Davis Corey, Carr Derek
J Am Pharm Assoc (2003). 2017 Mar-Apr;57(2S):S180-S184. doi: 10.1016/j.japh.2016.11.007. Epub 2017 Jan 7.
The opioid overdose epidemic continues to claim the lives of tens of thousands of Americans every year. Increased access to the opioid antagonist naloxone can reduce opioid-related morbidity and mortality. In this commentary, we describe several recent legal innovations designed to encourage pharmacists to ensure that naloxone is available when and where it is needed, and dispel some common misconceptions regarding potential legal risks associated with pharmacy naloxone dispensing.
Data are drawn from state laws and regulations, as catalogued by the Westlaw database.
States have rapidly modified law and policy to increase layperson access to naloxone. As of August 2016, 44 states permit naloxone to be prescribed for administration to a person with whom the prescriber does not have a prescriber-patient relationship. Forty-two states permit naloxone to be dispensed via a non-patient-specific mechanism such as a standing or protocol order, and 5 states permit some pharmacists to prescribe naloxone on their own authority. The liability risk associated with naloxone dispensing is no higher than any other medication, and may be lower than some. However, to encourage the prescription and dispensing of naloxone, 36 states provide additional protection from civil liability for pharmacy naloxone dispensing, and 32 states provide protection from potential criminal action. Naloxone access laws in 31 states explicitly provide that dispensing naloxone as permitted by law cannot be grounds for disciplinary action by the state board of pharmacy or similar entity.
Pharmacists are key members of the health care team and are uniquely situated to reduce potential opioid overdose risk. Pharmacists should be aware of and utilize innovative state laws designed to increase access to naloxone.
阿片类药物过量流行每年继续导致数万名美国人死亡。增加阿片类拮抗剂纳洛酮的可及性可降低与阿片类药物相关的发病率和死亡率。在本评论中，我们描述了几项近期的法律创新举措，旨在鼓励药剂师确保纳洛酮在需要时和需要的地点可得，并消除一些关于药剂师分发纳洛酮潜在法律风险的常见误解。
数据取自韦斯特劳法律数据库编目的州法律法规。
各州已迅速修改法律和政策，以增加非专业人员获取纳洛酮的机会。截至2016年8月，44个州允许为开具处方者与患者没有医患关系的人开具纳洛酮用于给药。42个州允许通过非特定患者机制（如常规或协议订单）分发纳洛酮，5个州允许一些药剂师自行开具纳洛酮。与分发纳洛酮相关的责任风险不高于任何其他药物，甚至可能低于某些药物。然而，为鼓励纳洛酮的处方开具和分发，36个州为药剂师分发纳洛酮提供了额外的民事责任保护，32个州提供了免受潜在刑事诉讼的保护。31个州的纳洛酮获取法律明确规定，依法分发纳洛酮不能成为州药房委员会或类似实体采取纪律处分的理由。
药剂师是医疗团队的关键成员，在降低潜在阿片类药物过量风险方面具有独特地位。药剂师应了解并利用旨在增加纳洛酮可及性的创新性州法律。
