AMA Opioid Task Force Issues Updated Naloxone Guidance

August 28, 2017 04:30 pm Chris Crawford

Physicians are increasingly prescribing naloxone in the fight against the opioid abuse crisis. During the first eight weeks of this year, the number of naloxone prescriptions written by physicians increased 340 percent compared with the same period in 2016. Also during that time, the number of physicians prescribing naloxone increased 475 percent compared with the previous year.  

To aid in the response to this public health scourge, the AMA Opioid Task Force -- to which the AAFP belongs -- has released an updated resource(520 KB PDF) family physicians can use for guidance when co-prescribing overdose drug naloxone with opioid medications.

"The opioid epidemic continues to take thousands of lives in this country," said Jennifer Frost, M.D., medical director for the AAFP Health of the Public and Science Division. "While family physicians work with their patients to prevent opioid misuse and overdose, naloxone is potentially life-saving for those patients who remain at risk. This (opioid task force) resource encourages clinicians to consider co-prescription of naloxone and offers guidance about when this is most appropriate."

The updated resource recommends family physicians and other clinicians consider these factors when determining whether to co-prescribe naloxone to a patient and/or their caregivers:

Story highlights
  • On Aug. 24, the AMA Opioid Task Force released an updated resource family physicians can use for guidance when co-prescribing overdose drug naloxone with opioid medications.
  • During the first eight weeks of this year, the number of naloxone prescriptions written by physicians increased 340 percent compared to the same period in 2016.
  • The AAFP remains committed to providing family physicians with timely, relevant resources to help them combat the opioid abuse epidemic.
  • Does the patient's history or a state's prescription drug monitoring program (PDMP) show that my patient is on a high opioid dose?
  • Is my patient on a concomitant benzodiazepine prescription?
  • Does my patient have a history of substance use disorder?
  • Does my patient have an underlying mental health condition that might make him or her more susceptible to overdose?
  • Does my patient have a medical condition, such as a respiratory disease, sleep apnea or other comorbidities, that might make him or her susceptible to opioid toxicity, respiratory distress or overdose?
  • Would my patient be able to aid someone who is at risk for opioid overdose?

In the AMA's Aug. 24 "Advocacy Update,"(assets.ama-assn.org) Patrice Harris, M.D., M.A., chair of the AMA Opioid Task Force, said: "We know that naloxone -- by itself -- will not reverse the nation's opioid epidemic, but it is a critical component that saves lives and provides a second chance."

The AMA also hosts an End the Epidemic microsite that features additional naloxone resources(www.end-opioid-epidemic.org)

More Naloxone Co-prescribing Considerations

According to the task force's newly updated naloxone resource, family physicians who are trying to determine whether to co-prescribe naloxone should also consider discussing with patients

  • the risk for and symptoms of opioid overdose,
  • the potential stigma associated with opioid use disorder,
  • the broader issue of treating substance use disorder, and
  • appropriate training to deal with an overdose.

Additional benefits that co-prescribing naloxone offers include reducing emergency department visits and helping patients become more aware of the potential hazards of opioid misuse.

The task force document also referenced a study published online Sept. 20, 2016, in the journal Substance Abuse that found that co-prescribing naloxone for patients at risk for overdose doesn't increase the liability risk for practices. Specifically, the study stated that the legal risk associated with prescribing naloxone is no higher than that associated with prescribing any other medication and, in many cases, is lower.

"Additionally, laws in a majority of states provide explicit legal protections for providers who prescribe or dispense naloxone, in many cases extending this protection to prescriptions issued to friends, family members and others," the study said.

AAFP Resources on Pain Management, Opioids

The AAFP remains committed to providing family physicians with timely, relevant resources to help them combat the opioid abuse epidemic. Among those resources are a chronic pain management toolkit and a free members-only CME webcast on chronic opioid therapy.

Also featured is the Academy's "Chronic Pain Management and Opioid Misuse: A Public Health Concern" position paper.  

Other AAFP resources on pain management and opioid abuse include articles in American Family Physician, Family Practice Management and Annals of Family Medicine, as well as patient information from familydoctor.org on safe use, storage and disposal of opioid drugs(familydoctor.org).

Related AAFP News Coverage
Overcoming Barriers to Opioid Treatment Takes Center Stage
Presidential Commission, Annals of Family Medicine Study Call for Greater Access to MAT
(8/11/2017)

Should Medication-assisted Treatment Be Part of Primary Care?
(7/28/2017)

AMA Opioid Task Force Issues Safe Storage, Disposal Resource
AAFP Continues to Provide Members With Updated Opioid Assets
(4/10/2017)

Opioid Abuse Task Force: Increasing Access to Naloxone Saves Lives
(10/21/2015)