Approximately three out of five retail pharmacies in North Carolina now stock naloxone for use on opioid overdoses in support of a statewide standing order, according to research conducted at East Carolina University.
Naloxone, or Narcan, blocks receptors to the brain and restores breathing impaired by overdoses. As a means of countering the rise in opioid use and overdose, in 2016, North Carolina laid out a standing order allowing pharmacies to provide Narcan without any prescription necessary.
“It’s important to understand if pharmacies are implementing the standing order and if there are variations in implementation by pharmacy type or neighborhood characteristics,” Dr. Kathleen Egan, of ECU’s Department of Health Education and Promotion and one of the developers of the study, said.
The phone-based survey involved a random sampling chain of independent and health department pharmacies from a list of 2,044 active pharmacies provided by the North Carolina Pharmacy Board. Of 200 pharmacies called, more than half surveyed had naloxone available without prescription and all carried intranasal naloxone spray. Only 4.1 percent carried an injectable form. Notably, 75 percent said that Medicaid or other forms of health insurance could cover the cost of the average $123.24 — or $33.82, respectively — medication.
Not all pharmacies were operating at the same level, however. Independent pharmacies were less likely to stock Narcan than their chain-based competition, and either lacked same-day availability or were less likely to sell it without prescription. It was also less likely in communities with higher percentages of residents with public health insurance.
“Chains may have more streamlined protocols to roll out the standing order for naloxone,” Egan said. “There may not be an unwillingness to dispense naloxone without a prescription at the independent pharmacies, rather, they may not have all the information to do so. It could be a stocking issue.”
The study’s results were published in the American Journal of Preventive Medicine.