Can naloxone prescription and overdose training for opioid users work in family practice? Perspectives of family physicians.

OBJECTIVE: To explore family physicians' attitudes toward prescribing naloxone to at-risk opioid users, as well as to determine the opportunities and challenges for expanding naloxone access to patients in family practice settings.
DESIGN: One-hour focus group session and SWOT (strengths, weaknesses, opportunities, and threats) analysis.
SETTING: Workshop held at the 2012 Family Medicine Forum in Toronto, Ont. PARTICIPANTS: Seventeen conference attendees from 3 Canadian cities who practised in various family practice settings and who agreed to participate in the workshop.
METHODS: The workshop included an overview of information about naloxone distribution and overdose education programs, followed by group discussion in smaller focus groups. Participants were instructed to focus their discussion on the question, "Could this [overdose education and naloxone prescription] work in your practice?" and to record notes using a standardized discussion guide based on a SWOT analysis. Two investigators reviewed the forms, extracting themes using an open coding process. MAIN
FINDINGS: Some participants believed that naloxone could be used safely among family practice patients, that the intervention fit well with their clinical practice settings, and that its use in family practice could enhance engagement with at-risk individuals and create an opportunity to educate patients, providers, and the public about overdose. Participants also indicated that the current guidelines and support systems for prescribing or administering naloxone were inadequate, that medicolegal uncertainties existed for those who prescribed or administered naloxone, and that high-quality evidence about the intervention's effectiveness in family practice was lacking.
CONCLUSION: Family physicians believe that overdose education and naloxone prescription might provide patients at risk of opioid overdose in their practices with broad access to a potentially lifesaving intervention. However, they explain that there are key barriers currently limiting widespread implementation of naloxone use in family practice settings. Copyright© the College of Family Physicians of Canada.