# Improving Naloxone Access and Its Effects on Drug Abuse and Overdoses

> **NIH ALLCDC R01** · RAND CORPORATION · 2020 · $636,614

## Abstract

Project Summary/Abstract
 Opioid overdoses increased dramatically between 1999 and 2010. In 2010, 16,651
deaths were caused by a prescription opioid overdose, representing nearly 60% of all drug
overdose deaths, and exceeding overdose deaths from heroin and cocaine combined. Recent
modest declines in prescription opioid mortality rates have been paired with large increases in
heroin abuse. In 2014, there were over 13,000 deaths involving heroin. In response to these
trends, numerous federal and state policies have been adopted to curb the overdose rate.
Improving access to naloxone through policy is especially promising as naloxone is known to be
effective in reversing the life-threatening effects of opioids. Until relatively recently, however,
naloxone has had a rather limited distribution network, followed by a recent wave of policy
reforms motivated to improve naloxone access. The ability of policy to encourage additional
naloxone access and subsequently reduce overdoses is generally unknown.
 In this project, we propose to study the ability of state policy to improve naloxone access
and to understand which types of policies, if any, do so most effectively. We have preliminary
evidence that permitting prescribers to dispense naloxone under their own authority is crucial for
increasing naloxone prescribing. We will also place special emphasis on the responses of
private pharmacies to state policies which legalize dispensing of naloxone without a patient-
specific prescription. Large pharmacy chains have enacted their own private policies to improve
naloxone access, and these policies have spread over time across several states. The effects
of these private policies should vary geographically based the penetration of these chains in
different communities. We will study whether private pharmacy policy can improve access and
reduce overdoses above and beyond state policy.
 We will use a variety of rich data sets to measure our outcomes. We will use
comprehensive quarterly zip code-level data on naloxone dispensing for 2010-2017. We will
also collect data on pharmacy locations as well as pharmacy-level policy concerning naloxone
dispensing. We will explore what types of state policy improve naloxone access and the role of
pharmacy policy. We will subsequently test whether improved naloxone access affects fatal
overdoses and nonfatal overdoses
 This project will present some of the first evidence of the effectiveness of naloxone
policy on naloxone prescriptions while also exploring the mechanisms which make such policies
most effective in terms of dispensing and reducing overdoses.

## Key facts

- **NIH application ID:** 10005886
- **Project number:** 5R01CE002999-03
- **Recipient organization:** RAND CORPORATION
- **Principal Investigator:** David Powell
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2020
- **Award amount:** $636,614
- **Award type:** 5
- **Project period:** 2018-09-30 → 2021-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005886

## Citation

> US National Institutes of Health, RePORTER application 10005886, Improving Naloxone Access and Its Effects on Drug Abuse and Overdoses (5R01CE002999-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10005886. Licensed CC0.

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