Opioid Prescriptions Declined, Naloxone Prescriptions Increased Since 2017 in Arkansas, ACHI Analysis Finds

In response to the opioid epidemic, policies to expand access to the overdose-reversal drug naloxone have emerged across the country. In recent years, Arkansas has made progress on this front by requiring prescribers in 2021 to co-prescribe naloxone in certain situations, such as when an individual has a high-dose opioid prescription. In 2017, licensed pharmacists became authorized to order, dispense, and administer naloxone to individuals without a prescription under a state protocol.

For the third year since 2020, the Arkansas Center for Health Improvement analyzed the naloxone and opioid prescriptions for Medicaid and commercially insured beneficiaries to inform and understand the trends and patterns of naloxone prescriptions in Arkansas. Data for the analysis were from the Arkansas All-Payer Claims Database, part of the Arkansas Healthcare Transparency Initiative, for state fiscal years (FY) 2017 to 2021. The results of our analyses are contained in an updated data brief.

Key findings:

• Among Medicaid and commercially insured beneficiaries, the number of individuals receiving opioid prescriptions decreased from FY 2017 to FY 2021, while the number of individuals receiving naloxone prescriptions increased.
• The percentages of individuals who received both naloxone and high-dose opioid prescriptions increased from FY 2017 to FY 2021.
  • Among individuals with opioid prescriptions of 50 or more MME per day, the rate of naloxone co-prescribing increased from 0.05% in FY 2017 to 6.23% in FY 2021.
  • Among individuals with opioid prescriptions of 90 or more MME per day, the rate of naloxone co-prescribing increased from 0.12% in FY 2017 to 10.59% in FY 2021.
• The rate of naloxone prescriptions dispensed per number of individuals receiving high-dose opioid prescriptions improved from FY 2020 to FY 2021.
  • In FY 2021, one naloxone prescription was dispensed for every 16 individuals with opioid prescriptions of 50 or more MME per day, an improvement from one naloxone prescription per 22 individuals in FY 2020.
  • In FY 2021, one naloxone prescription was dispensed for every nine individuals with opioid prescriptions of 90 or more MME per day, an improvement from one naloxone prescription per 14 individuals in FY 2020.
• In FY 2021, pharmacists authorized 1,714 out of 5,506 naloxone prescriptions under state protocol, or 31.1%. This is a decrease from 46.3% in FY 2020.