Provision of Naloxone Nasal Spray: A Northern Territory Focus

Background: Opioids play a key role in healthcare, however, the challenges of opioid overdoses, especially from pharmaceutical opioids, are rising significantly. Naloxone reverses an opioid overdose, and naloxone nasal spray is routinely used internationally as a harm-reduction tool to reduce opioid fatalities. Aim: This study aimed to investigate the supply of naloxone nasal spray within Northern Territory (NT) pharmacies and the views of key professionals with experience in naloxone distribution and the related policies. Method: A mixed-method observational study design was utilised. Relying on retrospective analysis of naloxone dispensing and over-the-counter supply data, the amount of naloxone supply distributed in NT community pharmacies from January 2018 to August 2021 was captured. Targeted qualitative analysis of barriers to naloxone supply in the community was based on interviews with key stakeholders in the NT. Results: 23 of 40 NT community pharmacies provided data, of which 35% had naloxone products available at some point from 2018 to 2021. The most commonly supplied form was the intramuscular injectable (35%) with pharmacies less likely to supply the nasal spray (17%). Interview responses showed several consistent themes affecting naloxone provision from services, including demand versus supply, prescriber control of access, financial considerations, legalities, and several factors that facilitated supply. Conclusion: This study showed the supply of naloxone in the NT is limited. Barriers affecting the provision of naloxone nasal spray were the community pharmacy model of supply and thus increasing access points would assist to expand the supply.