Coprescription of Naloxone with Long-Term Opioids Is Safe, Effective
Coprescribing naloxone with long-term opioids significantly reduced opioid-related emergency department (ED) visits by 63% after 1 year of treatment, according to a recent study.
Opioid overdose is a leading cause of death in the United States. Therefore, the researchers aimed to evaluate the feasibility and effect of implementing naloxone prescription to patients prescribed opioids for chronic pain.
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To conduct their study, the researchers analyzed 1985 adults with chronic pain who were receiving long-term opioid therapy in 6 safety-net primary care clinics in San Francisco, California.
The researchers recorded the number of patients prescribed naloxone, the number of opioid-related ED visits, and the prescribed opioid doses based on chart review.
About 38% of patients were prescribed naloxone for 2 years. Those who had an opioid-related ED visit within the prior year and had been prescribed higher doses of opioids were more likely to have been prescribed naloxone.
After follow-up, the researchers found that patients who had received naloxone treatment had 47% fewer opioid-related ED visits per month in the 6 months after receiving treatment and 63% fewer visits after 1 year than patients who did not receive naloxone.
“Naloxone can be coprescribed to primary care patients prescribed opioids for pain,” the researchers concluded.
“When advised to offer naloxone to all patients receiving opioids, providers may prioritize those with established risk factors. Providing naloxone in primary care settings may have ancillary benefits, such as reducing opioid-related adverse events.”
—Amanda Balbi
Reference:
Coffin PO, Behar E, Rowe C, et al. Nonrandomized intervention study of naloxone coprescription for primary care patients receiving long-term opioid therapy for pain [published online June 28, 2016]. Ann Intern Med. doi:10.7326/M15-2771.