Naloxone Prescribing and Education in Outpatient Pain Management and Palliative Care

Abstract

Over the past two decades, opioid use and overdose have increased substantially. Naloxone, an opioid overdose reversal agent, has been one of many risk mitigation strategies for preventing mortality due to overdose. Most literature describing naloxone utilization has been about populations of illicit drug users and patients in hospitals, primary care, and pharmacies. There is limited information regarding naloxone prescribing and training for opioid users in specialty pain management clinics. Furthermore, there are no known publications concerning patients receiving palliative care services and overdose prevention. Pain and palliative care patients are commonly at risk of opioid overdose. In an interdisciplinary outpatient pain and palliative care clinic, pharmacists implemented naloxone prescribing and education. Eleven patients at increased risk for overdose were prescribed naloxone and educated on overdose risk factors, recognition, and management. Seven patients reported picking up their naloxone prescription from the pharmacy, and none reported using it within two weeks of the initial education. This intervention was deemed successful within the clinic, but small sample size and the pharmacist role may not be replicable within other pain and palliative care settings. It encourages further research of overdose risk and prevention in pain management and palliative care.

Keywords:

• Naloxone
• opioid
• overdose
• prevention
• safety

Acknowledgements

The authors would like to acknowledge Dr. Lan Ly and Cecilia Daskas, PharmD Candidate, for their role implementing this project in clinic, and Drs. Alvin Mathe, Nicholaus Mize, and Nori Watson for their support of the project. The authors would also like to thank Drs. Randy Martin and Cheng Yuet for their comments on the manuscript.

Declaration of interest

The authors have no conflict of interest. The present study was conducted without any external funding or support.