The policy landscape for naloxone distribution in four states highly impacted by fatal opioid overdoses

• Published in: Drug and alcohol dependence reports 2023-03, Vol.6, p.100126, Article 100126
• Main Authors: Bohler, Robert M., Freeman, Patricia R., Villani, Jennifer, Hunt, Tim, Linas, Beth S., Walley, Alexander Y., Green, Traci C., Lofwall, Michelle R., Bridden, Carly, Frazier, Lisa A., Fanucchi, Laura C., Talbert, Jeffery C., Chandler, Redonna
• Format: Article
• Language: English
• Subjects: Healing communities study; Naloxone; Naloxone access laws; Opioid policy; Overdose prevention
• ISSN: 2772-7246; 2772-7246
• DOI: 10.1016/j.dadr.2022.100126

•Policies varied between four states highly impacted by opioid overdose fatalities.•Policies were dynamic and moved towards greater naloxone access.•These four states have developed innovative but different policy responses.•Naloxone research and practice should consider the policy landscape of a state. Expanding access to naloxone is one of the most impactful interventions in decreasing opioid-related mortality. However, state distribution rates of naloxone are insufficient to meet community need. The current study sought to better understand this gap by focusing on state policies that may facilitate or impede naloxone distribution in four states highly impacted by fatal opioid overdoses – Kentucky, Massachusetts, New York, and Ohio. We provide a descriptive analysis of the policy landscape impacting naloxone distribution through pharmacy and community channels in the four states participating in the HEALing Communities Study (HCS). Publicly available data and the expertise of the research team were used to describe each state's naloxone access laws (NALs), Medicaid coverage of naloxone, and community overdose education and naloxone distribution infrastructure. Data presented in this study represent the most current policy landscape through September 2022. Variation exists between specific components of the NALs of each state, the structure of Medicaid coverage of naloxone, and the community distribution infrastructure networks. Massachusetts and New York have a statewide standing order, but other states use different strategies short of a statewide standing order to expand access to naloxone. Quantity limits specific to naloxone may limit access to Medicaid beneficiaries in some states. States participating in the HCS have developed innovative but different mechanisms to ensure naloxone access. Policies were dynamic and moved towards greater access. Research should consider the policy landscape in the implementation and sustainability of interventions as well as the analysis of outcomes.