The DEA (and wholesalers) have inappropriately cracked down on an unknown number of community pharmacies for dispensing too much buprenorphine. This has had a chilling effect for an already stigmatized medication, leading many pharmacies to limit access. npr.org/sections/healt… Our team @PhARMprogram found most pharmacies in TX are not prepared to dispense a common buprenorphine formulation for OUD. Availability is lower in independent pharmacies, possibly due to their direct financial stake in the business. doi.org/10.1111/add.15…

Thanks @UTMBFamilyMed for inviting me to present Grand Rounds today! I'm going to share a few pearls for other interested folks in #FamilyMedicine, #TwitteRx, & beyond.

A long but extremely visual🧵🧵🧵 To understand the "opioid crisis", you have to accept that the first wave was driven by excessive prescribing. BUT you also have to accept that reactionary supply reduction interventions drove a totally preventable second wave of deaths due to heroin.

#NARCAN Nasal Spray would be vastly more affordable/accessible if we acknowledged that 1 dose per kit is sufficient. Comparing plasma #naloxone concentrations following administration of various doses by intranasal (IN) & intramuscular (IM) routes tells us a lot. THREAD Consider this graph from #NARCAN prescribing info (ignore top 2 lines). 0.4mg IM (vial+syringe) achieves lowest peak level...but it still works & has saved countless lives. 2mg IN (prefilled+MAD) achieves higher peak, & 4mg IN (NARCAN) achieves highest peak.