Implementation of a multidisciplinary inpatient opioid overdose education and naloxone distribution program at a large academic medical center

Am J Health Syst Pharm. 2022 Dec 5;79(24):2253-2260. doi: 10.1093/ajhp/zxac252.

Abstract

Purpose: Opioid overdose-related deaths continue to rise. Despite public health efforts, there is still variability in obtainment of naloxone, a lifesaving antidote. We share our experience in the implementation of a novel opioid overdose education and naloxone distribution (OEND) program at a large academic medical center.

Methods: Collaborative efforts made by pharmacists, pharmacy students, physicians, nurses, and recovery coaches were employed in the design of the program. The service was available Monday through Friday, 9 am to 6 pm, and primarily carried out by pharmacy students on a rotating basis. Services offered included bedside delivery of naloxone and education prior to the day of discharge. In preparation for their role, the pharmacy students were required to complete a series of trainings and competency assessments.

Results: A total of 40 patients were included in the program evaluation. Of the completed consults 96.7% (n = 30) of patients received both counseling and naloxone delivery. Eighty percent of patients had a history of nonfatal opioid overdose, but only 37.5% had naloxone listed as a home medication. OEND services were provided to 66% of individuals with patient-directed discharges.

Conclusion: Implementation of an inpatient OEND program by mobilizing trained student pharmacists is feasible and expands naloxone access to patients during transitions of care. A similar model could be considered in the future for the delivery of harm reduction supplies to this patient population.

Keywords: academic medical center; harm reduction; interdisciplinary; naloxone; opioid overdose; pharmacist.

MeSH terms

  • Academic Medical Centers
  • Analgesics, Opioid / adverse effects
  • Drug Overdose* / drug therapy
  • Drug Overdose* / prevention & control
  • Humans
  • Inpatients
  • Naloxone / therapeutic use
  • Narcotic Antagonists / therapeutic use
  • Opiate Overdose*

Substances

  • Naloxone
  • Narcotic Antagonists
  • Analgesics, Opioid