In a session during APhA2022 titled "Yes You Can: Naloxone Distribution and Communication Strategies to Help Save Lives," Thomas Franko, PharmD, reported that all 50 states currently permit pharmacists to dispense naloxone to high-risk patients through either standing orders or statewide protocols.
Pharmacists, he stressed, are in the best position to boost naloxone use and save lives. However, Dr. Thomas, associate professor of pharmacy practice, Nesbitt School of Pharmacy, Wilkes University, Wilkes-Barre, Pennsylvania, lamented that many pharmacists remain unaware that they have the authority to dispense naloxone or they are not sure of the process.
To convey the scope of the drug-overdose epidemic, Dr. Franko pointed to that fact that over 100,000 people died from a drug-related overdose between April 2020 and April 2021, a greater than 28% increase for that time period. Of these, he said, more than 75,000 were opioid related. The rise in fentanyl, he said, is a major concern, due in part its ease in formulation, and he also reported a shift from an opioid epidemic to a holistic substance use epidemic.
Dr. Franko detailed how to use naloxone in an emergency situation, pointing out that employing a sternum roll and placing the patient in the recovery position are the accepted protocols. He also noted the existence of several naloxone-delivery devices: intranasal, IV, and IM. Most pharmacies and first responders, he said, carry the intranasal devices due to its lower cost and greater ease of use.
One way to boost use and improve naloxone distribution, he suggests, is to employ patient-centric communication strategies to improve naloxone distribution. "Language is important," he stressed. "We want to use is appropriate terminology and language to reduce stigma. A lot of what we need to change is also language that we used with the best of intentions, so we need to be sure that we use appropriate terms (found on the APhA's Opioid Resource page) to decrease stigma." For example, he said, pharmacists and pharmacy technicians should employ the phrase "Person in long-term recovery" versus "A person who is 'clean.'"
Dr. Franko said that person-first language should be used to further reduce stigma. For example, practitioners should use language that makes is clear that respiratory depression is a side effect of the drug, not a failing of the individual. Moreover, a pharmacist might remark, "In case you overdose, there is this medicine called naloxone."
Additional language strategies, Dr. Franko told attendees, include using open-ended questions and keeping it simple are effective, plus avoiding stigmatizing language.
Dispelling common misconceptions is another strategy for boosting naloxone distribution, such as the notion that someone will be arrested for having drug paraphernalia if they have naloxone. Other myths, Dr. Franko said, are that naloxone enables drug use, is only for people with a substance use disorder, and that naloxone access results in so-called "Narcan parties."
To further drive naloxone distribution, he also recommended communication strategies for pharmacy technicians. "Technicians are so important, and we need to continue to empower technicians be able do more and 'seal the deal,' in this case with naloxone."
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Published March 24, 2022