Study Identifies Gap in Naloxone Access During Pandemic

Individuals with opioid misuse disorders may be experiencing a decrease in access to naloxone amid the COVID-19 pandemic, according the results of a recent study.¹

Published in JAMA Health Forum, the study, which was conducted by clinician-researchers from Beth Israel Deaconess Medical Center (BIDMC), analyzed naloxone prescription trends during the pandemic in the United States and compared them with trends in opioids prescriptions and overall prescriptions between May 2019 and December 2020.¹ 

The investigators used data from a national pharmacy insurance claims database that includes claims from national retail pharmacies, mail-order pharmacies, and specialty pharmacies. The results showed that the number of individuals filling prescriptions for any medications decreased by 14%, whereas the number of individuals filling opioid prescriptions decreased by 9%.¹ 

However, when it came to naloxone, the number of individuals filling these prescriptions dropped by more than 25% and the number of individuals with Medicare and commercial coverage filling naloxone prescriptions dropped nearly a third. And since March 2020, there was no statistically significant recovery in naloxone prescriptions, “indicating that the number of individuals filling naloxone prescription has remained low throughout the pandemic,” the investigators wrote in the study. However, there was no statistically significant decline in naloxone prescriptions being filled among patients with Medicaid or cash payment during the pandemic.¹ 

This is particularly important because of the increase in substance use, including opioid use, that has been documented during the pandemic. According to the study investigators, nonfatal opioid overdose emergency department visits more than doubled during this time, but few patients who overdosed on opioids received naloxone prescription on discharge.¹ 

“Our study identifies an urgent gap in necessary access to lifesaving medications for individuals covered by Medicare and commercial insurance during the pandemic,” said senior author Jennifer P. Stevens, MD, MS, director for the Center for Healthcare Delivery Science at BIDMC.² “Continuing to distribute naloxone in densely populated areas and through community-based organizations could help mitigate some of the reductions in naloxone distribution via pharmacies and could also reduce some of the increases in fatal opioid overdoses during the COVID-19 pandemic.”

References

1. O’Donoghue AL, Biswas N, Dechen T, et al. Trends in filled naloxone prescriptions before and during the COVID-19 pandemic in the United States. JAMA Health Forum. 2021. Doi: 10.1001/jamahealthforum.2021.0393
2. Access to overdose-reversing drugs declined during pandemic, researchers find. News Release. Beth Israel Deaconess Medical Center. May 14, 2021. Accessed May 14, 2021. https://www.eurekalert.org/pub_releases/2021-05/bidm-ato051421.php