Term of Award

Fall 2020

Degree Name

Doctor of Public Health in Public Health Leadership (Dr.P.H.)

Document Type and Release Option

Dissertation (open access)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Department of Health Policy and Community Health

Committee Chair

Linda Kimsey

Committee Member 1

Bettye Apenteng

Committee Member 2

Samuel Opoku


Opioid overdose deaths have quadrupled since 1999. Georgia is one of 35 states with a significant increase in drug overdose deaths from 2013 – 2017, with deaths increasing by 70% during 2010-2018. Many states, including Georgia, have implemented naloxone standing orders to remove barriers to access to naloxone, an opioid overdose reversal drug that reverses opioid overdose symptoms. However, it is still not readily available in places where it is most needed. This research investigates naloxone availability in Georgia 44 months after the implementation of a statewide standing order. This research also seeks to determine if pharmacy and community-level factors are associated with naloxone availability. A stratified random sample of active retail pharmacies based on USDA Rural-Urban Continuum Codes was surveyed by phone using a simulated client methodology to gather information about naloxone availability. Chi-square analyses were conducted on each factor to assess associations with naloxone availability. A multiple logistic regression analysis was then conducted to explore further factors associated with availability and their ability to predict naloxone availability in a combined model. Results showed that pharmacy type and political leaning were both associated with and were statistically significant in predicting naloxone availability in Georgia. Pharmacy and community-level variables included in this study produced a statistically significant model to predict naloxone availability. Naloxone availability continues to be a vital harm reduction tool in preventing opioid overdoses. Pharmacies in Georgia are critical in providing statewide access to naloxone. Opportunities remain to understand better standing order implementation, factors that influence implementation, and opportunities to improve naloxone availability.

Research Data and Supplementary Material