Trends in Opioid Prescribing and Co-Prescription of Opioid Antagonists: A Retrospective Analysis over a 12-Month Period

Background: Opioid prescribing practices have come under increased scrutiny due to the ongoing opioid crisis, with efforts focusing on harm reduction strategies such as co-prescription of opioid antagonists. This study analyzes opioid prescribing trends and the frequency of opioid-antagonist co-prescription over the course of 2024.

Methods: A retrospective analysis was performed using electronic medical record data to identify all opioid prescriptions issued between January 1, 2024, and December 31, 2024. Each opioid prescription was cross-referenced with any concurrent prescription for an opioid antagonist. The analysis did not differentiate opioid type, duration of therapy, or prescribing indication.

Results: A total of 68,212 opioid prescriptions were issued in 2024. Quarterly totals were: Q1: 16,574; Q2: 16,882; Q3: 16,922; and Q4: 17,834. Among these, 7,586 (11.1%) were co-prescribed with an opioid antagonist, while 60,626 (88.9%) were not. The distribution across quarters was:

• Q1: 16,574 prescriptions
• Q2: 16,882 prescriptions
• Q3: 16,922 prescriptions
• Q4: 17,834 prescriptions

Of these, 7,586 (11.1%) were co-prescribed with an opioid antagonist, while 60,626 (88.9%) were prescribed without one. The quarterly breakdown of opioid-antagonist co-prescription was:

• Q1: 1,874 prescriptions with an antagonist, 14,700 without
• Q2: 1,867 prescriptions with an antagonist, 15,015 without
• Q3: 1,945 prescriptions with an antagonist, 14,977 without
• Q4: 1,900 prescriptions with an antagonist, 15,934 without

Conclusion: Despite ongoing recommendations to increase opioid-antagonist co-prescription, a large majority (88.9%) of opioid prescriptions in 2024 were issued without an antagonist. While there was a modest increase in overall opioid prescriptions over the year, opioid-antagonist co-prescription rates remained relatively stable. These findings highlight the need for further investigation into barriers preventing wider adoption of opioidantagonist co-prescription and the potential impact on patient safety. Psychopharmacology Bulletin. 2026;56(1):39–47.