Observational studyAnnals of internal medicine2016
Nonrandomized Intervention Study of Naloxone Coprescription for Primary Care Patients Receiving Long-Term Opioid Therapy for Pain.
Observational study in Annals of internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
89 citing papers in PubMed, 3 syntheses or guidelines pooled it, 190 citations in OpenAlex.
- CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2022Guideline
- Evidence for state, community and systems-level prevention strategies to address the opioid crisis.Drug and alcohol dependence · 2019Pooled it
- Acceptability and feasibility of naloxone prescribing in primary care settings: A systematic review.Preventive medicine · 2018Pooled it
- Recruiting a National Sample of First Response Agencies to Participate in an Overdose Prevention Research Project: Randomized Controlled Trial and Feasibility Study.JMIR formative research · 2026Trial
- Impact of a Multicomponent Educational Intervention on Community Pharmacy-Based Naloxone Services Implementation: A Pragmatic Randomized Controlled Trial.The Annals of pharmacotherapy · 2023Trial
- Naloxone Co-Dispensing with Opioids: a Cluster Randomized Pragmatic Trial.Journal of general internal medicine · 2022Trial
- Trial
- The association between naloxone distribution, buprenorphine treatment and retention and incident high-risk opioid prescribing with opioid overdose death in Kentucky, Massachusetts, New York and Ohio, United States: An exploratory community-level cohort study of data from the HEALing Communities Study.Addiction (Abingdon, England) · 2026Observational
- Exploratory associations between co-occurring opioid and alcohol use disorders and GIP/GLP-1 receptor agonist treatment.Communications medicine · 2026Article
- Complementary services improve recovery outcomes among college students with alcohol or other drug related use disorders.Scientific reports · 2026Article
- Nudges for Naloxone in the Opioid Epidemic.Journal of general internal medicine · 2026Article
- Naloxone Co-prescription in Chronic Opioid Therapy: Benefits, Pitfalls, and Lessons Learned.Cureus · 2025Article
- If It Were Enabling, Where's the Evidence? Applying Moral Hazard and Risk Compensation Theories to Community Naloxone Distribution and Other "Safety Net" Public Health Interventions.Journal of studies on alcohol and drugs · 2025Article
- Article
- A Pilot Assessment of Caregivers' and Patients' Perception of Naloxone Coprescribing in a Pediatric Sickle Cell Population.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Development of the barriers to opioid access scale among individuals with chronic pain.Exploratory research in clinical and social pharmacy · 2025Article
- Opioid Use Disorders: Prevention, Diagnosis, and Treatment Strategies to Mitigate Addiction Risks.Current drug safety · 2025Review
- Overdose Education and Naloxone Distribution: An Evidence-Based Practice That Warrants Course Correcting.American journal of public health · 2025Article
- An evidence-based digital prescription opioid safety toolkit for national dissemination: co-design and user testing.Frontiers in digital health · 2025Article
- The contribution of nonmedical opioid use to healthcare encounters for opioid overdose and use disorders among long-term users with metastatic cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundUnintentional overdose involving opioid analgesics is a leading cause of injury-related death in the United States.
objectiveTo evaluate the feasibility and effect of implementing naloxone prescription to patients prescribed opioids for chronic pain.
design2-year nonrandomized intervention study.
setting6 safety-net primary care clinics in San Francisco, California.
participants1985 adults receiving long-term opioid therapy for pain.
interventionProviders and clinic staff were trained and supported in naloxone prescribing. MEASUREMENTS: Outcomes were proportion of patients prescribed naloxone, opioid-related emergency department (ED) visits, and prescribed opioid dose based on chart review.
results38.2% of 1985 patients receiving long-term opioids were prescribed naloxone. Patients prescribed higher doses of opioids and with an opioid-related ED visit in the past 12 months were independently more likely to be prescribed naloxone. Patients who received a naloxone prescription had 47% fewer opioid-related ED visits per month in the 6 months after receipt of the prescription (incidence rate ratio [IRR], 0.53 [95% CI, 0.34 to 0.83]; P = 0.005) and 63% fewer visits after 1 year (IRR, 0.37 [CI, 0.22 to 0.64]; P < 0.001) compared with patients who did not receive naloxone. There was no net change over time in opioid dose among those who received naloxone and those who did not (IRR, 1.03 [CI, 0.91 to 1.27]; P = 0.61). LIMITATION: Results are observational and may not be generalizable beyond safety-net settings.
conclusionNaloxone can be coprescribed to primary care patients prescribed opioids for pain. When advised to offer naloxone to all patients receiving opioids, providers may prioritize those with established risk factors. Providing naloxone in primary care settings may have ancillary benefits, such as reducing opioid-related adverse events. PRIMARY FUNDING SOURCE: National Institutes of Health.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.