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.

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🎧 Related Episode (CE Available)

• Rumor vs Truth: Laxatives
  (Opioid FACTS OR FEARS?)
  🎧Listen: https://rumorvstruth.buzzsprout.com/episodes/19647733
  ▶️ Watch: https://youtu.be/sl3upSCxfwM 

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TRC Healthcare Editor Hosts

• Steve Small, PharmD, BCPS, BCPPS, BCCCP, CNSC
• Don Weinberger, PharmD, PMSP

Guest

• Dr. Nicole Gastala, MD

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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. 

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The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

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