Programs and Initiatives in Communities – Expanding Nalaxone Access for Opioid Overdose

Programs & Initiatives in Communities
Expanding Naloxone Access for Preventing Opioid Overdose

Naloxone is a potentially lifesaving drug that can reverse an opioid overdose. Visit Opioid Overdose Prevention & Control for more information.

Minnesota's response

Minnesota is experiencing an alarming increase in drug overdose deaths. In 2015, nearly half of all drug-related deaths were related to opiate pain relievers and heroin. Drug overdose deaths among Minnesota residents, 2000-2015.

In 2016, the Minnesota Legislature responded to the continued increase in statewide opioid overdoses by passing Session Law, Chapter 124. One of the goals of this legislation is to increase the availability of naloxone through pharmacies across Minnesota.

Pharmacists, in collaboration with a registered practitioner, may enter a written protocol to provide naloxone to persons at risk for, or know of someone at risk for, opioid overdose.

Dispensing naloxone – pharmacists 

Pharmacists may enter a written protocol with:

Option A: Any Minnesota Licensed Practitioner

  • Pharmacists may enter into a written protocol in collaboration with a licensed practitioner, who is permitted by law to prescribe an opiate antagonist, such as a physician, advanced practice registered nurse, or physician assistant. Together they may either use the Minnesota Board of Pharmacy’s Opiate Antagonist Protocol developed as a result of the 2016 legislation or develop their own protocol.

Option B: A local Community Health Board Medical Consultant

  • Your local Community Health Board may have designated a local medical consultant (e.g., health department medical director) as the prescriber of record for your community. Check the MN Opiate Antagonist Prescribers of Record list below to find the designated prescriber of record for your community.

Prescriber of Record – Minnesota Department of Health Medical Director Ruth Lynfield, MD
Point of contact – Dana Farley dana.farley@state.mn.us

  • Aitkin-Itasca-Koochiching CHB
  • Anoka County CHB
  • Beltrami CHB
  • Benton County Human Services
  • Blue Earth County CHB
  • Brown-Nicollet CHB
  • Cass County Health, Human and Veterans Services
  • Chisago County CHB
  • Cook County
  • Countryside CHB
  • Crow Wing County CHB
  • Dakota County CHB
  • Des Moines Valley HHS
  • Dodge-Steele CHB
  • Faribault-Martin CHB
  • Fillmore-Houston CHB
  • Freeborn County CHB
  • Goodhue County HHS
  • Hennepin County CHB
  • Horizon Public Health
  • Isanti County CHB
  • Kanabec CHB
  • Kandiyohi-Renville CHB
  • Lake-St. Louise CHB
  • Le Sueur-Waseca CHB
  • Meeker-McLeod-Sibley CHB
  • Mille Lacs County CHB
  • Minneapolis CHB
  • Morrison-Todd-Wadena CHB
  • Mower County CHB
  • Nobles County CHB
  • North Country CHB
  • Olmsted County CHB
  • Partnership4Health CHB
  • Pine County CHB
  • Polk-Norman-Mahnomen CHB
  • Quin County CHB
  • Rice County CHB
  • Scott County CHB
  • Sherburne County CHB
  • Southwest Human and Health Services (SWHHS)
  • Stearns County CHB
  • St. Paul-Ramsey County CHB
  • Wabasha County CHB
  • Washington County CHB
  • Watonwan County CHB
  • Winona County CHB
  • Wright County CHB

Prescriber of Record – Local
Please contact the personnel listed below to enter a naloxone protocol with a designated local prescriber.

Option C: Minnesota Department of Health’s Medical Director

  • Pharmacists who need a licensed practitioner also have the option of entering into the Board of Pharmacy’s Opiate Antagonist Protocol with the Minnesota Department of Health’s Medical Director, Ruth Lynfield, MD. To enter this protocol, pharmacists, group pharmacies and chain pharmacies must complete the Opiate Antagonist Protocol Registration form at their earliest convenience. For questions or concerns regarding this option, please contact Dana Farley, MS, Alcohol and Drug Policy Director at dana.farley@state.mn.us.

Prescribing naloxone – designated (or registered) practitioners

Release of Liability

All licensed health care professionals may directly or by standing order, prescribe, dispense, distribute, or administer naloxone to a person without being subject to civil liability or criminal prosecution per 2016 Minnesota Statutes 604A.04 Good Samaritan Overdose Prevention. This immunity is also extended to the Commissioner of Health and Minnesota Department of Health practitioner by section 3.736, subdivision 9.

