Local Pharmacy Promotes Naloxone to Save Lives on Overdose Awareness Day

Today is Overdose Awareness Day. This annual awareness day aims to reduce the stigma of drug-related overdose, prevent overdose-related death, and remember loved ones injured or lost to overdose.

Opioid-related overdoses and overdose fatalities are a growing epidemic in the United States and in San Diego. Opioids, including prescription opioid pain relievers and heroin, killed more than 28,000 people in the U.S. in 2014 alone. Home naloxone decreases overdose-related fatalities. Naloxone is an antidote to opioids and when given, reverses the effects of opioid overdose immediately. California and some other states have expanded access to home naloxone through pharmacist prescribing and dispensing.

Naloxone on Overdose Awareness DayThe Pharmacists Clinic is committed to saving lives by offering naloxone to patients. We offer overdose education and home naloxone kits to all patients who have a personal opioid overdose risk or a loved one at risk. Some of the risk factors for overdose are: history of overdose, history of opioid misuse or abuse, chronic prescription opioid use with complex medical problems, or taking long-acting opioids. Patients can choose to get naloxone to use at home as an injection, nasal spray, or auto-injection device. Our clinical pharmacist, Dr. Sally Rafie, will review the signs of an overdose, how to respond, and how to administer naloxone in case of emergency with each patient.

According to Dr. Rafie, “many patients underestimate their risk of opioid overdose or that of their loved ones. My goal is for my patients to have this available just in case. There’s no judgment or consequence to keeping this life-saving medicine on hand in case of emergency.” Anyone can book a quick appointment and walk out of the pharmacy equipped with a naloxone kit.

If you take opioids, here are some tips to help ensure you and your loved ones are safe:

  • Do not mix opioids with alcohol, other pain medications, anxiety medications, sleep medications, or street drugs. Mixing opioids with other substances is a leading cause of opioid injury and death. Talk to your doctor and pharmacist about other meds you are taking, and let them know if you have any changes in your meds.
  • Keep out of reach from children, other people, and pets. This medication can hurt people if taken by accident.
  • Get rid of any opioid medications that you no longer need.  The safest way to get rid of unused meds is by taking them to a drop off location. If you are unable to take them to one of these places, you should flush them down the toilet or the sink to prevent others from taking them accidentally.
  • Talk to your doctor about carrying naloxone (Narcan) with you in case of emergency. You will need someone else to give you naloxone, so tell your friends or family members where you keep it and how to use it. In an overdose, naloxone can reverse opioid side effects and save your life.
  • Take only as prescribed. Taking more than your doctor told you can lead to injury and in some cases, death. If you feel that your medication is not meeting your pain needs, talk to your doctor to discuss other options that may work better for you.
  • Do not drive or use heavy machinery after you have taken opioids until your doctor says that it is safe. Opioids can cause confusion and sleepiness, which can affect how well you do these activities.
  • Talk to your doctor if you have been taking opioids for a long time and you think that you no longer need them. Your body can get used to the medication. Your doctor may help you prevent withdrawal symptoms such as anxiety, sweats, trouble sleeping, loss of appetite, nausea, and fatigue.

For more information:

Hormonal Birth Control Now Available Directly At Pharmacies in California

Like our neighboring state to the north, pharmacists in California can now prescribe and dispense birth control directly to women.  Now this warrants a happy dance!  Women now have another choice in how they get their birth control.  They can either go see their primary care provider, Ob/Gyn, family planning clinic, or go straight to the pharmacy.  At the pharmacy, women will have their choice of birth control pills, patch, ring, or injection.  All thanks to a state law passed back in 2013.  So why the delay?  It took 2 and 1/2 years to develop and approve the protocol because of the multiple rounds of revisions.

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Is this safe?  What about the pap smear?  A pelvic examination and a pap smear are not necessary to initiate hormonal birth control.  They are important for other health reasons.  Women will need to complete a health history questionnaire and have their blood pressure taken at the pharmacy.  This helps the pharmacist figure out which methods of birth control are safe.  If the pharmacist finds something concerning in your health history or if you want a long-acting birth control device like the implant or IUDs, then you’ll be referred to a provider who can help with that.  Ultimately, the goal is to improve access to medications where there is a public health benefit.  After the visit, the pharmacist will send a note to your primary care physician to fill them in — unless you don’t want the pharmacist to do that of course.

