In response to the opioid epidemic, policies to expand access to the overdose-reversal drug naloxone have emerged across the country. In recent years, Arkansas has made progress on this front by requiring prescribers in 2021 to co-prescribe naloxone in certain situations, such as when an individual has a high-dose opioid prescription. In 2017, licensed pharmacists became authorized to order, dispense, and administer naloxone to individuals without a prescription under a state protocol.

For the third year since 2020, the Arkansas Center for Health Improvement analyzed the naloxone and opioid prescriptions for Medicaid and commercially insured beneficiaries to inform and understand the trends and patterns of naloxone prescriptions in Arkansas. Data for the analysis were from the Arkansas All-Payer Claims Database, part of the Arkansas Healthcare Transparency Initiative, for state fiscal years (FY) 2017 to 2021. The results of our analyses are contained in an updated data brief.

Key findings:

• Among Medicaid and commercially insured beneficiaries, the number of individuals receiving opioid prescriptions dropped from 385,774 in FY 2017 to 238,744 in FY 2021, a decrease of 38.1%. Over the same period, the number of individuals receiving naloxone prescriptions rose from 86 to 4,848.
• The percentage of individuals who received both naloxone and high-dose opioid prescriptions increased each year, from 0.05% for individuals with opioid prescriptions of 50 or more morphine milligram equivalents (MME) per day and 0.12% for individuals with opioid prescriptions of 90 or more MME per day in FY 2017 to 6.23% and 10.59%, respectively, in FY 2021.
• In FY 2021, one naloxone prescription was dispensed for every 16 individuals with opioid prescriptions of 50 or more MME per day, and one naloxone prescription was dispensed for every 9 individuals with opioid prescriptions of 90 or more MME per day. This is an improvement from 22 individuals and 14 individuals, respectively, per naloxone prescription in FY 2020.
• In FY 2021, pharmacists authorized 1,714 out of 5,506 naloxone prescriptions under state protocol, or 31.1%. This is a decrease from 46.3% in FY 2020.