Anyone taking opioids is at risk of an accidental poisoning.1 Patients taking fentanyl or fentanyl analogues may be at an increased risk, but patients taking medications containing codeine, on its own or in combination (e.g., acetaminophen/codeine tablets), may also be at risk for an accidental opioid poisoning.2,3 Despite your efforts in educating and counselling your patients on opioid use, pain can be a powerful motivator when it comes to human behaviour.4 Since acetaminophen is an over-the-counter medication that most people are familiar with, patients may think that there is no harm associated with taking a higher dose of their acetaminophen/codeine tablets than what they have been prescribed. This can increase their chance of having an accidental opioid poisoning.3
This is an example of why it is important to continue to educate patients on the risks associated with opioids, and to follow the Canadian National Consensus Guidelines for Naloxone Dispensing by Pharmacists and provide a take-home naloxone kit to ALL patients receiving an opioid prescription as a safety precaution.1,5
When talking to patients who do not think they need NARCAN® Nasal Spray, here’s an example of what you can say:1,5,6
“I’ve explained the benefits and risks associated with your medication. As I mentioned, it is very important to take it as prescribed. That being said, accidents do happen and, because anyone taking an opioid is at risk of an accidental opioid poisoning, I would like to offer you NARCAN® Nasal Spray as a safety precaution. This is something I do for all of my patients; however, you are allowed to refuse it. Having naloxone in the home is similar to having a fire extinguisher in the kitchen. You hope you don’t need it, but you are prepared if you do.”
When it comes to an accidental poisoning, any of your patients taking an opioid could be at risk.1 Consider talking to your patients who are taking opioids about mitigating that risk with NARCAN® Nasal Spray.
References: 1. Tsuyuki R et al. Canadian national consensus guidelines for naloxone prescribing by pharmacists. Canadian Pharmacists Journal. 2020;153(6):347-351. 2. Public Health Ontario. Opioid Mortality Surveillance Report: Analysis of Opioid-Related Deaths in Ontario July 2017–June 2018. June 2019. Available at: https://www.publichealthontario.ca/-/media/documents/O/2019/opioid-mortality-surveillance-report.pdf(Open in a new window). Accessed July 27, 2021. 3. Healthline. Tylenol with Codeine Overdose. Available at: https://www.healthline.com/health/acetaminophen-and-codeine-overdose(Open in a new window). Accessed July 27, 2021. 4. van Steenbergen H et al. The role of the opioid system in decision making and cognitive control: A review. Cogn Affect Behav Neurosci. 2019;19:435-458. 5. Ontario Pharmacists Association. Pharmacist clinical tool for initiating naloxone discussions. Available at: https://opatoday.com/wp-content/uploads/Practice/Tools/Naloxone/Pharmacist-Clinical-Tool-for-Initiating-Naloxone-Discussions.pdf(Open in a new window). Accessed July 27, 2021. 6. Mueller SR et al. Attitudes toward naloxone prescribing in clinical settings: a qualitative study of patients prescribed high dose opioids for chronic non-cancer pain. Gen Intern Med. 2016;32(3):277-283.
PP-NAR4-CA-00087_05-2024 EN