Naloxone Co-prescribing to Patients Receiving Prescription Opioids in the Medicare Part D Program, United States, 2016-2017

Abstract

Co-prescription of naloxone to patients receiving long-term opioid therapy provides an opportunity to expand naloxone access to patients at risk for opioid overdose.¹ The 2016 Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain recommends that clinicians consider co-prescribing naloxone to patients at increased overdose risk, such as those receiving daily opioid dosages of 50 morphine milligram equivalents (MME) or greater or those receiving benzodiazepines.² In 2017, Vermont mandated naloxone co-prescribing when patients receive opioids at dosages of 90 MME/d or greater or concomitant benzodiazepines,³ and Virginia mandated co-prescribing when patients receive opioids at dosages of 120 MME/d or greater or concomitant benzodiazepines.⁴ To date, the extent of naloxone co-prescribing is unknown. We used Medicare Part D data to compare national and state rates of naloxone co-prescribing in 2016-2017.