Limitations of this study include that the findings may be relevant for solely 1 state, such as in the case of state-specific barriers to keeping naloxone in stock that we are unaware of. However, it is unclear why that would be the case, and it is more likely that similar barriers are pervasive. Additionally, repeat phone calls, which we did not follow up with, may have yielded more pharmacies with naloxone availability. However, due to the stigma associated with obtaining naloxone, it may be that patients will not make multiple calls either—highlighting how important real-time availability is.
Conclusion
Urgent solutions are needed to address the epidemic of deaths from opioid overdoses. Naloxone availability is an important tool for reducing these deaths, resulting in numerous state laws attempting to increase access. Despite this, there are persistent barriers to patients receiving naloxone, including a lack of same-day availability at pharmacies. Our results suggest that this underexplored barrier is widespread. Improving both availability and accessibility of naloxone may include legislative policy solutions as well as patient-oriented solutions, such as distribution in clinics and hospitals when opioid prescriptions are first written. Further research should be conducted to determine patient-centered, effective solutions that can improve outcomes.
Corresponding author: Eileen Barrett, MD, MPH, Department of Internal Medicine, University of New Mexico; ebarrett@salud.unm.edu.
