Provision of Naloxone Without a Prescription by California Pharmacists 2 Years After Legislation Implementation | Clinical Pharmacy and Pharmacology | JAMA | JAMA Network
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Research Letter
November 13, 2018

Provision of Naloxone Without a Prescription by California Pharmacists 2 Years After Legislation Implementation

Author Affiliations
  • 1Keck Graduate Institute School of Pharmacy, Claremont, California
  • 2Department of Family and Community Medicine, University of California, San Francisco
JAMA. 2018;320(18):1933-1934. doi:10.1001/jama.2018.12291

Layperson access to the opioid overdose reversal medication naloxone can reduce mortality.1,2 Legislation in California has allowed trained pharmacists to furnish naloxone without a physician’s prescription since January 27, 2016.3 Under a Board of Pharmacy protocol, naloxone is available by patient request or pharmacist suggestion. A furnishing pharmacist is required to screen and educate patients on opioid overdose prevention, recognition, and response. With patient consent, the pharmacist must notify the primary physician that naloxone was furnished. We estimated the availability of pharmacist-furnished naloxone 2 years after implementation.

The Office for Human Research Protections at Claremont Graduate University deemed this study nonhuman research. An anonymous telephone survey of a 20% random sample of California community pharmacies was conducted between January 23 and February 28, 2018. The California State Board of Pharmacy website was accessed on January 2, 2018, to identify all licensed California pharmacies, excluding pharmacies with canceled, revoked, probationary, or restricted licenses and hospital, correctional, or specialty pharmacies. Thirty trained interviewers posed as potential customers. Using a standardized script, they asked any pharmacy staff: “I heard that you can get naloxone from a pharmacy without a prescription from your doctor. Can I do that at your pharmacy?” If the response was affirmative, they asked what formulations were available, the cash price, and whether naloxone could be billed to insurance. Additional unsolicited information was recorded.