“Behind the counter” is in quotation marks because this is not always technically correct, but it is the de facto experience for the patient ─ they walk into a pharmacy without having seen a prescriber and walk out with naloxone. The mechanism making this possible varies by state and the specific language is important.
For example, some states use a Collaborative Practice Agreement (download CPA sample language), sometimes combined with a broad standing order; other states have chosen to operate under pharmacist-initiated prescriptions.
Procedural language and operating documents listed here are provided by state. Naloxone laws are changing rapidly, so please help us to stay current by contacting us if your state information needs updating.
As of mid-2015, some states do not have a mechanism in place for “behind the counter” naloxone, so there is a great opportunity for you to shape the overdose prevention initiatives in your state. Please contact us to discuss strategy and successes in other states.
Collaborative Practice Agreements
Models and case studies with strong leadership from pharmacists
Patient information from the San Francisco Department of Public Health & California Board of Pharmacy (2015)
NOTE that Project Lazarus compiles naloxone kits separately that include nasal adapters and delivers them to participating pharmacies. In adapting NC materials, be sure to account for the nasal adapter. Materials created by Northwest Community Care Network, as part of Community Care of North Carolina’s Chronic Pain Initiative – Project Lazarus.
- Go to https://www.uripharmacycpd.org/
- Login or register as a new user as directed
- Once logged in/registered, click on the last menu item, “View Home Study Activities”
- Click on “OPIOIDS: Addiction, Overdose Prevention (Naloxone) and Patient Education”
IMPORTANTLY: Registrants only pay for CE post-test, slides and narrated video are available for all viewers
Sample CDTA (2011)
The CDTA must be reviewed by a pharmacist consultant at the Pharmacy Quality Commission.