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How Can Standing Orders be used in Drug Overdose Prevention?

posted on Fri, Mar 11 2016 11:14 am by The Network

Many states have taken action to make naloxone, a medication that reverses the effects of opioid drugs, more available to the public as well as first responders. The laws regarding the prescribing and dispensing of naloxone vary by state, but most states have made efforts to make it easier for medical professionals to prescribe naloxone and for laypeople to receive naloxone for use in overdose reversal. Naloxone program participants have reported reversing more than 26,000 overdoses using the drug. For more general information about naloxone and naloxone law, see the Network’s Legal Interventions to Reduce Overdose Mortality.

A standing order is one strategy for making naloxone access easier. A standing order can be thought of as a non-patient-specific prescription that permits naloxone to be dispensed to any person who meets criteria specified by the prescriber, as opposed to a named patient. For example, a standing order from a physician might state that workers at a particular drug clinic who have gone through naloxone training may distribute naloxone to those who come to the clinic.

Maine is one of the 27 states that permits naloxone to be dispensed via standing order. The Network was recently contacted by a nonprofit employee who asked for help finding the specific language of Maine’s standing order law. The Network located the law – Title 22, Subtitle 2, Part 5, Chapter 556-A – which governs the distribution and use of naloxone, and provided it to the requestor.

Under the law, a health care professional “may directly or by standing order prescribe naloxone hydrochloride to an individual at risk of experiencing an opioid-related drug overdose.” Additionally, a person who has been prescribed naloxone can give the naloxone to a member of their immediate family, “to administer to the individual if the family member believes in good faith that the individual is experiencing an opioid-related drug overdose.”

Further, a physician may prescribe naloxone, directly or by standing order, to an immediate family member or friend of an individual at risk of opioid overdose (or “another person in a position to assist the individual” in case of an overdose). That person is permitted under the law to administer to the individual in the case of an overdose.

The law further states that law enforcement officers and municipal firefighters may administer naloxone if the officer or firefighter has received medical training.

Finally, under the law, acting under standing orders from a licensed health care professional permitted to prescribe naloxone, a public health agency that provides services to populations at high risk for a drug overdose may establish an overdose prevention program. That program may store and dispense naloxone, provided the program does not charge for the services.

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