Socio-ecological and pharmacy-level factors associated with naloxone stocking at standing-order naloxone pharmacies in New York City. (1st January 2021)

• Record Type: Journal Article
• Authors: Abbas, Bilal; Marotta, Phillip L.; Goddard-Eckrich, Dawn; Huang, Diane; Schnaidt, Jakob; El-Bassel, Nabila; Gilbert, Louisa
• Is Part Of: Drug and alcohol dependence. Volume 218(2021)
• Publication Date: 2021-01-01
• Subjects: Overdose -- Naloxone -- Neighborhoods -- Socioeconomic disparity -- Pharmacy -- Harm reduction; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2020.108388
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Surveys were administered to 662 pharmacists in New York City. Pharmacies in poorer neighborhoods were less likely to have naloxone. Pharmacies in the Naloxone Cost Assistance Program were more likely have naloxone. Pharmacies with private spaces were more likely to carry naloxone. Abstract: Background: Research on socio-ecological factors that may impede or facilitate access to naloxone in pharmacies remains limited. This study investigated associations between socio-ecological factors, pharmacy participation in the naloxone cost assistance program (NCAP), pharmacy characteristics and having naloxone in stock among pharmacies in New York City. Methods: Phone interviews were conducted with 662 pharmacies selected from the New York City Naloxone Standing Order List. Multi-level generalized linear modeling estimated associations between neighborhood racial and ethnic composition, poverty rates, overdose fatality rates, pharmacy participation in N-CAP, having private physical spaces within the pharmacy, knowledge of where to refer people to obtain naloxone and adjusted relative risk (aRR) that the pharmacy would have naloxone in stock. Results: Findings from this study supported several of the hypotheses. Greater neighborhood poverty was associated with a lower likelihood of carrying naloxone compared to neighborhoods with less poverty (aRR = .79, CI95 % = .69, .90, p < .001). Pharmacies that provided a private window for consultations (aRR = 1.34, CI95 % = 1.19, 1.51, p < .001), a private room (aRR = 1.42, CI95 % = 1.30, 1.56, p < .001), and a private area (aRR = 1.42, CI95 % = 1.30, 1.56, p < .001) were associated with a higher likelihood of carrying naloxone compared than those that did not. Conclusions: Findings from this study suggest that community-level socioeconomic marginalization is a contributor to disparities in naloxone availability among pharmacies in New York City. Findings support harm reduction interventions tailored to the built environment of pharmacies that respect privacy to those seeking naloxone.