Patients Treated for Opioid Overdose Rarely Prescribed Naloxone and Buprenorphine

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Study suggests emergency doctors prescribe naloxone to patients who overdose.

Less than 10% of patients treated for opioid overdose are prescribed naloxone or buprenorphine within 30 days of emergency department (ED) visits in the United States, according to a study published in Annals of Emergency Medicine.

Analyzing data from approximately 149,000 opioid overdose emergency room visits before and during the COVID-19 pandemic, investigators found that only 7.4% of patients had received a prescription for naloxone and the rate of prescription for buprenorphine was 8.5%.

Naloxone is designed to restore normal breathing in an overdose. According to investigators, it is increasingly available free of charge in pharmacies and other places. Buprenorphine itself is an opioid, but it is designed to block the action of other opioid drugs, including prescription drugs, heroin, and fentanyl. The drug is intended to help people overcome opioid addiction without causing euphoria on its own.

“In light of record levels of opioid overdose deaths, prescription low levels of naloxone and buprenorphine are simply unacceptable,” said Kao-Ping Chua, MD, PhD, study lead author and professor. pediatric assistant at Michigan Medicine, in a press release. “Clinicians are missing out on critical life-saving opportunities both in the emergency department and during follow-up after overdose visits. “

Investigators compared these prescription rates to patients treated for anaphylaxis in the emergency room. Almost 50% of these patients are prescribed an emergency epinephrine device, such as an EpiPen, within 30 days of their visit.

“The same standard that we use to care for patients after anaphylaxis and prepare them with a potentially life-saving prescription should also be applied to patients after an opioid overdose,” said Keith Kocher, MD, MPH, senior author of the article and associate professor. of emergency medicine at Michigan Medicine, in the release. “There are several points of intervention along the way to reduce the potential damage after an overdose. The emergency department has a role to play, as do ambulatory care providers. It may not always be the same solutions in every environment or community, but the bottom line is that we need to do better. “

The risk that patients who survive an opioid overdose will end up dying from another overdose is high, investigators say. Studies suggest that 1.1% of patients treated for an opioid overdose die within one month and 5.5% die within one year. The study authors recommend that emergency physicians prescribe naloxone to patients who overdose, and health systems should encourage this prescription, although they recognize that there is still a stigma surrounding the agent. overdose reversal.

“Some clinicians believe that prescribing naloxone encourages patients to engage in risky behaviors, again increasing their risk of overdose,” Chua said in the statement. “But there isn’t a lot of evidence that this is happening.”

REFERENCE

Less than 10% of opioid overdose patients are prescribed life-saving drugs after emergency treatment [news release]. EurekAlert; November 23, 2021. Accessed November 24, 2021. https://www.eurekalert.org/news-releases/935867


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