Interested in getting your birth control directly from your pharmacist?  Give them a call first to find out if they are providing this service.  Just because pharmacists CAN provide this service doesn’t mean they WILL.  California pharmacists want to participate but they are worried about time constraints at the pharmacy that prevent them from taking the time to do this.  Over time, more and more pharmacists will provide this service.  When you call the pharmacy, ask when would be a good time to come in for this service.  Pharmacies have “rush hours” and the pharmacist will be able to give you more time if you  come in when it’s slower.  Some pharmacies may even make appointments for this service.  In California, women of any age can access this service from a participating pharmacist.  No age minimums and no ID checks.  This service is completely confidential and no information can be shared with your parents or anyone else!

What’s this going to cost me?  If you go to the pharmacist for your birth control visit and fill your prescription, the prescription costs will be covered by your insurance the same as if it was written by a different provider.  Unfortunately, insurance companies aren’t paying pharmacists for the visit like they pay physicians and the long list of others who can provide birth control, including nurse practitioners, physician assistants, nurse midwives, and even nurses.  So you may have to pay out of pocket for the visit and submit the receipt to your insurance company and hope they reimburse you (if you try this, please let us know if this works or not!).

Is this a good idea?  This is an enormous step forward in increasing access to birth control.  Hopefully women will appreciate having more choices in where to get birth control.  Next steps?  Ideally more states will pass similar laws expanding access with pharmacist prescribing — Tennessee is already moving forward with legislation and many other states are considering it.  There is also growing support for over-the-counter birth control pills.  

Want to consult with Dr. Sally Rafie, PharmD, BCPS about your birth control and get a prescription?  Fill out the contact form and let her know how to reach you.

Will Pharmacists Give You Birth Control Without a Prescription? The Survey Says…

For those who may have been following this blog since its inception, you may recall that I was conducting a research project with Dr. Rafie last year. We conducted a survey study to gauge pharmacists’ attitudes towards a recent California law that will allow pharmacists to provide hormonal birth control directly to women without a prescription.

Kevin Vu ACCP MeetingI recently had the opportunity to present my findings at the American College of Clinical Pharmacy (ACCP) Global Conference on Clinical Pharmacy. Held in San Francisco, this conference was a gathering of pharmacists from around the world and provided a platform for those in the field to network, share and exchange ideas, as well as learn the latest developments in the pharmacy world.

So what were some of the findings I presented from our survey of community pharmacists in California?

  1. Only half of the pharmacists were familiar with the new law that allows direct pharmacy access to birth control.
  2. Most pharmacists (about 70%) said they were very likely or somewhat likely to participate in this new service. It’s promising to see all the excitement and interest within the pharmacy community around this new authority! We are hopeful that this will manifest as lots of pharmacists actually providing the service when it becomes available. We don’t want women to have to call or visit multiple pharmacies before they find a pharmacist who can help them.
  3. The main reasons for why pharmacists said they wanted to participate in this service was that patients would benefit from improved access and that this service would foster increased use of birth control. This increased use and consistent use could eventually translate to fewer unplanned pregnancies, which currently stands at half (51%) of all pregnancies that occur in the U.S. every year.
  4. Nearly all (98%) of pharmacists feel comfortable intervening if they notice a patient had a drug interaction with their birth control. This is encouraging given that pharmacists are often seen as the final safety check when it comes to medications, ensuring that patients are getting medications that are safe and effective.

As the service is on the brink of being rolled out, I’m glad to say that some California pharmacists have already begun participating in training programs specifically aimed to help prepare them for participation in this service. With time, the hope is that patients and pharmacists across the country will recognize the value of direct access to birth control, and that other states will follow and adopt a similar authority.


KevinVuPharmDCandidate

About the Author: Kevin Vu is a fourth-year pharmacy student at the University of California San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences.