Davis Corey S, Burris Scott, Beletsky Leo, Binswanger Ingrid
a Network for Public Health Law , Los Angeles , California , USA.
b Beasley School of Law, Temple University , Philadelphia , Pennsylvania , USA.
Subst Abus. 2016 Oct-Dec;37(4):498-500. doi: 10.1080/08897077.2016.1238431.
The opioid overdose epidemic claims the lives of tens of thousands of Americans every year. Opioid overdose is reversible by the administration of naloxone, a pure antagonist now available in formulations specifically designed and labeled for layperson use. Despite broad support for layperson access to naloxone from professional organizations, health officials, and clinical experts, qualitative studies suggest that some providers have concerns about legal risks associated with naloxone prescribing, particularly co-prescribing naloxone to pain patients. Such concerns are unfounded. The legal risk associated with prescribing naloxone is no higher than that associated with any other medication and is lower than many. 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. In this large and increasing number of states, the liability risk of prescribing or dispensing naloxone in good faith to a patient at risk of overdose (or, in states where such prescribing is permitted, to an associate of such a patient) is either extremely low or absent entirely. Where a prescriber determines, in his or her clinical judgment, that a patient is at risk of overdose, co-prescribing naloxone is a reasonable and prudent clinical and legal decision. No clinician should fail or refuse to issue such a prescription based on liability concerns.
阿片类药物过量流行每年夺走成千上万美国人的生命。通过注射纳洛酮可逆转阿片类药物过量，纳洛酮是一种纯拮抗剂，现在有专门为非专业人士使用设计和标注的制剂。尽管专业组织、卫生官员和临床专家广泛支持非专业人士获取纳洛酮，但定性研究表明，一些医疗服务提供者担心与开具纳洛酮相关的法律风险，尤其是给疼痛患者联合开具纳洛酮。这种担忧是没有根据的。开具纳洛酮相关的法律风险并不高于与任何其他药物相关的风险，且低于许多药物。此外，大多数州的法律为开具或配发纳洛酮的医疗服务提供者提供明确的法律保护，在许多情况下，这种保护延伸至开给朋友、家庭成员及其他人的处方。在越来越多的这类州中，真诚地给有过量风险的患者开具或配发纳洛酮（或者，在允许此类开具的州，给此类患者的同伴）的责任风险极低或完全不存在。在开具者根据其临床判断确定患者有过量风险的情况下，联合开具纳洛酮是合理且审慎的临床和法律决定。任何临床医生都不应基于责任担忧而不开具或拒绝开具此类处方。
