Ford Research Group
The approach to delivering injectable naltrexone services varies across community pharmacies. Interviews with community pharmacists identified three injectable naltrexone service delivery models.39 The primary differences among the three models relate to where the urine drug test is performed and if behavioral health consultation is offered within the community pharmacy. All other steps are consistent across the models.
In model 1, the community pharmacy only provides the injection. The clients’ rapid urine drug test, which should occur prior to receipt of the injection, is performed outside of the pharmacy, often at the prescribers’ office. The test results are then shared with the pharmacy when the appointment is scheduled. In the other two models, the urine drug test occurs at the pharmacy.
In model 2, the community pharmacy conducts the urine drug screen prior to providing the injection. Unlike model 3, the behavioral counseling occurs prior to the patient coming to the pharmacy for their naloxone injection. These appointments are typically scheduled at the pharmacy to allow time for the preparation of the injection prior to the appointment.
In model 3, the community pharmacy takes the client to their private consultation room and uses tele-health to connect with an outside behavioral health specialist prior to the receipt of the injection. Once the consultation is over, and when the behavioral health specialist and patient agree that injectable naltrexone is warranted, the pharmacist will be sent the prescription order. Pharmacy staff will then prepare and administer the injection.
