# Feasibility of a pharmacy-based overdose prevention program in rural/suburban NY

> **NIH NIH R21** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2020 · $202,509

## Abstract

The purpose of this mixed-methods exploratory study is to (1) investigate the support and diffusion of naloxone
pharmacy services that utilize a standing order, and (2) assess feasibility of an expanded public health role for
naloxone-registered pharmacists to help increase uptake of pharmacy-acquired naloxone in rural /suburban New
York (NY). The U.S. opioid overdose crisis has led to legislation in 49 states allowing naloxone (i.e., opioid
overdose reversal medication) to be dispensed through a non-patient specific prescription or “standing order”. In
New York State (NYS), over 2,600 pharmacies are registered to participate in the Opioid Overdose Prevention
Program (OOPP) which allows use of a standing order to dispense naloxone. Yet, pilot data as well as anecdotal
evidence suggests that pharmacy-acquired naloxone is infrequent in NY, and either non-existent or limited in
suburban/rural counties where burden of opioid-related overdose deaths is highest. Recent reports have
identified pharmacy reimbursement challenges, patient affordability, and patient-anticipated stigma
dampening naloxone demand as ongoing barriers – even where extensive pharmacy-targeted overdose
prevention training and education have taken place. The goal of this study is to explore barriers (eg. opioid-
related stigma) and facilitators (eg. use of a state-funded co-pay reimbursement program) of pharmacy naloxone
services in NY suburban/rural counties where pharmacy dispensation is low or non-existent, and overdose rates
are high. In addition, we will explore pharmacist interest in coupling naloxone services with other non-stigmatizing
pharmacy services to help increase uptake and support of pharmacy naloxone services (a successful stigma-
reducing intervention from our prior work in the HIV arena). The diffusion of innovation provides a theoretical
framework to examine adoption and rejection of pharmacy naloxone services. Specifically, we will identify
pharmacist/pharmacy characteristics, experiences, and practices associated with: (i) naloxone registration status
(Aim 1a), (ii) support for pharmacy naloxone services, and (iii) support for coupling naloxone with other non-
stigmatizing pharmacy services (Aim 1b) among 1,000 naloxone-registered and non-registered pharmacists.
We will also conduct in-depth interviews to contextualize the individual-, pharmacy-, and policy-level
barriers/facilitators of pharmacy naloxone services among key stakeholders: (a) pharmacists (n=24); (b) opioid-
related ED patients (n=20); and (c) community advocates/health officials (n=16) (Aim 2). We will target 8 counties
with the highest opioid overdose rates in NYS to administer a pharmacist computer-assisted phone survey
(online, and/or in-person also available), and 2 of those counties will be selected to conduct in-depth interviews
where our research capacity has been established. Survey and qualitative data will be analyzed and triangulated
for final data interpretation. Proposal significan...

## Key facts

- **NIH application ID:** 9979522
- **Project number:** 1R21DA049166-01A1
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** CRYSTAL FULLER LEWIS
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $202,509
- **Award type:** 1
- **Project period:** 2020-07-01 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9979522

## Citation

> US National Institutes of Health, RePORTER application 9979522, Feasibility of a pharmacy-based overdose prevention program in rural/suburban NY (1R21DA049166-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9979522. Licensed CC0.

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