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Divisions, Faculty, Featured, General, Pharmaceutical Outcomes and Policy, Research, Delesha Carpenter
Grayson Mendenhall
August 13, 2018

Injectable Naloxone HCl (Photo courtesy of Pennsylvania governor's office)
Injectable Naloxone HCl (Photo courtesy of Pennsylvania governor’s office)

Nearly one-third of North Carolina community pharmacists have never offered patients the opioid reversal agent naloxone, and approximately 20 percent have never dispensed it according to a survey conducted by researchers at the University of North Carolina at Chapel Hill.

More than 80 percent of pharmacists who responded to the survey worked in pharmacies that stocked naloxone. However, many pharmacists never offered or dispensed naloxone despite the drug’s wide availability and the existence of a statewide standing order that allows pharmacists to dispense naloxone to patients and caregivers who may benefit from it, according to the study led by Delesha Carpenter, an assistant professor at the UNC Eshelman School of Pharmacy. The study is published in the Journal of the American Pharmacists Association.

“State and federal directives aimed at increasing naloxone availability encourage pharmacists to discuss the drug with patients, but pharmacists’ comfort communicating about sensitive topics like overdose, along with time constraints and training levels, may play a role in how often they offer and dispense naloxone,” Carpenter said.

Over the past 20 years, opioid-related overdoses have increased fourfold, killing more than 42,000 people in 2016.

Delesha Carpenter, Ph.D.
Delesha Carpenter, Ph.D.

As of January 2018, all 50 states have granted pharmacists greater authority to dispense naloxone without a patient-specific prescription from a physician. Published in the Journal of the American Pharmacists Association, the UNC survey of 457 North Carolina pharmacists

revealed that more than 96 percent wanted additional naloxone training and that only about 56 percent had received naloxone training in the past five years.

Pharmacists who feel more comfortable discussing naloxone are more likely to offer it than those who are less comfortable, which shows that communication training may be key to increasing community access to naloxone via pharmacies, Carpenter said.

The study also showed that only 40 percent of pharmacists in regional, local and grocery chain pharmacies have ever offered naloxone — a significantly lower rate than national chain, independent or outpatient pharmacies (61 percent, 74 percent and 74 percent, respectively).

Naloxone was approved by the U.S. Food and Drug Administration for treating opiate and opioid overdoses in 1971. Originally the drug could only be administered by injection, but a nasal spray delivery system was approved in 2015 for use without a prescription. Opiates are derived from opium. Opioids are synthetic drugs that act like opiates in the body and are typically used to relieve pain.

Along with Carpenter, the study was authored by

  • Aditi Dhamanaskar, University College London School of Pharmacy;
  • Kelsea L. Gallegos, UNC Eshelman School of Pharmacy ;
  • Greene Shepherd, Pharm.D., UNC Eshelman School of Pharmacy;
  • Sherita Mosley, UNC Eshelman School of Pharmacy; and
  • Courtney Roberts, UNC Eshelman School of Pharmacy.

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