ArticleCureus2025
Naloxone Prescribing Among Long-Term Opioid-Prescribed Patients: Disparities and Opportunities.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionOpioids have a risk for opioid-induced respiratory depression (OIRD) that can be fatal. Naloxone has been proven to reverse opioid effects. However, co-prescribing of naloxone with opioids is underutilized. Through the query of a national outpatient healthcare dataset, the study aims to discern differences in co-prescribing naloxone to provide a framework of education to formulate recommendations on naloxone prescribing.
methodsA retrospective review of a de-identified, national outpatient healthcare dataset was analyzed for patients with a pain-provoking condition and receipt of ≥3 opioid prescriptions. Demographics, medical history, and prescribing data were used to identify high-risk patients for OIRD along with co-prescribing of naloxone between 2015 and 2021 and analysis between 2022 and 2024.
resultsAmong 181,964 patients, 1807 (1%) received a naloxone prescription of the total cohort. Examining co-prescribing for high-risk patients only, 107 (3.3%) were receiving >50 MME/day opioids, 468 (2.6%) were concomitantly prescribed benzodiazepines, and 273 (7.8%) who had opioid use disorder (OUD) history received naloxone prescriptions. Upon logistic regression, the likelihood of naloxone co-prescribing among patients with a history of OUD showed an odds ratio (OR) of 6.63 (95% CI 5.76-7.63; p>0.001), and that among patients concomitantly prescribed benzodiazepines showed an OR of 2.76 (95% CI 2.47-3.09; p>0.001). Hispanic patients (OR 0.87; 95% CI 0.76-0.98; p=0.27) and those uninsured or with unknown insurance (OR 0.65; 95% CI 0.51-0.81; p<0.001) were less likely to receive a naloxone prescription. Black (OR 1.30; 95% CI 1.15-1.47; p>0.001) and unknown race (OR 1.38; 95% CI 1.15-1.66; p=0.001) patients were more likely to receive naloxone prescriptions.
conclusionDespite recommendations that high-risk opioid-prescribed patients receive naloxone prescriptions, only a fraction are in receipt. There is variation among patient populations in co-prescribing, leaving opportunities to improve universal precautions that include naloxone co-prescribing to all high-risk patients for OIRD.
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