HHS: Co-Prescribe Naloxone with Opioids

The US Department of Health and Human Services has recommended that clinicians should “strongly consider” prescribing naloxone in patients at an elevated risk of opioid overdose.

“We have begun to see some encouraging signs in our response to the opioid crisis, but we know that more work is required to fully reverse the decades-long epidemic. Co-prescribing naloxone when a patient is considered to be at high risk of an overdose, is an essential element of our national effort to reduce overdose deaths and should be practiced widely,” said Admiral Brett P Giroir, MD, assistant secretary for health and senior advisor for opioid policy.

Overall, naloxone should be prescribed to:

Patients prescribed opioids who receive them at a dosage of 50 morphine milligram equivalents (MME) per day or greater, have respiratory conditions, have been prescribed benzodiazepines, or have a non-opioid substance use disorder.

Patients at high risk for opioid overdose who use heroin, illicit synthetic opioids, or misuse prescription opioids, use other illicit drugs, are receiving treatment for opioid use disorder, or have a history of opioid misuse and were recently released from incarceration or other controlled settings.

“Promoting the targeted availability and distribution of overdose-reversing drugs is one of the five pillars of HHS’s comprehensive, science-based strategy for the opioid epidemic,” said Health and Human Services Secretary Alex Azar. “This new guidance reflects our commitment to ensuring those who need overdose-reversing drugs have them and provides practical steps that clinicians, patients, and the public can take to reduce the risk of an overdose.”

—Michael Potts

Reference:

HHS recommends prescribing or co-prescribing naloxone to patients at high risk for an opioid overdose [press release]. December 19, 2018. https://www.hhs.gov/about/news/2018/12/19/hhs-recommends-prescribing-or-co-prescribing-naloxone-to-patients-at-high-risk-for-an-opioid-overdose.html.