Mainstreaming Naloxone Through Coprescription to Patients Receiving Long-Term Opioid Therapy for Chronic Pain
Authors: Alexander Y. Walley, Traci C. Green
Journal: Annals of Internal Medicine (2016)

Editorials16 August 2016Mainstreaming Naloxone Through Coprescription to Patients Receiving Long-Term Opioid Therapy for Chronic PainAlexander Y. Walley, MD, MSc and Traci C. Green, PhD, MScAlexander Y. Walley, MD, MScFrom Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts.Search for more papers by this author and Traci C. Green, PhD, MScFrom Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1348 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Coffin and colleagues report results of the NOSE (Naloxone for Opioid Safety Evaluation) study, which evaluated the implementation of overdose education and prescription of naloxone rescue kits (OENRKs) among patients in safety net community health centers who were treated with opioid therapy for chronic pain (1). They found that more than one third of patients were prescribed naloxone rescue kits, and prescription rates were highest among those with previous emergency department (ED) visits and higher opioid doses. Patients who were prescribed naloxone had substantially fewer opioid-related ED visits and no net change in the prescribed morphine-equivalent opioid dose compared with ...References1. Coffin PO, Behar E, Rowe C, Santos GM, Coffa D, Bald M, et al. Nonrandomized intervention study of naloxone coprescription for primary care patients receiving long-term opioid therapy for pain. Ann Intern Med. 2016;165:245-52. doi:10.7326/M15-2771 LinkGoogle Scholar2. Haegerich TM, Paulozzi LJ, Manns BJ, Jones CM. What we know, and don't know, about the impact of state policy and systems-level interventions on prescription drug overdose. Drug Alcohol Depend. 2014;145:34-47. [PMID: 25454406] doi:10.1016/j.drugalcdep.2014.10.001 CrossrefMedlineGoogle Scholar3. Oliva EM, Nevedal A, Lewis ET, McCaa MD, Cochran MF, Konicki PE, et al. Patient perspectives on an opioid overdose education and naloxone distribution program in the U.S. Department of Veterans Affairs. Subst Abus. 2016;37:118-26. 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Increase in naloxone prescriptions dispensed in US retail pharmacies since 2013. Am J Public Health. 2016;106:689-90. [PMID: 26890174] doi:10.2105/AJPH.2016.303062 CrossrefMedlineGoogle Scholar8. Walley AY, Xuan Z, Hackman HH, Quinn E, Doe-Simkins M, Sorensen-Alawad A, et al. Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis. BMJ. 2013;346:f174. [PMID: 23372174] doi:10.1136/bmj.f174 CrossrefMedlineGoogle Scholar9. Caudarella A, Dong H, Milloy MJ, Kerr T, Wood E, Hayashi K. Non-fatal overdose as a risk factor for subsequent fatal overdose among people who inject drugs. Drug Alcohol Depend. 2016;162:51-5. [PMID: 26993373] doi:10.1016/j.drugalcdep.2016.02.024 CrossrefMedlineGoogle Scholar10. Baehren DF, Marco CA, Droz DE, Sinha S, Callan EM, Akpunonu P. A statewide prescription monitoring program affects emergency department prescribing behaviors. Ann Emerg Med. 2010;56:19-23. [PMID: 20045578] doi:10.1016/j.annemergmed.2009.12.011 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts.Grant Support: Drs. Walley and Green are supported by grants from the Agency for Healthcare Research and Quality (R18 HS024021) and the National Institute on Drug Abuse (R01DA038082). Dr. Walley is also supported by additional grants from the National Institute on Drug Abuse (R01DA037768 and R25D13582) and a grant from the National Institute on Alcohol Abuse and Alcoholism (U01AA020784).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1348.Corresponding Author: Alexander Y. Walley, MD, MSc, Boston University School of Medicine and Boston Medical Center, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118; e-mail, [email protected]edu.Current Author Addresses: Dr. Walley: Boston University School of Medicine and Boston Medical Center, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118.Dr. Green: Boston University School of Medicine and Boston Medical Center, Injury Prevention Center, Department of Emergency Medicine, 1 Boston Medical Center Place, Boston, MA 02118.This article was published at www.annals.org on 28 June 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNonrandomized Intervention Study of Naloxone Coprescription for Primary Care Patients Receiving Long-Term Opioid Therapy for Pain Phillip O. Coffin , Emily Behar , Christopher Rowe , Glenn-Milo Santos , Diana Coffa , Matthew Bald , and Eric Vittinghoff Metrics Cited byPolysubstance use in the U.S. opioid crisisThe Importance of Learning Health Systems in Addressing the Opioid CrisisEpidemiology of the U.S. opioid crisis: the importance of the vectorOpiate addiction and overdose: experiences, attitudes, and appetite for community naloxone provision 16 August 2016Volume 165, Issue 4Page: 292-293KeywordsBehaviorDrug abuseEmergency departmentForecastingMedical educationMortalityOpioidsPrevention, policy, and public healthSafetySafety studies ePublished: 28 June 2016 Issue Published: 16 August 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...