OBJECTIVES : Despite guidelines and state laws that are designed to increase naloxone access, naloxone prescribing remains underutilized. The objective of this study is to describe the proportion of providers that prescribe naloxone and to identify the characteristics (demographic, specialty, geographic) of naloxone prescribers in Arkansas.

METHODS : The 2013-2018 Arkansas All Payers Claims Database (APCD) was used. A naloxone provider was defined as a provider that prescribed at least one naloxone prescription identified in the pharmacy claims. The provider socio-demographic, county of practice and provider specialty were obtained from the provider file. The proportion of naloxone prescribers was calculated by dividing the naloxone providers by the total number of prescribers and was stratified by in state and out of state providers.

RESULTS : A total of 44,943 practicing prescribers were identified and of those 44,121 had a practice in AR. Overall 1867 naloxone prescriptions were prescribed for 1463 patients that were prescribed by 204 naloxone prescribers which translated into a proportion 0.45%. Of the 204 naloxone prescribers, 139 practiced in AR which revealed that 0.31% of AR prescribers prescribed naloxone. Most naloxone prescribers were male and younger than 53 years of age. Primary care physicians accounted for the largest share of naloxone prescribers (overall: 50%; Arkansas:58%) followed by pain medicine/anesthesia physicians (overall:15%; Arkansas:13%) and non-physicians (overall:10%; Arkansas:10%). Out of 139 naloxone prescribers in Arkansas, 89 were located in urban Arkansas counties and 49 of 75 Arkansas counties had no naloxone prescribers.

CONCLUSIONS : Our findings show that few prescribers prescribe naloxone and most naloxone prescribing occurs in the primary care office setting. Efforts should be undertaken to increase naloxone prescribing throughout the state and in particular counties where there is no access to naloxone.