Chains Step up Efforts Against Drug Abuse


Naloxone can now be dispensed without a prescription in 33 states and Washington, DC. Here's how two big pharmacy chains are making the livesaving opioid antagonist more accessible.

As 2016 drew to a close, Walgreens stepped up its efforts to combat drug abuse in the community. The national pharmacy chain announced late in December that it had expanded the availability of naloxone, without a prescription, to Mississippi, Missouri, and Washington, D.C. According to Walgreens, this brings the total to 33 states, plus the District of Columbia, where the livesaving opioid antagonist can be dispensed without a prescription.

Naloxone can now be furnished without a prescription in about 5,800 Walgreens pharmacies nationwide, said
Walgreens in a written release.

CVS Health has also stepped up its efforts to “prevent and address prescription drug abuse in the communities we serve.” With efforts recently expanded to Nevada, “naloxone is available without a prescription at CVS pharmacy locations in 37 states,” a CVS spokesperson told Drug Topics.

“By making naloxone available without a prescription, we are making it easier for families and caregivers to help their loved ones by having it on hand in case it’s needed,” said Rick Gates, BSPharm, Walgreens Group Vice President of Pharmacy.

“CVS Health has worked to increase access to naloxone, a safe and effective antidote to opioid overdose, because we believe that by expanding the availability of this medication, we can save more lives and give people a chance to get the help they need for recovery, “ said the CVS spokesperson.

The chains’ expansion of their naloxone programs comes on the heels of a meeting in early December between NACDS and the Department of Health and Human Services where naloxone was discussed. According to National Association of Chain Drug Stores spokesman Chris Krese, the chain pharmacy organization conveyed the message that “chain pharmacy supports the adoption of laws and policies that authorize pharmacists to dispense naloxone without a patient-specific prescription from a prescriber, such as via statewide protocols. This approach serves to make naloxone more accessible for overdose prevention purposes.”

In a 2015 letter to the National Alliance for Model State Drug Laws, NACDS urged the alliance to “promote state laws and policies that eliminate administrative barriers to pharmacist-provided naloxone. Pharmacists are recognized medication experts who are well-situated in communities to improve access to naloxone…. community pharmacists are the most readily accessible healthcare providers for some individuals.”

The chain pharmacy organization also urged the Alliance to “pursue liability protections for all health care providers, including pharmacists, who prescribe and dispense naloxone in good faith. Such liability protections can help to eliminate the fears of health care providers who may otherwise be wary of providing naloxone because of liability concerns.” In the letter, NACDS noted that recent laws have addressed this issue.

CVS explained that in each state where naloxone is available without a prescription, the chain “has entered into a collaborative practice agreement or standing order agreement with a prescriber to dispense naloxone, for patients. As such, the patient does not need to present an individual prescription for naloxone, but it remains a prescription medication that is dispensed at the pharmacy counter. These are similar to the agreements we have in place that allow pharmacists to provide flu shots to patients without an individual prescription.” In some states, according to information provided by NACDS, the collaborative agreement is through the Board of Pharmacy.

In addition to complying with state protocols, individual training is important for pharmacists who are involved in dispensing naloxone without a prescription. At both Walgreens and CVS, such pharmacists undergo a training program, as well as completing any training an individual state may require. CVS has developed training in coordination with the Boston University School of Medicine. “Following the training, CVS pharmacists who dispense naloxone are able to counsel patients and caregivers on a  number of important points, including identifying an overdose, calling 911, giving rescue breaths, administering naloxone, and remaining with patients until help arrives,” said the CVS spokesperson. “When naloxone is dispensed, training is provided [to patients] on how to use the medication, including steps to contact 911, as naloxone is not a substitute for medical care, and anyone who is administered the drug should seek immediate medical attention,” said Phil Caruso, a spokesman for Walgreens.

In early 2017, Walgreens plans to further expand the naloxone program to Arkansas, California, Connecticut, Iowa, Kentucky, Nevada, and Tennessee. “We’re committed to making the medication easier to obtain and will continue to make the medication available state-by-state where regulations allow,” Caruso said. CVS Health agrees. “We support the expanded availability of naloxone and are exploring opportunities in other states.”  

Kathleen Gannon Longo is a Contributing Editor.

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