BONUS: Mailbag – Does Naloxone Increase Opioid Misuse?

Naloxone and nalmefene are reaching more hands than ever—through bystander programs, pharmacy dispensing protocols, and over-the-counter sales. But as access expands, one question keeps coming up: **Does easier access to naloxone or nalmefene actually make opioid misuse worse?** In this **BONUS mailbag episode of *Rumor vs Truth***, we answer a listener question about whether increasing naloxone and nalmefene access encourages opioid misuse or overdose. Hosts **Don Weinberger, PharmD**, and **Steve Small, PharmD**, bring in addiction medicine specialist **Dr. Nicole Gastala, MD,** to unpack what the evidence actually shows. Together, they discuss: - Whether increasing naloxone or nalmefene access actually encourages riskier opioid use - What a large systematic review and 2025 American Heart Association guidance say about public-access naloxone - Why carrying naloxone is more like carrying an EpiPen than a “permission slip” for risk - The one real risk to watch for after a reversal: precipitated withdrawal - Why OTC naloxone and statewide pharmacy dispensing protocols matter for practice **No CE credit is available for this bonus episode.** Want the full breakdown? CE credit is available for our full episode on opioids. \*\*\*\*\** **🎧 Related Episode (CE Available)** - **Rumor vs Truth: Laxatives** *(Opioid FACTS OR FEARS?)* 🎧Listen: https://rumorvstruth.buzzsprout.com/episodes/19647733 ▶️ Watch: https://youtu.be/sl3upSCxfwM \*\*\*\*\** **TRC Healthcare Editor Hosts** - Steve Small, PharmD, BCPS, BCPPS, BCCCP, CNSC - Don Weinberger, PharmD, PMSP **Guest** - Dr. Nicole Gastala, MD \*\*\*\*\** **Clinical Resources:**  - FAQ: Meds for Opioid Overdose - Checklist: Opioid Reversal Agents Quick Start Guide 🏷️ Our listeners can get **10% off** a new or upgraded subscription with code **rvt1026** at checkout.  \*\*\*\*\** Send us Fan Mail Email us: [rumorvstruth@trchealthcare.com](mailto:rumorvstruth@trchealthcare.com) *The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment.* Find the show on YouTube by searching for ‘TRC Healthcare’ or clicking here. Learn more about our product offerings at trchealthcare.com.