Expanding Naloxone Access for Preventing Opioid Overdose - Minnesota Department of Health

Opioids
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.

Register a pharmacy to participate in the Opioid Antagonist Protocol (Form).

Minnesota’s response

Minnesota is experiencing an alarming increase in drug overdose deaths. In 2017, there were 422 opioid overdose deaths related to opiate pain relievers and heroin. Visit the Opioid Dashboard for all statewide data related to opioid use, misuse, and overdose death prevention.

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.

Pharmacies that dispense naloxone

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

You can get naloxone at any of the pharmacies listed on Participating Pharmacies with a Naloxone Protocol (PDF). These pharmacies have entered a naloxone protocol with MDH. Pharmacy chains like Walgreens and CVS (not included in map above) also have their own company naloxone protocols.

Dispensing naloxone

Pharmacists may enter a written protocol with:

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 (PDF) developed as a result of the 2016 legislation or develop their own protocol.

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.

  • 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.

  • Bloomington CHB – John Bjorklund, MD
    • Contact: Bonnie Paulsen, bpaulsen@bloomingtonmn.gov
  • Carlton County – Kenneth Ripp, MD
    • Contact: Kenneth Ripp, MD KRipp@raiterclinic.com
  • Carver County CHB – David Willey, MD
    • Contact: Richard Scott, rscott@co.carver.mn.us
  • Edina CHB — John Bjorklund, MD
    • Contact: Jeff Brown, jbrown@EdinaMN.gov
  • Richfield CHB – John Bjorklund, MD
    • Contact: Betsy Osborn, BOsborn@cityofrichfield.org
  • St. Louis County - Elisabeth Bilden, MD
    • Contact: Louise Anderson, LouiseA@communityhealthboard.org

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 Cody Bassett, MDH Naloxone Coordinator at cody.bassett@state.mn.us.

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.

Laws and Protocol

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 and legalities may be directed to the Board of Pharmacy at pharmacy.board@state.mn.us.

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.

Substance Abuse Treatment Referrals

Substance Abuse and Mental Health Services Association

Safe Disposal Resources

  • 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.

Other Resources

Frequently Asked Questions

Yes. Email an Excel list of store names, numbers, street address, county, and phone number to cody.bassett@state.mn.us. Please indicate if any locations are safe disposal sites.
Once your registration is received, it will be processed by MDH. You will receive a registration confirmation email. Pharmacists should communicate the naloxone protocol to their pharmacy staff.
There is no expiration date at this time. 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. Visit the Drug Enforcement Agency’s website about excluded nonnarcotic substances.
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 -952-943-3937
  • Rural AIDS Action Network - 320-257-3036
  • Valhalla/Meridian - 651-925-8200
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.

Get involved

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Updated Wednesday, 11-Sep-2019 16:25:19 CDT