Opioid Antagonist FAQs

The dispensing of opioid antagonists approved by the FDA for use in treating an overdose must be reported to the CSMP. You must work with your software, or, if need be, work with your software provider, to include all opioid antagonists as a reportable item.

West Virginia Board of Pharmacy
Protocol for Pharmacists or Interns Furnishing
Opioid Antagonists
Developed in Consultation with the Department of Health and Human Resources, Bureau for Public Health

West Virginia’s “Access to Opioid Antagonists Act” provides that a pharmacist or pharmacy intern under the supervision of a pharmacist may dispense an opioid antagonist without a prescription pursuant to a protocol developed by the Board of Pharmacy in consultation with the DHHR Bureau for Public Health. See W. Va. Code §16-46-1 et seq.

As used in this protocol:

(1) “Recipient” means the person to whom an opioid antagonist is furnished; and

(2) “Opioid antagonist” means a federal Food and Drug Administration approved drug for the treatment of an opiate-related overdose, such as naloxone hydrochloride or other substance, that, when administered, negates or neutralizes, in whole or in part, the pharmacological effects of an opioid in the body.

A pharmacist or pharmacy intern who dispenses an opioid antagonist without a prescription under this [protocol] shall provide patient counseling to the individual for whom the opioid antagonist is dispensed. The pharmacist or intern shall inquire if the individual to whom the opioid antagonist would be administered has a known hypersensitivity to the opioid antagonist (the product should not be dispensed if the individual has a known hypersensitivity). The patient counseling described in this section is mandatory, and the person receiving the opioid antagonist may not opt-out. Appropriate counseling shall include, but is not limited to:

Dosing of the product dispensed;
Proper administration of the opioid antagonist;
Effectiveness of the opioid antagonist;
Safety/adverse effects from the use of the opioid antagonist;
Storage conditions;
Shelf life/expiration date of the opioid antagonist; and
The importance of contacting emergency services as soon as possible, either before or after administering the opioid antagonist, and the risks associated with failure to contact emergency services after administering an opioid antagonist.

All pharmacists or pharmacy interns must provide educational materials including the tri-fold brochures “Save a Life” and “Resources for Substance Use Disorder.” The pharmacist or intern shall also provide the recipient with the number 1-844-HELP-4-WV so the recipient can talk with someone about available substance abuse treatment and recovery services near them. This phone number is contained in both tri-fold brochures listed above.

The pharmacist or intern shall answer any questions the recipient may have regarding the opioid antagonist.

Product Selection: A pharmacist or intern may supply an opioid antagonist in any FDA-approved product form indicated for the treatment of a known or suspected opioid overdose (may include naloxone and nalmefene).

Labeling: The dispensing shall be documented and labeled as a prescription (excluding OTC formulations of opioid antagonists) dispensed per this protocol.

Privacy: All pharmacists or interns furnishing an opioid antagonist in a pharmacy or health care facility shall operate under the pharmacy or facility’s policies and procedures to ensure that recipient confidentiality and privacy are maintained.

Although not required, a pharmacy may have a prescribing practitioner sign the protocol to treat it as a standing order.

Updated: 09/2023