Prescribing Naloxone and Pharmacy Access to Naloxone in MA

This page includes information on the policies, procedures, and best practices that are relevant to prescribing naloxone as well as information on pharmacy access to naloxone rescue kits.

 

How to Get a Naloxone from a Pharmacy:

The MA Board of Registration in Pharmacy has issued a policy statement regarding naloxone dispensing via standing order. All MA Pharmacies have a standing order to dispense naloxone and are required to stock naloxone. A standing order enables any person at risk of experiencing an overdose, or those in a position to assist individuals at risk of experiencing an opioid overdose (friends, family and community members) to get a naloxone rescue kit with or without a prescription. The customer’s insurance will be billed, and a co-pay or full price will be charged depending on the insurance coverage.

Those who are most likely to experience or be exposed to an overdose should consider carrying naloxone. Members of the community who wish to acquire naloxone from a pharmacy can request a naloxone rescue kit from their pharmacist with or without a prescription from a provider. Insurance coverage varies for privately insured individuals and co-pay costs differ per plan.

MassHealth covers the cost of a naloxone rescue kit for its members.

 

How to Prescribe Naloxone to Patients:

The MA Board of Registration in Medicine issued a statement that endorses prescribing Naloxone to the family and friends of people at risk of experiencing an opioid overdose.

Prescribers may consider incorporating the following information regarding the prescription of naloxone to high risk patients and families into their practice:

Prescribe to Prevent.org  provides resources involving training materials, naloxone formulations, printable prescriptions, and on-line continuing education and training for prescribers and pharmacists

For guidance and reference, please reference the following sample prescribing policies:

Boston Healthcare for the Homeless Sample Prescribing Policy:

Boston Medical Center Sample Prescribing Policy

 

Establishing Policies and Procedures for On-site Emergency Response:

The Bureau of Substance Addiction Services has published a practice guidance on integrating opioid overdose prevention into treatment settings for treatment providers, that contains guidance on addressing opioid overdose that may be helpful in a variety of settings.

Health and mental health care agencies that have clients at risk of experiencing an opioid overdose on-site should establish policies and procedures regarding overdose response and naloxone administration, and should consider the following example policies for guidance:

Example Policy provided by Boston Health Care for the Homeless

Example Policy provided by Stanley Street Treatment and Resources (SSTAR)

 

Approved Pharmacist Training Resources:

Training programs on opioid antagonists that have been approved by the commissioner include:

Prescribe to Prevent: Overdose Education and Naloxone Rescue Kits for Prescribers and Pharmacists

End Mass Overdose: Pharmacist and Pharmacy Intern Naloxone Training

Drug Store News: “Navigating Naloxone’s use in the community: Addressing education, engagement and distribution

Pharmacist’s Letter

CVS Pharmacy Training available to employees through the company’s intranet

Walgreen’s Training available to employees through the company’s intranet

If your pharmacy would like to use a different training than the approved trainings listed above, please contact Michelle Chan at the Board of Registration in Pharmacy at (617) 973-0814 and Michelle.Chan@state.ma.us

 

MA Naloxone Prescribing Laws:

Prescribers and pharmacists should become familiar with the laws and regulations concerning the prescription, dispensing, and utilization of naloxone.

The following Massachusetts laws aim to prevent fatal opioid overdose by requiring training guidance to pharmacists on dispensing naloxone and counseling patients, making prescriptions available to anyone at risk for experiencing or witnessing an an opioid overdose, and protecting those who carry and utilize naloxone to save the lives of others:

Chapter 94C Section 19

“(d) Naloxone or other opioid antagonist may lawfully be prescribed and dispensed to a person at risk of experiencing an opiate-related overdose or a family member, friend or other person in a position to assist a person at risk of experiencing an opiate-related overdose. For purposes of this chapter and chapter 112, any such prescription shall be regarded as being issued for a legitimate medical purpose in the usual course of professional practice.”

Chapter 94C Section 19B

“(b) Notwithstanding any general or special law to the contrary, a licensed pharmacist may dispense an opioid antagonist in accordance with written, standardized procedures or protocols developed by an actively practicing physician registered with the commissioner to distribute or dispense a controlled substance in the course of professional practice pursuant to section 7, if such procedures or protocols are filed at the pharmacist's place of practice and with the board of registration in pharmacy before implementation.

(c) Before dispensing an opioid antagonist pursuant to this section, a pharmacist shall complete a training program approved by the commissioner on opioid antagonists. The training program shall include, but not be limited to, proper documentation and quality assurance.”

Chapter 94C Section 34A

“(e) A person acting in good faith may receive a naloxone prescription, possess naloxone and administer naloxone to an individual appearing to experience an opiate-related overdose.”