Perspectives from the Oregon board of Pharmacy NALOXONE and DRUG TAKE BACK: Perspectives from the Oregon board of Pharmacy Fiona Karbowicz, RPH, OBOP Pharmacist Consultant

Naloxone Prescribing Law 2016 HB 4124 A pharmacist may prescribe unit-of-use naloxone and the necessary supplies for administration to a person who: Conducts training…so that the person may possess and distribute it to “trainees” Successfully completes training…so that the person may possess and administer to an individual experiencing and overdose

Naloxone Prescribing Law An employee of a social services agency may administer to an individual a unit-of-use package of naloxone that was not distributed to the employee if: (a) The employee conducts or has successfully completed opiate overdose training; (b) The unit-of-use package of naloxone was distributed to another employee of the social services agency who conducts or has completed the opiate overdose training; and (c) The individual appears to be experiencing an opiate overdose For purposes of this section, “social services agency” includes, but is not limited to, homeless shelters and crisis centers.

INCREASE ACCESS TO NALOXONE!! The Take Home Message?? INCREASE ACCESS TO NALOXONE!!

Naloxone Prescribing Rules Board adopted a temp rule to expedite No additional RPH education required (such as a mandated CE, etc.) OHA developed a written training that RPH utilize to effectively train an individual seeking naloxone RPH can prescribe and dispense at that moment of contact

Screen Shot of the OHA Approved Written Training

RPH Prescribing Process Example: Person seeking naloxone presents to pharmacy counter RPH gives written pamphlet for person to review Person finishes reading the materials and RPH reviews the information with him/her. The pharmacist shall determine that the individual seeking naloxone demonstrates understanding of educational materials related to opioid overdose prevention, recognition, response, and the administration of naloxone.

RPH discusses dosage forms available and issues rx – see page 7 Pharmacy processes the rx Pharmacist counsels prior to releasing the completed rx RPH retains documentation

OBOP Rules – Newly Adopted Drug Take Back – OAR 855-041-1046 Collection receptacle CANNOT be located behind the pharmacy counter! Plan to remove the inner liner when the hauler arrives to pick it up Pharmacy staff cannot handle drugs collected Pharmacy cannot dispose of unwanted inventory in the receptacle Pharmacy cannot host a “Take Back Event” offsite and bring unwanted drugs back to their receptacles… Must work with local Law Enforcement

DEA Aggregate Production Quota (APQ) Defined as the total amount of “a controlled substance necessary to meet the estimated medical, scientific research, industrial, and export needs for the year and for the maintenance of reserve stocks” 2017 APQ for opiates is reduced by eliminating the 25% buffer from 2013-2016 (that had been in place to protect against medication shortages)

RESOURCES Board of Pharmacy Website Contact Board directly http://www.oregon.gov/pharmacy/Pages/index.aspx Contact Board directly Email: pharmacy.board@state.or.us

QUESTIONS? Fiona Karbowicz, R.Ph. OBOP Pharmacist Consultant Contact: Fiona Karbowicz, R.Ph. OBOP Pharmacist Consultant fiona.Karbowicz@state.or.us