Physicians are able to prescribe naloxone (an opioid reversal drug) at the time they prescribe any opioid. This practice is called co-prescription. In some states, co-prescription is required by law. However, no such legislation mandating co-prescription exists in West Virginia. The WV DII is working with community partners to educate physicians and other prescribers as well as pharmacists on the importance of co-prescribing. In West Virginia, pharmacists are able to dispense naloxone without a prescription. Therefore, one model might also be dual dispensing meaning that when a patient picks up his/her opioid prescription at the pharmacy, the pharmacists counsel them and dispenses naloxone at the same time.  

 

At the WV DII, we are advocates for co-prescription or dispensing of naloxone at the time of the first opioid fill. Additionally, we believe that medication disposal kits (or bags) should be readily available free of charge at pharmacies and that pharmacists and physicians should be trained (often called academic detailing) and equipped to counsel patients on safe medication disposal. The WV DII is developing online tutorials, white papers, and briefs for lawmakers and associations, and academic detailing curriculum for health professionals on the importance of co-prescription/dispensing.  In addition, we are working with managed care organizations (or MCOs) and pharmacies throughout West Virginia to make medication disposal kits widely available at no cost. 

 

The Importance of Co-Prescribing/Dispensing

Although opioid prescribing rates have decreased due to tightened regulations and legislation at both the state and federal levels, [i]fatal and non-fatal overdoses have not significantly declined. This is especially true in West Virginia, the state with the highest 2018 Drug Overdose Death Rate. The CDC reported a significant increase in West Virginia’s rate of all opioid overdoses per 10,000 emergency department visits from January 2019 to January 2020. Research indicates that co-prescribing naloxone (an opioid overdose reversal drug) with an opioid is effective in decreasing non-fatal and fatal overdoses.

 

Danger at Home

Having naloxone at home can be key to preventing overdose. You may not overdose yourself, but a child in your home could accidentally ingest the medication—especially if it’s not stored properly.​