Area pharmacy professors advocate ramping up opioid antidote prescriptions

WEST FARGO-North Dakota pharmacists should be more active in prescribing the opioid antidote naloxone, according to instructors at a continuing education event here Friday.During the North Dakota State University School of Pharmacy forum, two ass...
FILE PHOTO: A bag of heroin seized by police sits next to Narcan, a drug for treating overdoses. (Steve Kuchera/Duluth News Tribune)

WEST FARGO-North Dakota pharmacists should be more active in prescribing the opioid antidote naloxone, according to instructors at a continuing education event here Friday.

During the North Dakota State University School of Pharmacy forum, two associate professors said pharmacists should consider prescribing naloxone to people at risk for opioid overdose, even if the patients don't ask.

"You have the authority, the right and, I would argue, the obligation" to offer naloxone in those cases, said Elizabeth Skoy, associate pharmacy professor.

A 2015 law gives pharmacists in North Dakota the authority to prescribe naloxone without a doctor's approval, provided they've gone through certified training.

According to the state Board of Pharmacy website, there are about a dozen naloxone-certified pharmacies in Fargo, one in West Fargo, and about a half dozen in Grand Forks.

However, NDSU associate pharmacy professor Amy Werremeyer said she doesn't think pharmacists are dispensing the antidote as often as the opioid crisis requires.

"So that's one of the purposes, to try to ramp that up even more so that naloxone is in the places where it needs to be, when people need it," Werremeyer said.

Statistics provided by Fargo Cass Public Health show naloxone was administered 99 times by F-M Ambulance in 2016, and 16 times by the Fargo Fire Department during the last half of 2016.

Community Health Educator Melissa Markegard said there were 31 opioid overdose deaths in Cass County in 2016, and 14 such deaths through the first half of 2017.

"We are on course to either meet or exceed that death toll, which you know, we want to be going down," Markegard said.

SouthPointe Pharmacy, along 32nd Ave. S. in Fargo, is authorized to prescribe naloxone.

Owner Dave Olig has several signs posted advertising that fact.

"We haven't had a request (for naloxone), not one," he said, "and we dispense, like many others, thousands of doses (of opioids)."

Pharmacists there do offer naloxone as an option to all new patients receiving opioids, if they indicate they may be at risk for misuse.

"It's safe, there's no downside," Olig said.

Warning signs for opioid abuse include patients who see multiple doctors, ask for early refills and only pay cash for prescriptions.

Pharmacists can try to identify those at highest risk by using an opioid triage tool and checking the state's Prescription Drug Monitoring Program, or PDMP, Skoy said.

Beyond prescribing naloxone, a pharmacist's other role in opioid abuse prevention is education.

That includes informing patients about the option of partially filling their prescription and explaining that opioids are meant to make pain tolerable, not non-existent, she said.