OBJECTIVES

Access to naloxone (opioid overdose reversal drug) is crucial to combat the epidemic of opioid overdose deaths in the United States. Despite expanded availability, naloxone remains underutilized in opioid overdose situations. We examined access to naloxone and preferences regarding purchase of naloxone from online pharmacies among individuals who are affected by opioids.

METHODS

We conducted a semi-structured, online survey among 504 individuals who were personally affected or had family/friends who were affected by misuse or dependence involving prescription opioids or heroin. The survey was posted on social media groups of individuals affected by opioids on Facebook and Reddit.

RESULTS

The survey included participants from 48 states with the highest number of respondents from New York (7.4%), California (6.7%), Pennsylvania (6.7%), Texas (6.7%), and Ohio (6.0%). Opioids had affected self (37.5%), family/friends (32.1%), or both self and family/friends (30.4%). About 44.0% participants were heroin users, 40.9% had purchased or been given naloxone, and 73.5% were willing to purchase naloxone or other overdose reversal drugs. About 18.6% participants had tried to purchase naloxone but experienced issues in getting naloxone. The biggest barriers to purchasing naloxone included high cost (39.5%), not getting prescription from the doctor/pharmacist (14.8%), pharmacy didn’t carry naloxone (9.9%), naloxone was out-of-stock (2.5%), no access to pharmacy (4.9%), or one or more of these issues (28.4%). About half of the participants (47.1%) preferred purchasing naloxone online and getting it delivered at their home or a chosen place, 47.3% preferred a pharmacy store, and 7.7% preferred other sources for purchasing naloxone.

CONCLUSIONS

Although naloxone is available without a written prescription in most states, opioid affected individuals continue to face significant barriers in purchasing naloxone. Reduced cost, increased insurance coverage, and a wider availability of naloxone on online pharmacies may significantly improve access to naloxone and curtail opioid overdose death rates.