# Intervention to Increase Naloxone Engagement and Distribution in Community Pharmacies: A Four-State Randomized Trial

> **NIH NIH R01** · BRANDEIS UNIVERSITY · 2021 · $587,534

## Abstract

Access to the opioid antidote naloxone is a critical component of addressing the opioid epidemic. Naloxone is a
population-level prevention intervention associated with substantial reductions in overdose mortality.
Furthermore, emerging data suggest that co-prescription of naloxone to people at risk of overdose from chronic
opioid therapies may reduce negative health outcomes earlier in the risk horizon by avoiding nonfatal overdose.
Expanding access to naloxone in the community through the pharmacy can be a critical mechanism for extending
this lifesaving medication’s reach. Pharmacies exist in nearly every community and are staffed by knowledgeable
health professionals trained in counseling patients about medication safety; many states also permit pharmacies
to sell syringes over the counter for drug injection. Pharmacies’ pivotal role in dispensing medications and selling
syringes places them at the crossroads of opioid access and risk mitigation methods like naloxone provision.
Testing ways to optimize pharmacy based naloxone (PBN) provision will be key as the country expands the
implementation of naloxone through the medical system. We propose a large, practical study of a pharmacy-
focused intervention to increase PBN dispensing and improve opioid safety. The intervention is comprised of
two successful demonstration research projects (RESPOND, PI: Hartung; MOON Study, PI: Green, both R18),
which include online and one-on-one educational outreach (i.e. academic detailing) demonstrated to provide
knowledge and training for pharmacists to identify and effectively engage with patients who may be at high-risk
for an opioid overdose. The overarching goal of this study is to reduce the number of opioid overdose deaths in
the United States through greater access and use of naloxone, and safer opioid use. Uniquely, the study will
draw from partnerships with two large retail pharmacy chains, CVS Pharmacy and Fred Meyer (a division of
Kroger Corporation), who will provide a “real-world” sample to support replicability and external validity. Specific
aims are to: Aim 1: Integrate the MOON and RESPOND toolkit materials into one cohesive educational program
(MOON+), and streamline the materials to enhance the focus on naloxone policy, communication, and
administration; Aim 2: Using a stepped wedge, clustered randomized trial design, evaluate the effectiveness of
MOON+ in 160 community pharmacies in increasing: a) PBN distribution rates, naloxone-related patient
engagement, and pharmacists’ attitudes, knowledge, perceived behavioral control and self-efficacy toward
naloxone; and b) pharmacy syringe sales, and pharmacists’ attitudes, knowledge, perceived behavioral control
and self-efficacy toward dispensing buprenorphine for opioid use disorder (secondary outcomes). Aim 3:
Applying a mixed methods approach, identify facilitators and barriers (e.g. state and store policies, regional
characteristics) to implementation and effectiveness. Study findings will ...

## Key facts

- **NIH application ID:** 10249360
- **Project number:** 5R01DA045745-04
- **Recipient organization:** BRANDEIS UNIVERSITY
- **Principal Investigator:** TRACI C GREEN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $587,534
- **Award type:** 5
- **Project period:** 2020-05-01 → 2023-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10249360

## Citation

> US National Institutes of Health, RePORTER application 10249360, Intervention to Increase Naloxone Engagement and Distribution in Community Pharmacies: A Four-State Randomized Trial (5R01DA045745-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10249360. Licensed CC0.

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