Laws and Protocol

Minnesota Statutes § 151.37, subdivision 13

This statutory language, enacted during the 2016 Legislative Session, requires the Minnesota Board of Pharmacy to develop an opiate antagonist protocol. Community Health Board medical consultants or a practitioner working for the Minnesota Department of Health may enter into this protocol with any licensed pharmacist(s). This subdivision also extends certain liability protections to the medical consultants and the practitioner.    

Board of Pharmacy Opiate Antagonist Protocol

The Minnesota Board of Pharmacy has developed a written protocol for the use of pharmacists who want to work with medical consultants of Community Health Boards, and the Minnesota Department of Health’s practitioner. Pharmacists may also use this protocol if they are working with a different practitioner. However, pharmacists are not required to use this protocol in order to be involved in the prescribing of opiate antagonists. Instead, they can work with another licensed practitioner to develop their own written protocol as allowed by Minn. Stats. §151.01, subd. 27(6). Questions regarding the protocol, implementation and legalities may be directed to Cody Wiberg, PharmD, MS, RPh, Executive Director, MN Board of Pharmacy at cody.wiberg@state.mn.us.

Training Opportunities
Practitioners and pharmacists are encouraged to complete training on opioid overdose and naloxone.

Pharmacist Letter (Webinar)

Accessible via subscription to Pharmacists Letter.

Overdose Prevention and Naloxone Rescue Kits for Prescribers and Pharmacists (PDF)

Boston College and the Substance Abuse and Mental Health Services Administration

Through a case study, you will learn how to prevent overdoses among your patients and their social networks. Videos of Patient-Pharmacist-Prescriber encounters model how to provide patient overdose education and naloxone rescue kits.

Naloxone Access: A Practical Guideline for Pharmacists (PDF)

College of Psychiatric & Neurologic Pharmacists

Drug overdoses are occurring at an alarming rate in the United States. Most overdoses have been linked to opioid analgesics, which may have been obtained from community pharmacies. One potential solution is to offer take-home naloxone. Please note this this training requires an account.

Naloxone for Opioid Safety: A Tool in California for Saving Lives (Webinar)

California Society of Addiction Medicine

In 2014, the Overdose Treatment Act, became law in California. It allows lay people to possess and administer prescription naloxone to someone in urgent need who is experiencing life-threatening respiratory depression from excessive opiate use. Naloxone is a nonscheduled, non-addictive, safe, and inexpensive prescription medication which is becoming available in pharmacies throughout the state in nasal spray and injectable forms. To learn how to use it safely requires minimal instruction.

Prescribe to Prevent (Video)

Various short-form videos explaining naloxone use for opioid overdose prevention, recognizing the signs of overdose and responding to overdose.

Opioid Overdose Prevention Toolkit (PDF)

Substance Abuse and Mental Health Services Administration

Equips health care providers, communities and local governments with material to develop practices and policies to help prevent opioid-related overdoses and deaths. Addresses issues for health care providers, first responders, treatment providers, and those recovering from opioid overdose. Updated in 2016.

Overdose Prevention

Steve Rummler Hope Network

Training on three types of naloxone administration devices.

  • Evzio Auto Injector®
  • Intermuscular Injection with Vial and Syringe
  • Narcan Nasal®

Substance Abuse and Mental Health Services Association

Managing Unwanted Medications

The Minnesota Pollution Control Agency describes ways the community can manage and dispose unwanted medications.

Disposing of Needles and Syringes

The Minnesota Pollution Control Agency also provides information on safe disposal of needles, lancets and syringes (sharps) to prevent injury and disease transmission from needle-sticks.

CDC Guideline Information for Providers

Calculating Total Daily Dose of Opioids for Safer Dosage

CDC’s fact sheet on morphine milligram equivalents (MME). Includes MME comparisons for commonly prescribed opioids, conversion factors and applications in clinical practice.

Drug overdose deaths among Minnesota residents 2000-2015

Minnesota Department of Health’s report on overdose death data by various geographic and demographic variables.

MN Board of Pharmacy Naloxone Prescribing and Dispensing Questions

Frequently asked questions and answers provided by the Board of Pharmacy.