Naloxone barriers identified

Walgreens pharmacist with naloxone
A US pharmacist with naloxone kit. Image: Walgreens

Two studies presented at this week’s drug and alcohol conference have examined the barriers to pharmacists providing naloxone

Awareness and preparedness to supply were identified as two key barriers by researchers including Robyn Dwyer from Curtin University, who presented the new data at the APSAD Alcohol and Other Drugs conference.

To date there has been limited research on pharmacists’ perspectives on the February 2016 downscheduling to S3 of the life-saving drug.

The researchers conducted semi-structured interviews with 26 community pharmacists across Queensland, NSW, Victoria and the ACT, and then organised, coded and analysed the transcripts.

They found that lack of awareness of naloxone or the reschedule was a central barrier to pharmacist provision of the drug; lack of preparedness to supply was also a problem.

Just under half of the pharmacists were aware of the reschedule, but only three had provided OTC naloxone.

Pharmacists currently providing harm reduction services to people who inject drugs were more likely to be aware of and willing to provide OTC naloxone.

Other barriers identified included pharmacy-level logistical challenges and stigma associated with people who inject drugs.

“Pharmacy provision of OTC naloxone offers an important opportunity to contribute to the reduction of overdose mortality,” the researchers say.

“Our study suggests this opportunity is yet to be realised and highlights several individual- and structural-level impediments to the expansion of public access to naloxone via community pharmacies.”

They identified a need to develop strategies to improve pharmacists’ knowledge of OTC naloxone and address other logistical and cultural barriers that limit its provision, at the individual as well as the system level.

Another study, presented at the conference by Joyce Chun from the National Drug and Alcohol Research Centre, UNSW and School of Pharmacy, University of Queensland, examined pharmacists’ education needs on OTC naloxone.

The mixed-methods study looked at how willing community pharmacists were to receive training on opioid overdose prevention and naloxone. It took a particular focus on pharmacists’ education needs, training preferences, and the identification of barriers and facilitators.

It included data from an online survey and 21 semi-structured phone interviews.

The study found that 81% of pharmacists (479 pharmacists) were willing to attend such training. Being younger, female, an earlier career pharmacist and having previously attended education on substance use disorder were all associated with willingness to attend naloxone training, as was having higher confidence in issues relating to substance use disorder.

“In-depth interviews confirmed community pharmacists’ willingness to attend training; however participants expressed low awareness, confidence and knowledge around naloxone and opioid overdose prevention,” the researchers found.

They said this highlights the role for professional pharmacy organisations and pharmaceutical companies in providing education materials, guidelines and demonstration kits to facilitate naloxone supply in pharmacies.

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