Non-Patient Specific Dispensing

[princepharmd]

With the increase in states passing laws that allow for drugs like naloxone to be dispensed to non-specific patients, anonymous partner expedited therapy, and now NY passing a law to allow pharmacists to dispense HIV post-exposure prophylaxis to non-specific patients, I'm curious to what you all are seeing in your practice?

Do you find yourself commonly doing this? Do you feel odd about dispensing not knowing who the medication is really for? Finally, do you even feel comfortable dispensing opioid-reversal drugs to patients who could be using a drug like naloxone as a safety net to achieve higher highs?

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[RxPreceptor]

In NYS, I have yet to have anyone inquire about Naloxone Tx other than an ER worker. I am a bit conflicted with the situation in that Naloxone could give someone a false sense of immunity from overdosing on opioids since he/she has a safety net...might encourage one to experiment overdosing knowing he/she can be revived without consequences. On the other hand, seems like a good idea for accidental overdose (stupid teenager abuses a parent's meds, someone accidentally doubles up, infant/child gets into someone's meds, etc.).

 

[ldiot]

I too am yet to see naloxone even be dispensed which is odd considering I see 24323809742 subutex scripts a day

 

[zelman]

I've never had a customer willing to pay cash price for one of these. Once I tell them that the anonymous sex partner isn't covered by their insurance, they just leave.

 

[gwarm01]

It's hard to imagine someone pushing their heroin dose even higher because they have some naloxone, but I guess drug addicts do a lot of unpredictable and dangerous things.

I wouldn't feel conflicted dispensing it for the same reason I wouldn't mind giving out needles. It's a net positive for public health and I try not to involve moral judgement.

 

[RxPreceptor]

Must be some USP Heroin if the person can rely that the dose is going to be the same on a weight or volume measure (humor). The whole syringes/needle dispensing is completely different; there's huge financial benefits from preventing costly blood borne illness treatment say vs. preventing 1 heroin addict from dying prematurely (cost of rehab & chance in returning to be a productive member of society). Of course, naloxone isn't just meant for heroin addicts though...

 

[rph3664]

chance in returning to be a productive member of society

For heroin addicts, that's so close to zero it isn't even worth discussing.

 

[princepharmd]

Yeah, from what I've been hearing it seems that "what if" stories just do not outweigh the overall benefit to public health. I mean a story recently dropped about imodium being linked to drug abuse, but I don't think we will see that pulled off shelves lol