Connecticut State Department of Consumer Protection

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Opioid Overdose Information for Pharmacists

NEW: Pharmacist Protocol for Prescribing and Dispensing Naloxone HCl Outside the Licensed Pharmacy Premise
Steps:
  1. Download the Protocol
  2. Download and complete the Protocol Request for Approval
  3. Email (preferred) or Mail the Protocol Request for Approval along with the Protocol to DCP.DrugControl@ct.gov or the mailing address on the form. (This should be completed 30 days prior to the event)
  4. Wait for the Approval Letter from the Drug Control Division (Sent via email)
  5. Report the total number of naloxone units prescribed and dispensed to DCP.DrugControl@ct.gov.
Helpful forms: 
 
Certification Program
    1. University of Connecticut School of Pharmacy (ACPE #0009-9999-15-073-H03-P)
    2. Pharmacist Letter (ACPE # 0422-0000-15-652-H01-P and 0422-0000-16-242-H01-P)
    3. Walgreens Connecticut Naloxone Training
    Handouts and Forms
    Suggested Intranasal Naloxone Kit Components
    • 2 x 2 mg/2 mL prefilled naloxone cartridges
    • 2 plastic syringes
    • 2 mucosal atomization devices
    • A rescue breathing mask
    • Step-by-Step instructions for responding to an opioid overdose (See Naloxone Handout above)
    • Directions for naloxone administration (See Naloxone Handout above)
    • Sample Prescription for Intranasal Kit (use Adobe Acrobat for best results)
    • VA Intranasal Counseling Video
    Suggested Intramuscular Naloxone Kit Components
    Suggested Auto Injector Naloxone Kit Components
    Resources