New law helps to fight opioid overdose in Tennessee

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Tennessee has a powerful new tool to fight opioid overdose with the passage of Public Chapter 596. This new law allows authorized pharmacists to dispense naloxone to a person at risk of opioid overdose or to a family member, friend or other person to assist someone at risk of an opiate-related overdose.

Public Chapter 596 sets up a statewide pharmacy practice agreement for what is called "opioid antagonist therapy." This law authorizes the Tennessee Department of Health's chief medical officer to enter the collaborative agreement with any willing licensed, practicing Tennessee pharmacist with proper training in opioid antagonist therapy. This agreement allows an authorized pharmacist to dispense an opioid antagonist such as naloxone to help prevent an opiate-related overdose. The pharmacist must provide proof of completing an opioid antagonist training program within the past two years before he or she can enter into the agreement to dispense naloxone.

"Administering naloxone can prevent death in many opioid overdoses by reversing the life-threatening effects of opioids almost immediately, allowing time, and this is critical, for the person to reach further medical treatment," said Tennessee Health Commissioner John Dreyzehner, MD, MPH. "This 'overdose antidote' can save lives and give more people a second chance at recovery."

Once under the collaborative practice agreement found on the TDH website, pharmacists will need to take an opioid antagonist training course. Individuals such as 'good Samaritans' picking up naloxone will also need instruction on how to administer it, and can either receive that from the dispensing pharmacist or find it online at www.tn.gov/health/article/naloxone-overdose-information-steps.

Public Chapter 596 was sponsored in the Tennessee General Assembly by Sen. Doug Overbey and Rep. Bryan Terry, and was strongly supported by the Tennessee Pharmacists Association.

"The Tennessee Pharmacists Association greatly appreciates the continued commitment from the Tennessee General Assembly, the Tennessee Department of Health and the Tennessee Department of Mental Health and Substance Abuse Services to pursue new strategies to prevent deaths due to opioid medication overdoses," said Micah Cost, PharmD, MS, executive director of the Tennessee Pharmacists Association. "This legislation will allow our pharmacists to serve patients in a more integrated capacity by providing increased access to essential care and life-saving medications. Through innovative approaches like this law, our state will continue to move closer toward meaningful recovery from prescription drug addiction."

"We are grateful for the opportunity to work with pharmacists across the state to empower more people to save lives," said TDH Chief Medical Officer David Reagan, MD, PhD. "Naloxone counseling should be a part of almost every opioid treatment course. This new law will empower pharmacists and their patients to assure safer prescribing and Good Samaritan opportunities."

In recent years, Tennessee has taken other significant steps to make naloxone available by removing civil liability, allowing prescribers to dispense the medication to third parties, and removing minor criminal penalties to first-time abusers who use the drug to reverse an overdose. However, Public Chapter 596 is more significant because it reduces barriers to give the general public access to the drug. A participating pharmacist can now educate and dispense naloxone along with opioids for naive users or can dispense it to family members who do not have time and/or funds to schedule a doctor's visit and then follow up by filling the prescription.

Drug overdose is now one of the top causes of death in Tennessee, claiming 1,263 lives in 2014. The CDC reports that for every overdose death in the U.S., a person taking opioids on average will overdose nine times. While overdose deaths can occur anytime, the most high-risk individuals are those using escalating doses of drugs and those using a combination of drugs such as opioids and benzodiazepines.

Learn more about naloxone at www.tn.gov/health/topic/information-for-naloxone.

Substance abuse is treatable and preventable. For information on treatment services, please visit www.tn.gov/behavioral-health/section/substance-abuse-services.

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