Australian community pharmacies are stocking naloxone at almost three times the rate reported a decade ago, but researchers say time, training, and knowledge gaps are still keeping the lifesaving drug off some shelves.
Almost three-quarters of Australian community pharmacies now stock naloxone, according to a national study that found pharmacists’ knowledge and attitudes towards overdose prevention have improved substantially over the past decade.
The study, published in the International Journal of Clinical Pharmacy, surveyed 730 community pharmacists across all Australian states and territories between January and April 2025.
“A large proportion of community pharmacies in Australia stocked naloxone, with variability across states/territories,” the researchers wrote.
“While pharmacists’ attitudes and knowledge were positive overall, there remains scope to increase provision of adequate education and targeted support to strengthen community pharmacies’ harm reduction capacity and provide equitable access.”
The researchers found 73.2% of pharmacies stocked naloxone, up from 23% reported nationally in 2016. Among pharmacies stocking the opioid overdose reversal medicine, 83% were signed up to the federal Take Home Naloxone program.
Under the national program, which began in July 2022 following a four-year $19.6 million federal investment, participating pharmacies can supply naloxone free and without a prescription and claim reimbursement for dispensing it.
Lead author Louisa Picco, from the Monash Addiction Research Centre, and colleagues said naloxone provision had increased by 50 percentage points over the past decade, representing a nearly 200% relative increase.
Knowledge appeared to make a substantial difference to whether pharmacies stocked the medicine.
Around 81% of pharmacists had good or excellent knowledge of naloxone and overdose, including 29.3% who answered all five knowledge questions correctly.
Pharmacists with good knowledge had more than four times the adjusted odds of working in a pharmacy that stocked naloxone compared with those with poor knowledge, while those with excellent knowledge had more than six times the odds.
Attitudes were also overwhelmingly favourable. Of the 698 pharmacists who completed the relevant questions, 44.7% had positive and 44.4% had very positive attitudes towards naloxone and overdose prevention.
More than four in five agreed pharmacists had a role in injury prevention, including overdose prevention, while just 5.6% agreed that overdose prevention for people using opioids was a waste of time and money. Attitudes were significantly more positive than those recorded in a 2016 survey, the researchers found.
Pharmacists with very positive attitudes had more than twice the adjusted odds of stocking naloxone compared with those with negative attitudes. Pharmacies providing opioid agonist treatment were also almost three times as likely to stock it.
There were notable jurisdictional differences. Compared with NSW pharmacies, those in Queensland had about twice the adjusted odds of stocking naloxone, while pharmacies in the combined ACT, NT, Tasmania, and South Australia group had more than twice the odds.
The researchers suggested differences in state-level implementation and regulation of the national program may contribute to the variation.
Among pharmacies that did not stock naloxone, practical barriers remained prominent. Of the 175 pharmacists who answered the question, 59.4% cited insufficient time to develop, implement, or sustain the program and 44.6% cited inadequate training among pharmacy technician staff.
Related
More than a third cited insufficient knowledge of state naloxone laws and regulations, while 33.1% pointed to the lack of reimbursement for patient education and counselling. Almost one-quarter cited insufficient profit margins.
The researchers said the findings suggested targeted implementation support and adequate staff training could further strengthen pharmacies’ role in harm reduction and improve equitable access to naloxone.
They cautioned that the study relied on self-reported data and had a response rate of 27.7%, meaning recall, response, and social desirability biases were possible.
“Over the past decade, pharmacists’ naloxone knowledge has increased significantly, with most community pharmacies now stocking naloxone, with variability across jurisdictions,” the researchers concluded.
“Negative pharmacists’ attitudes towards naloxone may indicate a lack of knowledge and stigma towards people who use drugs, highlighting an important area for intervention.
“Targeted support to implement the provision of naloxone service within community pharmacies and adequate staff training may be critical for continued service provision and strengthening the broader harm reduction capacity within community pharmacies.”
