Systems and Policies
Local and state laws or policies can affect the implementation of OEND programs.
Barriers
Complex and outdated laws can contribute to uncertainty about the legality of naloxone dispensing and whether bystanders can use naloxone on a person experiencing an opioid overdose. Restrictive pharmacy board regulations for on-site medication dispensing can also present additional barriers, such as regulations relating to recordkeeping and reporting.
OEND implementation can be negatively impacted by a lack of clarity regarding whether naloxone can be billed to a person's insurance or questions about whether receiving naloxone could impact one's eligibility for life insurance or premiums.
Facilitators
State laws can be a facilitator of OEND programs. Many states have now encouraged OEND programs by clarifying the civil and criminal legality of naloxone-related activities and have created publicly funded programs to support OEND.
Several state and local governments have established publicly-funded supplies of naloxone that can assist organizations seeking to build and implement an OEND program — a clear solution to overcoming the financial barrier of securing naloxone. These publicly funded naloxone supplies also serve to establish the legitimacy of OEND programs and can assist in overcoming barriers relating to uncertainty and legality.
OEND programs may be facilitated by clarifications from health insurers supporting naloxone distribution, such as the recently created Healthcare Common Procedure Coding System (HCPCS) Billing Code for take-home naloxone dispensing in opioid treatment programs.