Naloxone prescription fills and use by patients treated for opioid use disorder by telehealth.

Background: It is unknown how many people in treatment for opioid use disorder (OUD) have naloxone, use naloxone, and what their perceptions and barriers to obtaining it are.
Methods: This was a survey of patients treated in a large telehealth OUD program. Between December 6, 2023 and January 6, 2024, all patients who had access to the program's phone app (n=17,899 individuals, of whom 12,887 were in active treatment), were invited to complete an anonymous online survey.
Results: There were 701 individuals who completed the survey. Nearly all patients (n=693, 99%) knew what naloxone is, and the majority (n=601, 86%) knew how to administer it. A quarter of these patients (n=177, 25%) reported either having naloxone used on themselves or using it on someone else. 161 patients (23%) reported taking a naloxone training course. Of patients who recalled receiving a prescription, 72% (n=382) filled the prescription, and 85% (n=321) reported that insurance paid for all or part of it. If filled, the naloxone was reported as used by 30 (8%) patients. If not filled, reasons were: already had it (n=55, 37%), did not think it was needed (n=54, 37%) or too expensive (n=36, 23%). Patients who reported knowing how to administer naloxone (OR 2.63 (95% CI 1.35-5.00) were more likely to fill the prescription.
Conclusions: Patients prescribed naloxone in a telehealth treatment program filled the prescription 72% of the time, and when it was filled, 8% used the naloxone. Education and cost policy changes may reduce barriers to obtaining naloxone.
Competing Interests: All authors were employed by Bicycle Health, Inc at the time of this research. Dr. Clear serves as an officer, and Dr. Clear and Ms. Burke have equity interest. To reduce bias, the research team, comprised of Ms. Burke, Ms. Miller and Dr. Weiner, worked largely independently of the rest of the group. The research team was supervised by Dr. Clear, who is the only company officer on this paper. Dr. Clear did not modify the study’s findings in any way but did provide input on the study design and approval of the final manuscript. Furthermore, no one else from Bicycle Health edited or reviewed this work beyond the four authors.
(© 2024 The Author(s).)