KGI Study Examines the Furnishing of Naloxone by California Pharmacists

A recent public health advisory from the U.S. Surgeon General called for increased awareness and use of naloxone, an opioid overdose reversal drug. Most states, including California, have legislation or protocols in place allowing trained pharmacists to provide naloxone to individuals without a prescription.

A new study by faculty at the Keck Graduate Institute (KGI) School of Pharmacy and Health Sciences and collaborators with the UC San Francisco’s Department of Family and Community Medicine investigated California pharmacists’ furnishing of naloxone without a prescription two years after legislation was implemented.

The study, released today in JAMA, collected data from 1,147 California pharmacies, a sample representing 20 percent of California’s community pharmacies. The investigators found that only 23.5 percent of pharmacies were furnishing naloxone.

“Pharmacists are trusted, knowledgeable, and accessible medication experts,” says KGI Associate Professor Talia Puzantian, who led the study in collaboration with substance use disorder pharmacist and consultant James Gasper. “They are poised to identify individuals at risk for opioid overdose, to provide awareness and education around opioid safety, and most importantly to furnish this life saving drug.”

Differences by urbanity were not statistically significant, although rural pharmacies were underrepresented. There was a significant difference by pharmacy type, with 31.6 percent of chain pharmacies compared with 7.5 percent of independent pharmacies furnishing naloxone.

Of pharmacies furnishing naloxone, only 50.6 percent had nasal naloxone in stock. The study revealed some gaps in knowledge by pharmacy staff including which forms of naloxone should be furnished and whether furnished naloxone could be billed to insurance.

“The next steps will be to address the barriers likely contributing to this low level of furnishing: training of pharmacists, raising public awareness, stigma, time, and cost limitations.”

California’s Board of Pharmacy has provided live meetings with pharmacists throughout the state with the training required before they can furnish naloxone. In the past two years, they have trained nearly 1,000 pharmacists.

In an effort to reach the 40,000+ licensed pharmacists within the state of California, the board’s website now features a free webinar developed by Puzantian and Gasper (linked here). The webinar meets the board’s training requirement for pharmacists to furnish naloxone.