Back to Top Skip to main content

DoD program focuses on opioid safety and prescribing naloxone

Airman holding Narcan, a brand of naloxone Naloxone is a temporary antidote for opioid overdose that provides short-term airway relief. The Food and Drug Administration encourages providers to prescribe naloxone alongside an opioid if patients or their families are at risk for potential overdose. (Photo by Senior Airman Amber Mullen)

Recommended Content:

Opioid Safety | Pain Management | September Toolkit

For any patient who suffers from an opioid overdose, naloxone represents the best shot at reversing the symptoms long enough to receive medical attention. Naloxone provides a temporary antidote for opioid overdose as it gives short-term airway relief. The Food and Drug Administration encourages providers to prescribe naloxone alongside an opioid if patients or their families are at risk for potential overdose. However, naloxone prescriptions carry a stigma due to misconceptions about the drug’s intent.

Last year, representatives from the Defense Health Agency, Uniformed Services University of the Health Sciences, and the Defense and Veterans Center for Integrative Pain Management established the Opioid Overdose Education and Naloxone Distribution Program, or OEND. The program was created as a way to reduce the stigma of naloxone as a drug strictly for patients struggling with opioid addiction.

OEND promotes education throughout the Military Health System on naloxone’s life-saving properties. Based on the Department of Veteran Affairs program of the same name, OEND’s goal is to increase co-prescribing of naloxone to reduce opioid-related overdoses and death.

Patients can be at risk for opioid overdose for factors not related to opioid abuse. Conflicts with other medications, underlying medical conditions like lung problems and sleep apnea, and even taking opioids after not taking them for a long time can increase risk of opioid overdose or death. OEND provides information about safe opioid use and naloxone on its website, through social media campaigns, and by train-the-trainer programs for providers. These resources and tools all contribute to what Army Lt. Col. Lori Whitney sees as the program’s top priority: patient safety.

“That is our concern. That is the work we do,” said Whitney, who chairs the Defense Health Agency’s Pain Management Clinical Support Service. “A naloxone prescription along with an opioid is just like having an inhaler for asthma or a fire extinguisher in your kitchen. You’re not planning to have a fire every time you cook, but it could happen. Naloxone is that fire extinguisher for opioid overdose, so you want to have naloxone handy to save a life.”

Whitney expects that use of the OEND Program will increase the number of naloxone prescriptions for at-risk patients and their families when opioids are prescribed. The MHS goal is a 90% prescription rate of naloxone to at-risk patients. The OEND program is one way that the organization will meet this goal and has already been successful at its pilot sites.

OEND was piloted in 2019 at Madigan Army Medical Center at Joint Base Lewis-McChord, Washington, to see how the program affects knowledge and prescription rates of naloxone. The medical staff at Madigan took a multipronged approach, training not only opioid prescribers but also outpatient and clinical pharmacists on best practices for naloxone. Dr. Ji Eun Kim, pharmacist and one of the program leads for OEND at Madigan, emphasized the importance of this approach for opioid safety.

“The first time that a patient is prescribed an opioid is with the medical provider who's prescribing it, so that's our first chance to provide naloxone,” Kim said. “Another opportunity is when the patient goes to the pharmacy and the outpatient pharmacy staff reviews the patient's medication list. The pharmacy staff can also provide naloxone if indicated. That's why we thought it’s important and also necessary to train our outpatient pharmacists. We knew that this would work best as a team effort.”

The team at Madigan measured knowledge and understanding of naloxone both before and after completing the OEND pilot program. Kim said Madigan saw an increase in knowledge and comfort for both providers and pharmacists when it comes to naloxone.

“I think with the current opioid crisis and sometimes negative light around using opioids, patients feel like they have to justify why they’re on the prescription,” Kim said. “We need to be able to have a conversation about it with each other and with our patients. I think OEND is a good program and provides information where the pharmacist and providers feel comfortable about having this discussion.”

Whitney hopes that OEND can help more commands and providers reduce stigma and educate patients on opioid safety so they become more comfortable with accepting a naloxone prescription.

“We want to continue to train the providers to have a conversation with their patients and let them know that the answer to pain management isn’t always opioids,” she said. “But if we're going to give you opioids, we also want to give the lowest effective dose for the shortest amount of effective time and we want to keep you safe while you have them. Naloxone is part of that.”

For more information and resources from the Opioid Overdose Education and Naloxone Distribution Program, visit Health.mil.

You also may be interested in...

Military Health podcasts provide resources for patients and providers

Article
11/6/2020
Hands holding a smartphone with the Living Beyond Pain podcast playing on the device.

Podcasts have become an increasingly popular way of getting information.

Recommended Content:

Technology | Pain Management | Connected Health

WRNMMC Providers Urge Holistic Approach to Pain Management

Article
10/14/2020
Three hands; one set putting a needle into another

The Military Health System’s efforts to address chronic pain includes a holistic strategy that’s multidisciplinary and multimodal.

Recommended Content:

Opioid Safety | Pain Management

Rethinking pain management within the MHS

Article
9/25/2020
Nurse wearing gloves, putting acupuncture needle in patient's ear

Treating pain beyond a prescription.

Recommended Content:

Pain Management | September Toolkit

Opioid tool on MHS GENESIS improves patient safety

Article
9/1/2020
Pharmacist holding out prescription bottle

[The tool] screens a patient’s medical history before an opioid is prescribed.

Recommended Content:

Opioid Safety | Pain Management | September Toolkit

Getting creative: Reducing opioid use for returning warriors

Article
11/5/2019
Airmen of the 174th Attack Wing participate in a weekly yoga class. Classes are intended to present an alternative way for 174th members to build both mental and physical strength. Yoga is also a way to alleviate chronic pain in the body. (U.S. Air Force photo by Staff Sgt. Duane Morgan)

With the rise in opioid-related drug abuse and death, the Military Health System looks to complementary pain management treatments

Recommended Content:

Opioid Safety | Pain Management | Warrior Care

Proper pain management with a proper scale

Article
9/12/2019
The Defense and Veteran’s Pain Rating Scale

A new pain scale that measures intensity and effects on daily life helps providers and patients better understand pain

Recommended Content:

Pain Management

I learned how to retrain my brain to manage chronic pain

Article
9/3/2019
Retired Navy Senior Chief Petty Officer Jim Wilt

Active lifestyle, healthy diet can reduce reliance on meds

Recommended Content:

Pain Management | September Toolkit

Breaking the pain cycle

Article
4/9/2019
Ashley Blake, an acupuncture nurse at Naval Hospital Pensacola’s Pain Management Clinic, treats a patient with Battlefield Acupuncture (BFA), one of many opioid alternatives offered at many treatment facilities in the Military Health System. BFA consists of inserting five tiny and sterile 2 mm needles into specific points of the ear where they can remain for up to three days. (U.S. Navy photo by Petty Officer 1st Class Brannon Deugan)

Live in agony or risk addiction? MHS pain management initiatives offer options

Recommended Content:

Prescription Monitoring Program | Mental Wellness | Mental Health Care | Substance Abuse | Physical Disability | Warrior Care | Opioid Safety | Pain Management
Showing results 1 - 8 Page 1 of 1

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.