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TN Makes Naloxone Available without Rx

Tennessee has passed legislation that will allow authorized pharmacists statewide to dispense naloxone, the opioid overdose antidote, without a prescription.

Sponsored by Sen. Doug Overbey, R-Maryville, and Rep. Bryan Terry, R-Murfreesboro, Public Chapter 596 sets up a statewide pharmacy practice agreement for what is called "opioid antagonist therapy," the state said. The 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.

Any pharmacist who enters the agreement can then dispense naloxone, without an individual prescription, to a person at risk of opioid overdose or to a family member, friend or other person with the intention of preventing an opiate-related overdose.

To be part of the collaborative agreement, a pharmacist must provide proof of completing an opioid antagonist training program within the past two years, per the law.

The new law opens the door for wider access to naloxone, which public health officials say has the potential to dramatically reduce the number of opoid overdose deaths. Knox County alone had 170 drug-related deaths in 2015, most of them opioid-related. In 2014, 1,263 Tennesseans died of drug overdoses — more than were killed in motor vehicle accidents. 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.

A few chain pharmacies, such as CVS and Fred's, already had separate agreements with the state to dispense naloxone, and some independent pharmacists also had made arrangements to make it available.

But the new law means any pharmacist willing to enter the agreement and complete the training can give the antidote to anyone who wants to use it to prevent an overdose death — including those who may not have the time or the funds to visit a doctor for a prescription. Tennessee already has passed "Good Samaritan" laws that protect people who give the drug in good faith to prevent an overdose death from liability, and that prevent people who call E-911 when someone is overdosing from being charged themselves with a drug-related crime.

Individuals picking up naloxone as 'good Samaritans' can be trained on its administration from the dispensing pharmacist or online at Cost of the drug ranges from around $75 for a generic nasal spray to about $4,000 for the brand-name drug with an autoinjector kit.

More than half of states now allow pharmacists to dispense naloxone without a prescription.

"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 Dr. John Dreyzehner. "This 'overdose antidote' can save lives and give more people a second chance at recovery."

The Tennessee Pharmacists Association strongly supported the legislation, said Micah Cost, the group's executive director.

"Through innovative approaches like this law, our state will continue to move closer toward meaningful recovery from prescription drug addiction," Cost said.

Tennessee recently received federal grants to help increase treatment options, especially for the uninsured. Earlier this year, the Tennessee Association of Mental Health Organizations released a report that said only 4 percent of Tennessee adults who needed addiction treatment in 2014 received services.

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