Naloxone Dispensing to Youth Ages 10–19: 2017–2022

Abstract

BACKGROUND AND OBJECTIVES: Naloxone is lifesaving in the event of an opioid overdose but is underutilized in adolescents. Youth-serving clinicians can play a role in expanding naloxone access by offering it to all youth at risk for opioid-involved overdose, including by prescription. Understanding naloxone dispensing trends to youth can inform efforts to expand its use. METHODS: We used IQVIA National Prescription Audit Patient Insights data, which contains prescriptions dispensed from ∽48 900 retail pharmacies, representing 93% of all prescriptions from all payers in the United States. Cross-sectional analyses were used to describe naloxone dispensing trends among youth ages 10 to 19 years over time and by patient sex, out-of-pocket cost, prescriber specialty, and payer. RESULTS: From 2017 to 2022, 59 077 prescriptions for naloxone were dispensed to youth ages 10 to 19. Dispensing rates increased 669%, from 6.6 to 50.9 prescriptions per 100 000 adolescents, with increases each year. Dispensing varied by specialty and sex. Pediatricians accounted for an increasing proportion of prescriptions dispensed with a 6-year increase of 991%. Seventy-four percent of prescriptions were paid through commercial insurance. Although most prescriptions dispensed had low to 0 cost-sharing, 20% had out-of-pocket costs exceeding $25, and over 6% had out-of-pocket costs exceeding $75. CONCLUSIONS: Pediatricians and other youth-serving clinicians can play an important role in expanding access to naloxone and harm reduction information by prescribing naloxone to all youth who are at risk for overdose. Clinician prescribing of naloxone can augment community distribution and over-the-counter access by making naloxone more widely available at all touchpoints with the health care system.