Traditionally, a prescriber could only prescribe medication to a person with whom he or she has a patient-provider relationship. However, this arrangement is not practical in the context of naloxone because 1) many of the people at high risk for overdose do not regularly see a prescriber, and 2) naloxone cannot be self-administered when someone is experiencing an overdose; thus, bystanders need to be able to obtain naloxone in order to administer the lifesaving drug.

The Naloxone Access Law (NC General Statute 90-12.7) aims to reduce barriers to getting naloxone into the hands of those who need it by encouraging the adoption and use of standing orders.

The Naloxone Access Law allows medical providers to

  • issue standing orders that authorize the dispensing of naloxone to any person who meets the criteria that the law specifies, even if they are not traditional patients of that provider, and
  • issue standing orders to organizations to distribute naloxone to any person who meets the criteria that the law specifies, even if they are not traditional patients of that provider.

 There are two types of naloxone standing orders in North Carolina:

  • Dispensing Standing Orders
  • Distribution Standing Orders

 What is the difference between dispensing and distribution?

“Dispensing” describes how an individual or a distributing organization comes to possess naloxone is “dispensed” to them by a licensed healthcare professional such as a pharmacist.

“Distribution” comes into play after an organization has naloxone in its possession—after naloxone has been “dispensed” to it. The organization can then “distribute” the naloxone out into the community.

Dispensing Distribution
  • Requires an individual patient prescription or meeting the criteria of the statewide standing order or a local standing order
  • Is performed by a licensed healthcare professional (as listed in table #2)
  • Generally, involves payment via insurance, insurance co-pay, or cash, but not required
  • No specific patient order is required, although the organization needs a distribution standing order
  • Is performed by an agent of the organization covered under the distribution order, who need not be a licensed healthcare professional
  • Generally, involves no payment

For a more detailed explanation of dispensing standing orders and distribution standing orders, or for guidance on how to create a naloxone distribution program, please see the North Carolina Naloxone Distribution Toolkit.