In a new study, researchers found that only a tiny minority of people at risk for an opioid overdose actually are prescribed a drug that could save their lives
In all, less than 2% of people who had at least one of the main risk factors for opioid overdose had filled a prescription for the life-saving drug naloxone by the last 6 months of the study period.
This means naloxone prescribing may be missing a large proportion of those at the highest risk.
The research was conducted by a team from the University of Michigan and VA Ann Arbor Healthcare System.
National guidelines issued in 2016 by the Centers for Disease Control and Prevention call for physicians to prescribe naloxone to anyone who takes high doses of opioid pain medicine and to anyone who has other major overdose risk factors including a history of opioid use disorder or opioid overdose.
People who take opioids at the same time they’re taking a type of sedative called a benzodiazepine should also receive it because the two drugs can interact.
Opioid overdose can occur when someone takes too much of an opioid-containing drug accidentally or on purpose, or when an opioid interacts with another prescription drug, alcohol or an underlying health condition.
Naloxone, given by injection or nasal spray, can help reverse an overdose of any type of opioid, from prescription pain medicines to heroin.
In the study, the team uses data from a national sample of people covered by private health insurance.
They found that naloxone prescription fills by adults with private health insurance rose during the study period from January 2014 to mid-2017, but the percentage of patients receiving it was still very low.
Only 1.6% of those taking high doses of prescription opioids had filled a naloxone prescription in the last six months of the study period.
The percentage was no higher for those who had already survived an opioid overdose or had a formal diagnosis of an opioid use disorder, some of the most concerning risk factors for overdose.
The team says the vast majority of naloxone prescribing is to patients who have received opioid prescriptions, but there are other groups at high risk for overdose but not receiving prescription opioids, including people using only street drugs, that warrant further attention.
One author of the study is Lewei (Allison) Lin, M.D., M.Sc., an addiction psychiatrist at the U-M Addiction Center and the VAAAHS.
The study is published in the Journal of General Internal Medicine.
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