Opioids: Standing Order for Naloxone

Naloxone is a medication that can reverse an opioid overdose. It can be given as an injection or as a nasal spray. The Statewide Standing Order for Naloxone allows pharmacists in Wisconsin to sell naloxone without a health care provider's prescription to anyone at risk of an opioid overdose, as well as their family, friends, and anyone who may witness an opioid overdose.

 

 

Statewide Standing Order

The Statewide Standing Order for Naloxone is for pharmacies interested in dispensing naloxone using the prescription order signed by Jonathan Meiman, M.D., a chief medical officer for DHS.

The Pharmacy Society of Wisconsin has developed an implementation webinar and a list of frequently asked questions for pharmacies interested in dispensing naloxone under the statewide standing order.

All pharmacists dispensing naloxone under the statewide standing order must complete at least one hour of training.  The Pharmacy Society of Wisconsin recommends its training, which has been tailored specifically for Wisconsin pharmacists.

To get access, complete the following steps:

  1.  Visit http://www.pswi.org/Education/Online-CE.
  2. The link will take you to a list of courses. Click on the link for “Naloxone Statewide Standing Order Training.”
  3. To register, you must login with your PSW account. If you do not have a login, you will be given the opportunity to register when you click “Please login here to register for the event.”
  4. Once logged in/registered, navigate back to the Naloxone Statewide Standing Order Training.

Note: Pharmacies reporting dispensing data will receive an auto-generated email at the end of the quarter with a direct link to the data reporting page in REDCap. This link will be specific to your pharmacy because it is directly connected to your NPI number. Data reporting is no longer done through the link above.

If you are a pharmacist and have questions about the standing order, email DHS.

Local Prescriber Standing Order

The local prescriber standing order is for pharmacies interested in using their own medical provider to issue a prescription order for naloxone. This should be used as a template or a guide.

Local Prescriber Naloxone Standing Order for Pharmacists, F-01802A (Word)

In order to be eligible for a local prescriber standing order, all pharmacists dispensing naloxone under the standing order must complete at least one hour of training.  The training should include, at a minimum, identification of patients at risk for opioid overdose, administration of intranasal and intramuscular naloxone, patient education and counseling, naloxone precautions and contraindications, and medication storage. The Pharmacy Society of Wisconsin recommends its training, which has been tailored specifically for Wisconsin pharmacists.

To get access, complete the following steps:

  1. Visit http://www.pswi.org/Education/Online-CE.
  2. The link will take you to a list of courses. Click on the link for “Naloxone Statewide Standing Order Training.”
  3. To register, you must login with your PSW account. If you do not have a login, you will be given the opportunity to register when you click “Please login here to register for the event.”
  4. Once logged in/registered, navigate back to the Naloxone Statewide Standing Order Training.

If you are a pharmacist and have questions about the standing order, email DHS.

Pharmacist and patient materials

Use the following materials to implement a standing order for naloxone. These materials are available in English and Spanish.

Tools for pharmacists

  • Post this sign in a highly visible location: Naloxone Available Poster, P-01577
    • Tip: If company policy does not allow you to post this in a highly visible location, use this as a tool to start a discrete conversation about getting naloxone for patients who are prescribed opioids or who may be at increased risk of overdose.
  • Use this guide when assembling naloxone kits: Naloxone Toolkit Assembly, P-01570
  • Provide this screening checklist to customers who pick up a prescription for opioids: Screening Checklist, P-01572
    • Tip: If you cannot have the patient fill this out while waiting for prescriptions to be filled, use it as a tool to have an informed conversation with a patient about factors that increase risk of opioid overdose.
  • Post a copy of this red flags checklist in the area where staff fill prescriptions: Red Flags: Are you about to fill a prescription for opioids? P-01574
    • Tip: Use this as a tool during a patient consult when dispensing opioids to a patient.

Tools for patients

 

Note for prescribers: Prescribers are encouraged to talk about naloxone with any patient who is prescribed opioids, especially those at increased risk of overdose, including:

  • Patients with history of overdose.
  • Patients prescribed higher than 50 MME/daily.
  • Patients with clinical depression.
  • Patients with evidence of increased risk of overdose (e.g. family history, certain co-prescriptions or health conditions, behaviors, PDMP, etc.).

Co-prescribing is a helpful way to protect patients on long-term opioid therapy or high doses of opioids. Health care providers have the option to co-prescribe naloxone for patients who are prescribed opioids or who have health conditions that put them at increased risk of overdose.​

 

Related information
Last Revised: January 27, 2020