Naloxone Prescribing and Dispensing - Minnesota Department of Health

Opioids
Naloxone Prescribing and Dispensing

Naloxone, also known as Narcan©, is a potentially lifesaving drug that can reverse an opioid overdose. It can be administered as an injection or nasal spray. Any health care provider licensed to prescribe medications in Minnesota may prescribe naloxone.

Pharmacists may enter into a protocol to independently prescribe naloxone by using the Minnesota Board of Pharmacy’s Opiate Antagonist Protocol (PDF) to provide naloxone to persons at risk for, or know of someone at risk for, opioid overdose. The Minnesota Board of Pharmacy’s Naloxone Prescribing and Dispensing Questions web page provides more information.

Pharmacies that dispense naloxone

Map of naloxone distributors in MN. See PDF link below map for full list of pharmacies distributing naloxone.

These are the known Participating Pharmacies with a Naloxone Protocol (PDF). Pharmacy chains like Walgreens and CVS (not included in map above) also have their own company naloxone protocols.

Dispensing naloxone

Previously, pharmacists could enter into a protocol with a Minnesota Licensed Practitioner, a local Community Health Board Medical Consultant, or the Minnesota Department of Health’s Medical Director. These aforementioned protocols are still effective as long as needed but going forward the Minnesota Department of Health encourages pharmacists to establish a naloxone protocol with the Board of Pharmacy. For more information and to review the protocol please visit the Board of Pharmacy Naloxone Prescribing and Dispensing Questions web page.

Prescribing naloxone

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.

Training Opportunities for Practitioners and Pharmacists

University of Minnesota Naloxone Resource Site
CME/CPE presentation on identifying risks, signs and symptoms of opioid overdoses and understanding the various naloxone formulations. Healthcare providers who watch the video are able to earn CME/CPE credit at no cost.

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 ®

Overdose Prevention and Naloxone Rescue Kits for Prescribers and Pharmacists
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
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.

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
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.

Frequently Asked Questions

There is no expiration date for that protocol. If a pharmacy party wishes to update their information or exit the protocol at any time, please fill out the Minnesota Department of Health's Opiate Antagonist Protocol Registration form.
Naloxone is exempted from DEA scheduling and is a legend drug. In Minnesota, a legend drug is a drug that is required by federal law to be dispensed only pursuant to the prescription of a licensed practitioner. Minn. Stat. § 151.01-17. No PMP reporting is required as it is not a controlled substance.
It will depend on the individual patient. Some patients may have insurance that covers the dispensing of naloxone, others may not. For those who do not have insurance coverage, they may need to pay cash. The cost of naloxone also depends on the type of naloxone being prescribed (injection or nasal spray).

If a person is unable to get naloxone at a pharmacy, there are other ways to get naloxone free or at lower cost. The following community-based organizations provide free training and naloxone kits at no charge:

Prescriptions for legend drugs may have refills if the provider indicates so within the valid prescription. Since naloxone may also be ‘prescribed’ by a pharmacist with a collaborative agreement working under protocol with a physician or other provider, then refills would be entirely dependent on what the current, enacted protocol indicated. The Opiate Antagonist Protocol under Dr. Lynfield does not specify refills, therefore each encounter would need to be a new protocol prescription based on the pharmacy enacted protocol rather than a refill.
The protocol provides directions for pharmacists (see Opiate Antagonist Protocol, section 2 “Procedure”). Pharmacists are obligated to ensure patients understand how and when to use naloxone, and are encouraged to participate in trainings listed in the protocol. Additionally, pharmacists should be well aware that naloxone is not a self-administered drug, so naloxone recipients must be well educated on when and how to administer naloxone.

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Updated Friday, 10-Dec-2021 13:24:58 CST