What do I need to do to begin dispensing naloxone under the State Health Director’s standing order?

By signing the statewide standing order for naloxone, North Carolina’s State Health Director has given pharmacists licensed in North Carolina automatic authority to dispense naloxone to persons meeting the criteria of the standing order. There are no particular steps your pharmacy needs to take in order to activate its ability to use the standing order. We do ask that your pharmacy notifies the Division of Public Health through the form on this website if your pharmacy decides to dispense naloxone under the statewide standing order.

 

Why is my pharmacy being asked to let the Division of Public Health know it is planning to dispense under the statewide standing order by filling out a form on the NaloxoneSaves.org website?

Letting the Division of Public Health know that your pharmacy plans to dispense naloxone under the State Health Director’s standing order will enable us to keep track of what locations are distributing naloxone through the standing order. Using this information, a list of pharmacies will be generated and posted on NaloxoneSaves.org to enable those seeking naloxone through the standing order to obtain it more easily. We will also be able to contact your pharmacy in the case of changes to the standing order.

Please note that filling out this form is not a prerequisite to your pharmacy being able to dispense under the statewide standing order. Your pharmacy may dispense under the standing order whether or not it has notified the Division of Public Health of its plans to do so. As explained above, however, we do ask that your pharmacy notify us so that we may publicize its location and stay in communication with your pharmacy about the standing order.

 

Can I initiate a conversation with a patient about naloxone even though the standing order says that the patient must “voluntarily request” naloxone?

Yes. This language was meant to deter rote dispensing of naloxone through the standing order to patients who have prescriptions for opiates without individual consideration of the person’s need for naloxone. If a pharmacist identifies a patient whom the pharmacist believes may be at risk for overdose, that pharmacist may initiate a conversation with the patient to determine whether he or she would like to receive naloxone. At that point,  if the patient indicates a desire to obtain naloxone, he or she would be considered to have “voluntarily requested” the drug under the standing order.

What type of patient education is required under the standing order?

Patients who receive naloxone under the standing order of the State Health Director should receive education regarding

  • the risk factors of overdose
  • signs of an overdose
  • overdose response steps
  • the use of naloxone

Pharmacies may use patient education materials found on this website below or they may use their own patient education materials.

Will my pharmacy be asked to share any information about its naloxone dispensing with the Division of Public Health?

Yes. The NC Division of Public Health (DPH) monitors the opioid overdose epidemic in North Carolina and efforts to prevent overdose deaths. In order to save lives, one of DPH’s top priorities is to broaden access to naloxone, including through pharmacies.

To that end, DPH would like to receive data from pharmacies that are dispensing naloxone under the statewide standing order regarding the amount of naloxone being dispensed, where and when, and other simple related questions. DPH will work with pharmacy representatives to determine what data is already available or easily collected without overly burdening pharmacies.

How do I process a prescription using the State Health Director’s standing order?

Treat the standing order as you would any other prescription. You will go through all of the usual steps you would go through clinically and administratively in dispensing any other prescription. Record keeping, documentation, billing, and labeling requirements all remain the same as other prescriptions. The only difference is that the State Health Director will be listed as the prescriber for the drug.

Who pays for naloxone dispensed under the State Health Director’s standing order?

Naloxone dispensed under the standing order is paid for the same way that other prescriptions are paid for—either by the patient’s insurance or by the patient paying out-of-pocket for the drug if it is not covered by the patient’s insurance or if the patient does not have insurance.

Will an insurance company pay for naloxone that is dispensed to their insured if it is intended to be used on someone else, rather than to be used to prevent an overdose by the insured himself/herself?

Insurance companies may decide not to pay for naloxone that is being purchased by their insured to protect someone else who is not their insured. This is a question to pursue with the insurance company.

I see there is a map of pharmacies offering naloxone on the NaloxoneSaves.org website. Can my pharmacy be included on that map if it is dispensing under a standing order other than the State Health Director’s standing order?

Absolutely. We would like the citizens of North Carolina to know all of their options regarding where to purchase naloxone under a standing order–whether it is the State Health Director’s standing order or another standing order. Pharmacies that notify us they are participating in the State Health Director’s standing order will automatically be added to the map on this website. Pharmacies that are dispensing under a separate standing order and want to be included on the map should send a message to naloxonesaves@gmail.com with their pharmacy name, physical address, phone number (for consumers), and the county where it is located.