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. 2023 Mar:6:100126.
doi: 10.1016/j.dadr.2022.100126. Epub 2022 Dec 5.

The policy landscape for naloxone distribution in four states highly impacted by fatal opioid overdoses

Robert M Bohler  1 , Patricia R Freeman  2 , Jennifer Villani  3 , Tim Hunt  4 , Beth S Linas  5 , Alexander Y Walley  6 , Traci C Green  1 , Michelle R Lofwall  7 , Carly Bridden  6 , Lisa A Frazier  8 , Laura C Fanucchi  9 , Jeffery C Talbert  10 , Redonna Chandler  3
Affiliations

The policy landscape for naloxone distribution in four states highly impacted by fatal opioid overdoses

Robert M Bohler et al. Drug Alcohol Depend Rep. 2023 Mar.

Abstract

Background: Expanding access to naloxone is one of the most impactful interventions in decreasing opioid-related mortality. However, state distribution rates of naloxone are insufficient to meet community need. The current study sought to better understand this gap by focusing on state policies that may facilitate or impede naloxone distribution in four states highly impacted by fatal opioid overdoses - Kentucky, Massachusetts, New York, and Ohio.

Methods: We provide a descriptive analysis of the policy landscape impacting naloxone distribution through pharmacy and community channels in the four states participating in the HEALing Communities Study (HCS). Publicly available data and the expertise of the research team were used to describe each state's naloxone access laws (NALs), Medicaid coverage of naloxone, and community overdose education and naloxone distribution infrastructure. Data presented in this study represent the most current policy landscape through September 2022.

Results: Variation exists between specific components of the NALs of each state, the structure of Medicaid coverage of naloxone, and the community distribution infrastructure networks. Massachusetts and New York have a statewide standing order, but other states use different strategies short of a statewide standing order to expand access to naloxone. Quantity limits specific to naloxone may limit access to Medicaid beneficiaries in some states.

Conclusion: States participating in the HCS have developed innovative but different mechanisms to ensure naloxone access. Policies were dynamic and moved towards greater access. Research should consider the policy landscape in the implementation and sustainability of interventions as well as the analysis of outcomes.

Keywords: Healing communities study; Naloxone; Naloxone access laws; Opioid policy; Overdose prevention.

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Conflict of interest statement

Declaration of Competing Interest No conflicts declared.

Figures

Fig 1
Fig. 1
Pharmacy dispensing, community distribution, and total distribution rates per 1000 residents of naloxone in HCS communities in Kentucky, Massachusetts, New York, and Ohio in 2019. Notes: *County-defined community population estimates based on Unites States Census for Kentucky and Ohio. *ZIP code-defined community population estimates based on American Community Survey for Massachusetts. *New York HCS community population estimates based on American Community Survey (n = 3) and the United States Census (n = 13).
See this image and copyright information in PMC

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