Engaging healthcare providers to coprescribe naloxone to prevent opioid-induced mortality in Arizona

ABSTRACT

Purpose: This quality improvement (QI) project utilized an educational intervention to increase healthcare providers' (HCPs) willingness to coprescribe naloxone (Narcan) as a mitigation strategy to reduce fatal opioid overdoses.Background: In the late 1990s, pharmaceutical companies issued statements that opioids were not addictive, which resulted in overprescribing of opioids, and subsequently, a rise in overdoses that has increased since the emergence of COVID-19. Methods: A 15-minute, asynchronous online educational intervention summarized the epidemiology and health disparities associated with opioid-induced overdoses, described the evidence of naloxone distribution, explained the patient criteria and applicable laws for prescribing naloxone, and provided examples of administration methods and patient-centered approaches for discussing naloxone. An anonymous pre/post-survey evaluated HCPs motivations, barriers, and intent and their willingness to coprescribe naloxone as a harm reduction strategy at one federally qualified health center (FQHC) in Arizona.Results: The seven project participants generally had positive attitudes about naloxone. Baseline motivation and comfort levels to discuss naloxone as a harm reduction strategy were high;however, communication strategies and fixed time constraints were reported as potential barriers. Perceived barriers did not impact overall willingness to coprescribe naloxone. Participants with a behavioral health background were more likely to view naloxone administration as an opportunity to seek long-term treatment than those in the primary care specialty. Additionally, this QI project incidentally found a discrepancy between local and state policies for naloxone prescribing.Conclusions: The opioid epidemic continues to have devastating consequences due to addiction and misuse, resulting in high mortality rates due to unintentional or accidental overdoses. Coprescribing naloxone, a proven antidote to reverse an opiate-induced overdose, may help combat this national health crisis. HCPs who are well informed may be more likely to coprescribe naloxone and the intervention in this QI project successfully enhanced participant familiarity with the Arizona standing orders. Primary care, compared to behavioral health, providers may need additional education to improve willingness to coprescribe naloxone. Recommendations include that the FQHC continue efforts to create a culture where naloxone prescribing, and overdose prevention education becomes a routine in clinical practice for both primary care and behavioral health specialties. (PsycInfo Database Record (c) 2022 APA, all rights reserved)