Naloxone Prescribing and Dispensing

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.

Yes. Fill out and share a copy of the Minnesota Board of Pharmacy’s Opiate Antagonist Protocol (PDF) with any other locations.

There is no expiration date for that protocol. If you need additional sites added or removed to your protocol, please use the Minnesota Board of Pharmacy’s Opiate Antagonist Protocol (PDF) and use that going forward.

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:

• Steve Rummler HOPE Network—Call 952-943-3937 or sign up for training from the Steve Rummler HOPE Network.
• Rural AIDS Action Network (RAAN)—Call 320-257-3036.
• Red Door Clinic - Call 612-543-5555
• Indigenous Peoples Task Force - Call 612-870-1723
• LSS StreetWorks Collaborative—Call 612-354-3345 or e-mail street.works@lssmn.org.

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.