Coprescribing Naloxone Helps Reduce Unintentional Opioid Overdose

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Naloxone is an opioid antagonist that reverses the respiratory depression characteristic of opioid overdose.
Naloxone is an opioid antagonist that reverses the respiratory depression characteristic of opioid overdose.

HealthDay News — Patients on long-term opioid therapy who receive prescriptions for naloxone are less likely to return for emergency care related to opioid use, according to a study published online June 28 in the Annals of Internal Medicine.

Phillip Coffin, MD, of Substance Use Research with the San Francisco Department of Public Health, and colleagues tracked outcomes after 38.2% of 1,985 patients on opioids for chronic pain at San Francisco clinics received prescriptions for naloxone.

The researchers found that those who received naloxone prescriptions had 47% fewer opioid-related emergency department visits per month over the following 6 months, and 63% fewer over a year, compared to opioid patients who didn't receive naloxone. However, only about 12% of all patients went to the emergency department for opioid-related issues during the study period. Overall, the findings suggested that naloxone prescriptions for 30 patients would translate to one averted emergency department visit, Coffin told HealthDay.

"The [U.S.] Centers for Disease Control and Prevention now recommends offering naloxone to patients on long-term opioid therapy who are taking more than 50 morphine-equivalent milligrams daily, who have a history of overdose or substance-use disorder, or who are also taking medications such as benzodiazepines," Coffin said. "Even for patients who are unlikely to overdose, it may be important to have naloxone in the house in case of accidental exposures or unintentional diversion of medications."

Reference

Coffin PO, Behar E, Rowe C, et al. Nonrandomized intervention study of naloxone coprescription for primary care patients receiving long-term opioid therapy for pain. Ann Intern Med. 2016. doi: 10.7326/M15-2771.

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