PRACTICAL GUIDANCE: NALOXONE DISTRIBUTION IN THE SUBSTANCE USE DISORDER (SUD) TREATMENT SETTING UTILIZING INSURANCE AND PRESCRIPTION BENEFITS
Substance use disorder (SUD) treatment facilities are uniquely positioned to reduce overdoses by coordinating access to naloxone and providing overdose education to individuals who use drugs. For these reasons, accessibility to naloxone and education about its use are critical for clients in SUD and medical care.
Pursuant to Chapter 285 of the Acts of 2024, Substance Use Disorder (SUD) Treatment Facilities will be required to educate certain patients and residents on the use of naloxone and dispense not less than two doses of naloxone upon discharge effective July 1, 2025. In preparation for this new statutory requirement, this guidance has been created to assist SUD Programs in familiarizing themselves with obtaining naloxone for patient dispensing at discharge.
Standing Order for Dispensing Naloxone Rescue Kits
M.G.L. c. 94C, § 19B, as amended by section 32 of chapter 208 of the Acts of 2018, An Act for Prevention and Access to Appropriate Care and Treatment of Addiction, expanded access to naloxone through a statewide standing order. This authorizes licensed pharmacists to dispense naloxone rescue kits to anyone in a position to assist a person at risk of experiencing an opioid-related overdose or at risk of experiencing an opioid-related overdose.
Naloxone is available as a prescription and over-the-counter (OTC) medication. It can be obtained at a pharmacy, hospital, emergency department, certain retail settings, and community-based overdose prevention programs. The sustainable and most supportive approach is utilizing pharmacy benefits, also known as prescription drug coverage. This allows naloxone to be billed and reimbursed through a person’s insurance at a pharmacy. SUD Treatment Programs will be expected to coordinate pharmacy benefits when dispensing naloxone to patients and residents at discharge.
If you receive BSAS funding…
All BSAS Licensed and Approved programs must establish policies and procedures to ensure patients and residents have at least two naloxone rescue kits, either through direct prescribing or through a Qualified Service Organization Agreement (QSOA) in partnership with a local pharmacy, upon discharge from the facility and educate on its use.
You must develop a written policy and procedure regarding naloxone distribution.
You must work with the pharmacy to obtain naloxone.
You must train program staff regarding the distribution of naloxone to your clients.
You must make an offer for naloxone within 24 hours of admission to your program.
You must obtain a release of information for the pharmacy where the naloxone is ordered.
You must obtain a Consent to Bill Insurance, or Insurance Consent, for naloxone and share this information with the pharmacy.
You must educate the patient or resident on overdose prevention, recognition, and response.
You must document at discharge that the client is leaving with two doses of naloxone in hand.
