Opiate Antagonist Protocol Registration

Background

In 2016, the Minnesota Legislature responded to the increase in statewide opioid overdoses by passing Session Law, Chapter 124. One of the goals of this legislation is to increase the availability of naloxone through pharmacies across Minnesota.

Pharmacy

Individual pharmacists and group pharmacies can enter the Board of Pharmacy’s Opiate Antagonist Protocol with the MDH Medical Director by completing this registration form. Group pharmacies must register each location separately. If you would like to register three or more locations, please contact Dana Farley at dana.farley@state.mn.us.

This registration form is required to enter the Opiate Antagonist Protocol with MDH’s Medical Director. You can exit the protocol at any time by filling out this form.

Community Health Board and Local Health Departments

Community Health Boards (CHB) are to designate either a local medical consultant or the MDH Medical Director, as a prescriber of record for naloxone. Local health departments (LHD), independent of their CHB, may also enter the protocol with MDH or a local medical consultant.

This registration form is required to inform MDH of your CHB/LHD’s designation. You can update your designation at any time by filling out this form.

More Information

Visit MDH's website for more information regarding opioid overdose prevention in Minnesota. For questions or concerns, please email Cody Bassett, MPH, Naloxone Coordinator at cody.bassett@state.mn.us or call (651) 201-4244.

Select one option:

Pharmacy
CHB or LHD

Select your action:

Enter protocol with MDH Medical Director, Ruth Lynfield, MD.
Exit the protocol (provide effective date):

Is your pharmacy a safe disposal site?

No
Yes (please specify which location):

Notice of Liability

Section 604A.04 Good Samaritan Overdose Prevention, subdivision 3, extends release from liability for all licensed health care professionals permitted by law to prescribe an opiate antagonist. If acting in good faith, they may directly or by standing order, prescribe, dispense, distribute, or administer an opiate antagonist to a person without being subject to civil liability or criminal prosecution for the act. This immunity applies even when the opiate antagonist is eventually administered in either or both of the following instances: (1) by someone other than the person to whom it is prescribed or (2) to someone other than the person to whom it is prescribed.

I acknowledge

Trainings

While not required by law, the responsible pharmacists should strongly consider completing appropriate training related to opioid overdoses and the use of naloxone, unless they have already done so. A list of trainings can be found on the Minnesota Department of Health's website.

I acknowledge

Select your action:

CHB or LHD is designating MDH Medical Director, Ruth Lynfield, MD.
CHB or LHD is designating a local medical consultant.

What CHB or LHD are you from?

I acknowledge