Data Watch: Naloxone Prescription in Response to the Opioid Epidemic in Northwest Arkansas

In response to the opioid epidemic, policies to expand access to the overdose-reversal drug naloxone have emerged across the country. In Arkansas, Act 651 of 2021, which went into effect on July 28, 2021, requires a co-prescription of naloxone in certain situations, including when a dosage for an opioid prescription is 50 or more morphine milligram equivalents (MME) per day. In 2017, licensed pharmacists became authorized to dispense naloxone to individuals without a prescription under a state protocol.

Since 2020, ACHI has conducted annual analyses of naloxone and opioid prescriptions for Medicaid and commercially insured enrollees. Data for the analyses are from the Arkansas All-Payer Claims Database, part of the Arkansas Healthcare Transparency Initiative, for state fiscal years (FY) 2017 to 2023. We have updated our statewide analysis and conducted a separate analysis for Northwest Arkansas, defined for our purposes as Benton, Carroll, Madison, and Washington counties. Data for 2017 are omitted from our analysis for some measures due to small numbers.

Key findings for Northwest Arkansas:

• From FY 2022 to FY 2023, there was a 10.2% increase in naloxone prescription fills and a 12.8% increase in Northwest Arkansas enrollees who filled a naloxone prescription.
• The number of Northwest Arkansas enrollees who filled opioid prescriptions decreased overall from FY 2018 to FY 2023, while the number of enrollees who filled naloxone prescriptions increased.
• Among enrollees who filled opioid prescriptions of 50 or more MME per day, the rate of fills from naloxone co-prescribing increased from 1.98% in FY 2018 to 18.43% in FY 2023.
• Among enrollees who filled opioid prescriptions of 90 or more MME per day, the rate of fills from naloxone co-prescribing increased from 4.42% in FY 2018 to 23.83% in FY 2023.
• From FY 2022 to FY 2023, there was an 8.2% increase in opioid prescription fills among all Northwest Arkansas enrollees.
• The ratio of naloxone prescription fills to the number of Northwest Arkansas enrollees receiving high-dose opioid prescriptions remained stable from FY 2022 to FY 2023.
• In FY 2023, one naloxone prescription was filled for every five enrollees with opioid prescriptions of 50 or more MME per day, the same ratio seen in FY 2022.
• In FY 2023, one naloxone prescription was filled for every four enrollees with opioid prescriptions of 90 or more MME per day, the same ratio seen in FY 2022.
• In FY 2023, 421 out of 4,100 naloxone prescription fills, or 10.3%, were initiated by pharmacists.