Naloxone prescriptions have fallen significantly during the pandemic, and people on Medicare or with commercial insurance have experienced a more significant decrease in access to naloxone compared to those on Medicaid or cash payment, according to research published in JAMA.
The study's authors wrote that the findings show an urgent gap in necessary access to medication for people on Medicare and commercial health insurance.
Nonfatal opioid overdose visits to emergency departments more than doubled during the pandemic, but few patients who overdosed on opioids received naloxone prescriptions on discharge, despite the fact that studies show increased access to naloxone can reduce fatal overdoses.
The study, conducted by researchers from Beth Israel Deaconess Medical Center in Boston and published May 14, analyzed trends in filled naloxone prescriptions during the COVID-19 pandemic in the U.S. and compared those numbers with trends in opioid prescriptions and overall prescriptions. The researchers studied the period between May 2019 and December 2020.
They found that the average number of people filling naloxone prescriptions per week abruptly declined by 26 percent in March 2020. That exceeded the decline in people filling prescriptions for overall medications, which was 14.8 percent, and for opioid medications, which was 8.7 percent.
Since March 2020, there has been no statistically significant recovery in naloxone prescriptions, indicating the number of people filling naloxone prescriptions has remained low throughout the pandemic, the authors wrote.
People with Medicare and commercial health insurance had a statistically significant decline in filling naloxone prescriptions at the start of the pandemic, while patients with Medicaid or cash payment had no statistically significant decline. This indicates that people on Medicare and commercial insurance are experiencing decreased access to naloxone during the pandemic.
The decline in naloxone prescriptions isn't explained by a decline in opioid prescriptions, where naloxone coprescription is recommended, as opioid prescriptions only decreased by 8.7 percent in March.
"Continuing to increase naloxone distribution in densely populated areas and via mail order and delivery through community-based organizations could help to mitigate some of the reductions in naloxone distribution via pharmacies and could reduce some of the increases in fatal opioid overdoses during the COVID-19 pandemic," they wrote.
Limitations of the study included that researchers could only account for naloxone prescriptions at retail pharmacies and not naloxone kits distributed from other sources.
Find the full study here.