Naloxone Distribution in Texas 2018-2022: A State-Wide Program for Opioid Overdose Prevention

Abstract

Abstract Background Opioid-related overdose mortality has steadily increased throughout the United States. The distribution of the opioid agonist naloxone has been a critical first-line prevention strategy for preventing opioid overdose deaths. The continued geographic and demographic spread of opioid overdose poses significant challenges for targeting naloxone distribution to those most likely to witness and respond to an overdose. To achieve equity and impact, state-level naloxone distribution programs must account for numerous factors that shape the disproportionate burden of overdose mortality, including poor access to health services, rural location, cost, and responsiveness to shifting geographical trends. Case Presentation: This paper describes a large state-level, naloxone distribution initiative in Texas that aims to overcome these distribution challenges. Between 2018 and 2022, this centralized naloxone program distributed 576,360 doses of naloxone to individuals, agencies, and organizations. Naloxone went to 87.6% of Texas’ counties that reported overdoses. Fulfilled orders spanned sectors (Individuals, Community Organizations, Law Enforcement, Health Services, EMS/Fire, Schools, and Government Agencies) in mental health services shortage areas (91.3%), rural locations (4.7%), and Hispanic majority (21.6%) communities. Conclusions A centralized, statewide naloxone distribution program, like the one in Texas described in this paper, offers numerous benefits, including state-level monitoring of naloxone distribution effectiveness and reach across large geographic, service, and population sectors.