Introduction
Since 2017, a total of 10 states have mandated naloxone coprescribing intended to
prevent fatal opioid overdoses. This study aims to assess the association between
naloxone coprescribing/offering mandates and opioid-involved overdose deaths on the
basis of the opioid type.
Methods
Data on overdose deaths from 1999 to 2020 came from the National Center for Health
Statistics CDC WONDER Online Database. This study examined deaths stratified by illicit/synthetic
opioids and prescription/treatment opioids. Difference-in-difference negative binomial
regression models estimated average marginal effects and 95% CIs. Covariates included
opioid dispensing rate, Good Samaritan law, pharmacy-based naloxone access law, mandatory
use of prescription drug monitoring program, and recreational cannabis dispensaries.
Data collection and analysis were conducted in 2022.
Results
Ten states implemented naloxone coprescribing/offering mandates during the period.
Coprescribing/offering mandates significantly reduced the number of prescription/treatment
overdose deaths by 8.61 per state per quarter (95% CI= –15.13, –2.09), a 16% reduction
from the counterfactual estimates. Coprescribing/offering mandates did not significantly
impact illicit/synthetic overdose deaths (average marginal effect=0.32; 95% CI= –18.27,
18.91).
Conclusions
Coprescribing/offering mandates prevent overdose deaths for its target population,
individuals using prescription/treatment opioids. These mandates do not appear to
impact populations using illicit/synthetic opioids; thus, expanded efforts are needed
to reach these individuals.
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Publication history
Published online: December 08, 2022
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© 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
