(1315) A National Cross-sectional Survey of Consumers’ Comfort and Purchase Intentions Regarding Over-the-counter (OTC) Naloxone

Objectives: Naloxone access has been pertinent in the efforts to combat the opioid epidemic that the nation has been facing in the last decades. With the recent approval from the FDA of over-the-counter (OTC) naloxone, the role of pharmacists is essential to prevent opioid overdose mortality. However, little research to-date has explored the U.S. general public’s willingness to purchase OTC naloxone. Therefore, the purpose of this study was to better understand the public’s comfort level and purchase intentions regarding OTC naloxone at community (retail) pharmacies, with the goal to improve community pharmacy naloxone services.

Methods: A cross-sectional study design was used to assess the general public’s comfort and purchase intentions regarding OTC naloxone for management of opioid overdose and community-pharmacy delivered naloxone services. Individuals were recruited to participate in an online anonymous survey using Amazon's Mechanical Turk (MTurk) survey recruitment and distribution platform. Adults at least 18 years of age, residing in the US, and holding MTurk “Masters'' status were eligible to participate and received $5.00 upon completion of the survey. Primary outcomes included: 1) comfort obtaining OTC naloxone (12-items); and 2) purchase intentions regarding OTC naloxone (7-items). Items were measured using 5-point Likert-type scales from 1=strongly disagree to 5=strongly agree. The survey instrument was developed by the investigators and informed by Huang et al (2022) and Slocum et al (2022). Data was analyzed using descriptive statistics and internal consistency of comfort and intention scales was assessed using Cronbach’s alpha. All data were analyzed with SPSS Statistics software version 29. The study protocol received approval by the authors’ Institutional Review Board via exempt review and all participants provided informed consent.

Results: The majority of respondents were male (52.5%), White (77.2%), and 44.80 years of age on average (N=299). The public's overall comfort level regarding obtaining, storing, and administering OTC naloxone was fairly positive (mean [SD] scale score: 3.82 [0.750]), with 85.5% agreeing or strongly agreeing that they would feel comfortable storing OTC naloxone in their homes in case of needing it for an emergency. An outstanding 82.1% of respondents stated that they would feel comfortable purchasing OTC naloxone at a community pharmacy. About 69.6% of respondents believed that they would feel more comfortable administering OTC naloxone to a family member or friend experiencing an opioid overdose after talking to their pharmacist about it. However, the purchase intentions of OTC naloxone were generally low to neutral (mean [SD] scale score: 2.91 [0.935]), with 72.6% stating that they don’t plan to obtain OTC naloxone. Approximately 74.6% of respondents were willing to obtain OTC naloxone if they knew that a friend or family member was using illegally obtained opioids, while about 47.9% stated that they would obtain OTC naloxone if they were prescribed an opioid medication by their doctor. Internal consistency of the comfort (Cronbach’s alpha=0.887) and intention (Cronbach’s alpha=0.883) scales was high.

Conclusions: Overall, the comfort level regarding obtaining, storing, and administering OTC naloxone was fairly positive amongst adults in the United States. However, intentions to purchase OTC naloxone were low. This may be due to a gap in knowledge surrounding the importance of naloxone availability in cases of illegal opioid use as well as accidental overdose from prescription opioids. Further education is necessary to increase the public’s knowledge about the importance of OTC naloxone in both the use of prescribed opioid medications and illegally obtained opioids. Findings from the current study will inform efforts to develop educational materials to aid pharmacist-patient discussions about OTC naloxone. Future studies may explore community pharmacies’ organizational readiness to store, dispense, and educate patients about OTC naloxone.