MMC Research Leads to New Proactive Approach to Naloxone Prescribing Throughout MaineHealth

October 29, 2019

PORTLAND, Maine – After research through Maine Medical Center (MMC) found internal medicine clinics were not consistently prescribing naloxone to patients at high risk for an opioid overdose, the MaineHealth system has launched a year-long effort to promote overdose awareness and education among patients and providers about the best ways to prevent and treat substance use disorder.

The Journal of General Internal Medicine has published a research paper led by MMC physicians David Kispert M.D., Jenny Carwile Sc.D., M.P.H., and Kinna Thakarar, D.O., M.P.H., that found that between April of 2016 and December of 2018, just six percent of patients considered high-risk for an opioid overdose received a prescription for naloxone when they visited an internal medicine clinic at Maine Medical Partners, the outpatient division of MMC. Patients were more likely to receive prescriptions if they were younger, of Hispanic origin, receiving care at a clinic in a lower-income community, met more than one of the Centers for Disease Control and Prevention’s (CDC) criteria to be considered high risk for overdose or had a history of opioid use disorder.

“This research is significant because it found disparities of naloxone prescribing based on age, income and ethnicity,” Dr. Thakarar said. “What is encouraging is that these findings prompted MaineHealth to improve its naloxone prescribing practices.”

A team led by Kristen Silvia, M.D., who was a co-author on the paper, and Stephanie Nichols, Pharm.D., examined prescribing practices across MaineHealth, the system of health care providers that includes MMC, found that 17 percent of patients who met the CDC’s high-risk criteria had an active prescription for naloxone.

To address the disparity in prescribing practices, Drs. Silvia and Nichols developed a Naloxone toolkit and video aimed at providers and clinicians that helps them:

  • Recognize who is at highest risk of overdose.
  • Describe signs and symptoms of opioid overdose.
  • Understand the four different naloxone formulations and how to use each one.
  • Talk to patients about risk of overdose and about naloxone.

Locate tools that relate to naloxone prescribing.

“MaineHealth is invested in addressing the opioid crisis through prevention, education and medication-assisted treatment,” Dr. Silvia said. “We are taking a proactive approach to educate both providers and patients about the best ways to recognize risk factors for overdose and how to treat it.”

The video and toolkit underscore the investment MaineHealth has made to address the opioid crisis within its communities that include prevention, education and medication-assisted treatment. The material can be accessed at

A copy of the research article in The Journal of General Internal Medicine can be accessed at


About Maine Medical Center
Maine Medical Center (MMC), recognized as a Best Regional Hospital by U.S. News and World Report for 2018-2019, is a complete health care resource for the people of Greater Portland and the entire state, as well as northern New England. Incorporated in 1868, MMC is the state’s largest medical center, licensed for 637 beds and employing nearly 8,700 people. MMC's unique role as both a community hospital and a referral center requires an unparalleled depth and breadth of services, including an active educational program and a world-class biomedical research center. As a nonprofit institution, Maine Medical Center provides nearly 23 percent of all the charity care delivered in Maine. MMC is part of the MaineHealth system, a growing family of health care services in northern New England. For more information, visit

About MaineHealth
MaineHealth is a not-for-profit integrated health system consisting of eight local hospital systems, a comprehensive behavioral healthcare network, diagnostic services, home health agencies, and more than 1,500 employed and independent physicians working together through an Accountable Care Organization. With close to 19,000 employees, MaineHealth is the largest health system in northern New England and provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire.