Prescription and Pharmacy Access to Naloxone Rescue Kits

Table of Contents
 - MA Naloxone Prescribing Laws
 - Naloxone (Narcan) kit from a Pharmacy
 - Pharmacy Standing Order
 - Approved Training Resources
 - How to set up a pharmacy standing order
 - How to prescribe Naloxone (Narcan) to patients
 - How to set up a standing order for on-site emergency response
 - Training and Technical Assistance for BSAS-Funded Treatment Programs
 - Feedback

MA Naloxone Prescribing Laws:

Chapter 94C Section 19B

“(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 19d

“(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”

Chapter 94C Section 34A- 911 Good Samaritan Law including protection for possession and administration of naloxone

“(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.”

Naloxone (Narcan) kit from a Pharmacy:

There are two ways to access a naloxone rescue kit from a pharmacy:

  1.  Obtain a prescription from your prescriber and take it to a pharmacy that stocks naloxone.  Many pharmacies are able to fill naloxone prescriptions or can order what they need.

  2.  Go directly to a pharmacy with a naloxone standing order and request a naloxone kit.  For pharmacies with naloxone standing orders, a prescription is not needed.

MassHealth Coverage:

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

Pharmacy Standing Order:

In Massachusetts, when a pharmacy has an established standing order for naloxone, customers do not need a prescription to be dispensed a naloxone rescue kit. The customer’s insurance will be billed and a co-pay or full price will be charged depending on the insurance coverage.

-Pharmacies with a standing order

-Access Check list

The list of pharmacies with standing orders is generated by the Massachusetts Board of Registration in Pharmacy. Pharmacies that establish a standing order for naloxone must notify the Massachusetts Board of Registration in Pharmacy by sending a copy via email to naloxonestandingorders@massmail.state.ma.us.

For more information see the “DPH Board of Registration in Pharmacy Dispensing of Naloxone by Standing Order” link below.

Approved 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

If your pharmacy would like to use a different training than the approved trainings listed above, please contact Kelly Barnes at the Board of Registration in Pharmacy at (617) 973-0953 and kelly.a.barnes01@state.ma.us.

How to set up a pharmacy standing order:

For pharmacies that would like to offer Naloxone Rescue Kits to customers, go to:

DPH Board of Registration in Pharmacy Dispensing of Naloxone by Standing Order webpage

Prescribe to Prevent.org includes resources such as the following:

  • Stocking
  • Billing
  • Patient education videos
  • Naloxone kit materials
  • On-line continuing education and training for prescribers and pharmacists

How to prescribe Naloxone (Narcan) to patients:

For physicians, nurse practitioners, and physicians assistants who are interested in prescribing naloxone to high risk patients and families

Prescribe to Prevent.org Includes resources such as the following:

  • Training materials including videos
  • Naloxone Formulations
  • Printable Prescriptions
  • On-line continuing education and training for prescribers and pharmacists

Boston Healthcare for the Homeless Sample Prescribing Policy:  Prescribing of Nasal Naloxone Rescue Kits to patients to Reverse Opioid Overdose. Such a prescribing policy is not required. However, this example may provide guidance.

Boston Medical Center Sample Prescribing Policy

Statement from the MA Board of Registration in Medicine that endorses prescribing Naloxone to family/friends of people at risk

How to set up a standing order for on-site emergency response:

Health and mental health care agencies that have clients at risk of experiencing an opioid overdose on-site may want to establish a standing order for on-site emergency response including naloxone administration.

Example Policy provided by Boston Health Care for the Homeless

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

Practice Guidance: This Practice Guidance was written for Bureau of Substance Abuse Services funded providers. It contains guidance on addressing opioid overdose that may be helpful in a variety of settings. 

Training and Technical Assistance for BSAS-Funded Treatment Programs:

Please contact The Center for Social Innovation

Cheryl Gagne, (617) 467-6014 x253, cgagne@center4si.com

Feedback

For feedback, questions, or to report an issue related to pharmacy access to naloxone please contact Sarah Ruiz at Sarah.Ruiz@state.ma.us