be fined $250 (R3 692) for each day they are not in compliance of the law. Now, the question is, will the city enforce the law?" Guadamuz said.

The report was published online in the journal JAMA Network Open.

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