Narcan or Can't? Opioid Overdose Education for Patients with Cancer Pain

• Published in: Journal of pain and symptom management 2022-05, Vol.63 (5), p.873-874
• Main Authors: Afezolli, Debora, Austin, Vanessa DiMaria, Flemig, David, Easton, Eve, Tortu, Elizabeth, Scarborough, Beth
• Format: Article
• Language: English
• Subjects: Attitudes; Cancer; Chart reviews; Community pharmacists; Critical incidents; Drug overdose; Health education; Naloxone; Narcotics; Oncology; Opioids; Pain; Patients; Pharmacies; Pharmacy; Prescribing; Prescription drugs
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2022.02.068

1. Describe the available literature for naloxone use for patients using opioids for cancer pain 2. Identify some of the perceived barriers to prescribing and dispensing naloxone 3. Describe patient and provider attitudes after opioid overdose education and naloxone prescription Patients with cancer pain are often prescribed opioids, and these patients and their families are at risk of overdose. There is little guidance about when to offer naloxone (Narcan) to patients with cancer on opioid therapy. Additionally, providers worry that naloxone education is time consuming and may increase patients’ fear of opioid use. To assess patient and provider attitudes about naloxone education and prescription at a single-site outpatient supportive oncology practice. During a 3-month period, all new patients on opioids were offered naloxone education and prescription. If naloxone was prescribed, provider attitudes were surveyed at the initial visit, and patient attitudes were surveyed at a follow-up visit, by phone, or by electronic messaging. Naloxone prescribing rates were measured pre- and post-pilot via retrospective chart review. Naloxone dispense rates were obtained via pharmacy records. Pre-pilot, 68.7% (n = 44) of new patients were taking opioids; 4.5% (n = 2) were prescribed naloxone. Post-pilot, 66% (n = 63) of new patients were taking opioids; 66% (n = 42) were prescribed naloxone. 92% (n = 23) of responding providers reported education/prescribing took ≤5 minutes, and 100% reported either a positive (40%) or neutral (60%) impact on the patient encounter. 80.6% (n = 25) of responding patients reported no increased worry about opioid use, 67.7% (n = 21) felt safer with naloxone, and 96.7% rated the encounter as neutral (58%) or positive (38.7%). 88% (n = 37) of the naloxone prescriptions were dispensed, and 66.6% of patients (n = 16) paid