# The Safety and Impact of Expanded Access to Naloxone in Health Systems

> **NIH NIH R01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2020 · $633,265

## Abstract

PROJECT SUMMARY
Opioid overdoses have reached epidemic proportions in the United States. Our research team, along with
other groups, has identified key populations at risk for opioid overdose, including people with HIV, substance
use disorders, and mental health conditions. Naloxone is an effective opioid antidote which reverses opioid
overdose. Traditionally used by medical personnel, naloxone for take-home use is gaining wider acceptance to
prevent death among people who use drugs. Yet, take-home naloxone may also reduce the risk of overdose
death among patients prescribed opioids for pain. Our study will examine the safety and impact of expanded
access to naloxone for patients prescribed opioids in two large and diverse health systems. These health
system pharmacies serve many key risk groups for overdose. While naloxone delivered through health system
pharmacies is likely to prevent overdose fatalities, our developmental research has identified critical barriers to
wide scale adoption of this practice. These include medical provider concerns that naloxone will increase risk
behavior and that patients may not acquire adequate knowledge to effectively use the medication and educate
potential bystanders. In addition, providers had concerns about adverse health outcomes associated with
naloxone use among patients with co-morbidities. The proposed research will address these key evidence
gaps. We will conduct a clustered randomized pragmatic trial of co-dispensing naloxone with opioids under
new standing order legislation passed in Colorado. This trial will be conducted in an integrated safety net
network of community health centers and hospital and in a large managed care organization. Our outcomes
will include opioid risk behavior, overdose and naloxone knowledge, and overdose rates. This will be followed
by a qualitative investigation into overdose and naloxone use among people dispensed naloxone to elucidate
knowledge gaps, process failures, and unanticipated adverse outcomes. Finally, we will conduct a post-
implementation safety assessment of naloxone to examine the risk of adverse health outcomes using novel
self-controlled analytic techniques. Together, these aims will provide a comprehensive assessment of the
impact and safety of expanded access naloxone for patients prescribed opioids in HIV and other primary care
settings.

## Key facts

- **NIH application ID:** 9923636
- **Project number:** 5R01DA042059-05
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Ingrid A Binswanger
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $633,265
- **Award type:** 5
- **Project period:** 2016-08-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9923636

## Citation

> US National Institutes of Health, RePORTER application 9923636, The Safety and Impact of Expanded Access to Naloxone in Health Systems (5R01DA042059-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9923636. Licensed CC0.

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