Enhancing Rates Of Opioid Overdose Education And Naloxone Distribution In Emergency Departments

From Health Affairs:

Emergency departments (EDs) offer critical opportunities for addressing the opioid crisis because they are on the front lines of health and are an underutilized point of contact with people at risk of opioid overdose. Key interventions include reducing inappropriate ED opioid prescribing and thereby reducing excess availability of opioids by patients and in the community; working to ensure that EDs have access to real-time information about the already existing opioid prescriptions of their patients; initiating treatment in the ED for persons with opioid use disorder (OUD), including starting medications for OUD in the ED setting; and opioid overdose education and naloxone distribution (OEND). Naloxone is a medication called an “opioid antagonist” used to counter the effects of opioid overdose.

There is a trend toward decreased opioid prescribing in EDs, at least 49 states have operational prescription drug monitoring programs (PDMPs); in the area of OUD treatment, large federally funded ED-initiated buprenorphine implementation and research projects are underway. There has also been a substantial increase in naloxone dispensing; however, the rate of naloxone prescriptions dispensed per high-dose opioid prescription remains low. For example, in 2018, only 2.81 naloxone prescriptions were dispensed for every 100 high-dose opioid prescriptions in emergency medicine settings nationally.

Continuing improvement is needed in all these areas. We focus on the substantial missed opportunities that remain to provide naloxone to ED patients at risk for overdose.

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