Arkansas law leads to increase in naloxone, the drug used to treat opioid overdoses

The number of Arkansans covered by Medicaid or private insurance who filled a prescription for naloxone increased 340% following the passage of a law requiring an anti-overdose medication to be prescribed to patients receiving high doses of naloxone. opioids, according to an analysis by the Arkansas Center. for the improvement of health.

According to the center, 21,583 Medicaid or private health plan enrollees were prescribed naloxone in the fiscal year ended June 30, 2022, compared to 4,909 a year earlier.

Similarly, the number of prescriptions filled by these enrollees for naloxone increased from 5,575 in FY 2021 to 25,987 in FY 2022.

Act 651 of 2021 requires that naloxone or another anti-overdose medication be prescribed in certain situations, including when opioids are prescribed to a patient at a dose of 50 or more morphine milligram equivalents – the equivalent of approximately 10 hydrocodone tablets of 5 milligrams – – per day.

“It is crucial to get naloxone into the hands of people who have high-dose prescriptions, even if they are not at risk themselves, but may have children or family members who could. take too much by mistake,” said Craig Wilson, director of health policy at the Institute. said the Center for Health Improvement.

Act 651 also requires that naloxone be prescribed when the benzodiazepine is prescribed concurrently with an opioid or when an opioid is prescribed to a patient with a history of opioid use disorder or drug overdose. .

In recent years, Wilson said, Arkansas’ efforts to raise awareness about naloxone contributed to a slight increase in prescriptions filled, but that was “marginal” compared to the recent uptick.

“It’s the difference between a gentle approach with education, awareness or incentive and a requirement for health professionals,” he said.

He said the center’s analysis only considers naloxone prescriptions that have been filled, and he suspects most patients don’t fill their naloxone prescription every time they fill their opioid prescription.

“Naloxone has a shelf life that extends well beyond the time a patient receives their next opioid prescription, so they will likely forgo getting another prescription each time,” he said. he declares.

In 2021, Arkansas saw 637 drug overdose deaths, including 386 from opioids, according to the Kaiser Family Foundation.

“One of the key things is that naloxone is a harm reduction medication. It is here to save lives and is part of a spectrum of efforts to combat this problem, from initial prevention to treatment, harm reduction and recovery. support,” Wilson said.

A state law passed in 2017 allowed pharmacists to dispense naloxone to patients under a state protocol without the patient first having to obtain a prescription from a doctor.

However, the Center for Health Improvement’s analysis found that prescriptions filled under the state’s protocol accounted for only 9.7% of total naloxone prescriptions filled in fiscal year 2022.

This year, the U.S. Food and Drug Administration approved the first naloxone nasal sprays sold without a prescription.

The Center for Health Improvement’s analysis also found that the number of Arkansans filling opioid prescriptions fell 35 percent, from 367,702 to 238,440, from 2017 to 2022.

“Our legislators, health care providers and advocates are working hard to combat the devastating impacts of the opioid epidemic in communities across the state, and we continue to support their efforts,” said Dr. Joe Thompson , president and CEO of the center. A press release.

“The challenge ahead remains significant, and there is still work to be done to reduce the number of Arkansans dying from opioid overdoses.”

Ly is a member of the Report for America Corps.