The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City
Background: Naloxone distributed to people at risk for opioid overdose has been associated with reduced overdose death rates; however, associations of retail pharmacy-distributed naloxone with overdose mortality have not been evaluated. Methods: Our analytic cohort uses retail pharmacy claims data;...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Drug and Alcohol Dependence Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772724622000580 |
| _version_ | 1798003189441626112 |
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| author | Jake R. Morgan Christina E. Freibott Ali Jalali Philip J. Jeng Alexander Y. Walley Avik Chatterjee Traci C. Green Michelle L. Nolan Benjamin P. Linas Brandon D.L. Marshall Sean M. Murphy |
| author_facet | Jake R. Morgan Christina E. Freibott Ali Jalali Philip J. Jeng Alexander Y. Walley Avik Chatterjee Traci C. Green Michelle L. Nolan Benjamin P. Linas Brandon D.L. Marshall Sean M. Murphy |
| author_sort | Jake R. Morgan |
| collection | DOAJ |
| description | Background: Naloxone distributed to people at risk for opioid overdose has been associated with reduced overdose death rates; however, associations of retail pharmacy-distributed naloxone with overdose mortality have not been evaluated. Methods: Our analytic cohort uses retail pharmacy claims data; three health departments’ community distribution data; federal opioid overdose data; and American Community Survey data. Data were analyzed by 3-digit ZIP Code and calendar quarter-year (2016Q1–2018Q4), and weighted by population. We regressed opioid-related overdose mortality on retail-pharmacy and community naloxone distribution, and community-level demographics using a linear model, hypothesizing that areas with high overdose rates would have higher current levels of naloxone distribution but that increasing naloxone distribution from one quarter to the next would be associated with lower overdose. Results: From Q1–2016 to Q4–2018, the unadjusted naloxone distribution rate increased from 97 to 257 kits per 100,000 persons, while the unadjusted opioid overdose mortality rate fell from 8.1 to 7.2 per 100,000 persons. The concurrent level of naloxone distribution (both pharmacy and community) was positively and significantly associated with fatal opioid overdose rates. We did not detect associations between change in naloxone distribution rates and overdose mortality. Conclusion: Naloxone distribution volumes were correlated with fatal opioid overdose, suggesting medication was getting to communities where it was needed most. Amid high rates of overdose driven by fentanyl in the drug supply, our findings suggest additional prevention, treatment, and harm reduction interventions are required—and dramatically higher naloxone volumes needed—to reverse the opioid overdose crisis in the US. |
| first_indexed | 2024-04-11T12:05:26Z |
| format | Article |
| id | doaj.art-75b6ff6dd2ef48bb859449b6db65631a |
| institution | Directory Open Access Journal |
| issn | 2772-7246 |
| language | English |
| last_indexed | 2024-04-11T12:05:26Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Drug and Alcohol Dependence Reports |
| spelling | doaj.art-75b6ff6dd2ef48bb859449b6db65631a2022-12-22T04:24:45ZengElsevierDrug and Alcohol Dependence Reports2772-72462022-09-014100083The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York CityJake R. Morgan0Christina E. Freibott1Ali Jalali2Philip J. Jeng3Alexander Y. Walley4Avik Chatterjee5Traci C. Green6Michelle L. Nolan7Benjamin P. Linas8Brandon D.L. Marshall9Sean M. Murphy10Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States of America; Corresponding author.Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States of AmericaDepartment of Population Health Sciences, Weill Cornell Medical College, New York, NY, United States of AmericaDepartment of Population Health Sciences, Weill Cornell Medical College, New York, NY, United States of AmericaGrayken Center for Addiction, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, United States of AmericaGrayken Center for Addiction, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, United States of AmericaBrandeis University Heller School for Social Policy and Management, Rhode Island Hospital, RI, United States of America; Brown University School of Public Health, Department of Epidemiology, RI, United States of America; COBRE on Opioids and Overdose, Rhode Island Hospital, RI, United States of AmericaDepartment of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of AmericaGrayken Center for Addiction, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, United States of America; Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States of AmericaBrown University School of Public Health, Department of Epidemiology, RI, United States of America; COBRE on Opioids and Overdose, Rhode Island Hospital, RI, United States of AmericaDepartment of Population Health Sciences, Weill Cornell Medical College, New York, NY, United States of AmericaBackground: Naloxone distributed to people at risk for opioid overdose has been associated with reduced overdose death rates; however, associations of retail pharmacy-distributed naloxone with overdose mortality have not been evaluated. Methods: Our analytic cohort uses retail pharmacy claims data; three health departments’ community distribution data; federal opioid overdose data; and American Community Survey data. Data were analyzed by 3-digit ZIP Code and calendar quarter-year (2016Q1–2018Q4), and weighted by population. We regressed opioid-related overdose mortality on retail-pharmacy and community naloxone distribution, and community-level demographics using a linear model, hypothesizing that areas with high overdose rates would have higher current levels of naloxone distribution but that increasing naloxone distribution from one quarter to the next would be associated with lower overdose. Results: From Q1–2016 to Q4–2018, the unadjusted naloxone distribution rate increased from 97 to 257 kits per 100,000 persons, while the unadjusted opioid overdose mortality rate fell from 8.1 to 7.2 per 100,000 persons. The concurrent level of naloxone distribution (both pharmacy and community) was positively and significantly associated with fatal opioid overdose rates. We did not detect associations between change in naloxone distribution rates and overdose mortality. Conclusion: Naloxone distribution volumes were correlated with fatal opioid overdose, suggesting medication was getting to communities where it was needed most. Amid high rates of overdose driven by fentanyl in the drug supply, our findings suggest additional prevention, treatment, and harm reduction interventions are required—and dramatically higher naloxone volumes needed—to reverse the opioid overdose crisis in the US.http://www.sciencedirect.com/science/article/pii/S2772724622000580NaloxoneDistributionOpioid overdose |
| spellingShingle | Jake R. Morgan Christina E. Freibott Ali Jalali Philip J. Jeng Alexander Y. Walley Avik Chatterjee Traci C. Green Michelle L. Nolan Benjamin P. Linas Brandon D.L. Marshall Sean M. Murphy The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City Drug and Alcohol Dependence Reports Naloxone Distribution Opioid overdose |
| title | The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City |
| title_full | The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City |
| title_fullStr | The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City |
| title_full_unstemmed | The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City |
| title_short | The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City |
| title_sort | role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in massachusetts rhode island and new york city |
| topic | Naloxone Distribution Opioid overdose |
| url | http://www.sciencedirect.com/science/article/pii/S2772724622000580 |
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