Implementing a Scalable Statewide Emergency Department Take-Home Naloxone Program

Clinicians caring for patients in the emergency department (ED) have the unique opportunity to identify people at risk for opioid overdose and provide life-saving harm reduction interventions, such as naloxone; however, previous studies suggest only ~1% of patients fill a naloxone prescription after an ED visit for opioid or heroin overdose. Barriers such as transportation to pharmacies and insurance copays can prevent patients from filling naloxone prescriptions. Therefore, there is a strong rationale for ensuring patients receive naloxone prior to ED discharge. Despite growing consensus that ED-based interventions, such as naloxone distribution, are impactful and cost-effective, these treatment and harm reduction strategies have failed to get traction at most EDs. Major obstacles to adoption of these practices are the education, training, and resources required to effectively introduce and sustain these quality improvement efforts.

The Opioid Prescribing Engagement Network (OPEN) and Michigan Emergency Department Improvement Collaborative (MEDIC) have partnered to implement a take-home naloxone program with 31 EDs to increase access to naloxone and prevent future overdose deaths across Michigan. The team has distributed more than 4,800 kits to high-risk patients and demonstrated that the implementation of a statewide ED-based take-home naloxone program is a feasible and sustainable harm reduction intervention. Presenters will share the lessons learned and the tools and materials created.