Yesterday, Dr. Howard Haft of the Maryland Department of Health and Mental Hygiene (DHMH) issued a statewide standing order that allows pharmacists to dispense naloxone to individuals holding a training certificate under Maryland’s Overdose Response Program (ORP). See the press release here.

Naloxone (trade names Narcan^® and Evzio^®) is a prescription medication that is used to reverse the effects of opioids – a class of drugs that includes prescription medications like oxycodone, codeine, and morphine, as well as illicit drugs like heroin. It is a life-saving medication that can restore breathing in an individual that has stopped breathing due to an opioid overdose. Naloxone can be adminstered intranasally, intramuscularly, or subcutaneously. It is not a controlled substance, which means it does not carry any risk of dependency. Side effects are minimial, if any, and are usually self-limiting.

Prior to this standing order, patients had to obtain a prescription from their doctor, which may have required them to schedule an appointment, explain to the doctor why they wished to carry a naloxone kit, and perhaps experience some pushback from the prescriber (due to lack of education about naloxone, level of comfortability prescribing naloxone, or other reasons). The time spent trying to obtain a prescription is valuable time lost, during which an overdose could occur.

Now, patients who have completed training through the Maryland ORP (and present a valid training certificate) may obtain a prescription from any pharmacy in Maryland under the new standing order. This is a huge win for pharmacists! DHMH is recognizing both our role in overdose prevention, as well as the trust our patients place in us as an integral part of their healthcare team. It has been said that pharmacists are the most accessible healthcare provider, with over 90% of Americans living within five minutes of a community pharmacy.

Under the standing order, patients will still be responsible for paying for the medication and/or kit, whether through prescription insurance or other means. Maryland Medical Assistance (Medicaid) covers the medication at a $1.00 copay. The nasal atomizer used to administer the naloxone intranasally is covered by Medicaid as a Durable Medical Equipment (DME) benefit.

If you or a loved one are interested in more information about naloxone, how to obtain it, consult one of these resources:

• GetNaloxoneNow.org – great resource for patients and healthcare professionals alike
• PrescribeToPrevent.org – dedicated to healthcare professionals, and includes information for prescribers and pharmacists, including patient education resources.

Photo credit: dispatch.org