**Intervention to Increase Naloxone Engagement in Community Pharmacies: A Focus Group Investigation**
**Background/Objectives:** Community-based pharmacies play a pivotal role towards improving opioid safety by dispensing naloxone, medications for opioid use disorder and selling nonprescription syringes for safe injection. This study explored pharmacist attitudes, knowledge, and experience in dispensing naloxone, providing buprenorphine and selling nonprescription syringes as well as the acceptability of a pharmacy-based training program, entitled RESPOND TO PREVENT, aimed at improving these three content areas to reduce opioid-related harms. **Methods:** Two online asynchronous focus groups were conducted with community-based chain pharmacists (n = 32) across Massachusetts, New Hampshire, Oregon, and Washington state. Eligible participants were those pharmacists who had completed the baseline assessment and online course. Each pharmacist participated anonymously for approximately 30 minutes across a 52-60 hour window. Questions focused on prescriber support, policy impacts at the store, state, and federal level, experiences with pharmacy-based naloxone, and intervention implementation barriers and facilitators. Qualitative data analysis was conducted by a multidisciplinary team using an immersion-crystallization approach. **Results:** Five major themes were identified in the focus groups: (1) gaps in pharmacist and broader pharmacy team knowledge of opioid use disorder, pharmacy-based naloxone, buprenorphine and syringe safety and sales; (2) shifts in self-efficacy to initiate “tough” conversations with patients and counseling about naloxone using intervention materials; (3) attitude changes regarding the pharmacist’s role as community caretaker; (4) practice changes to increase provision of naloxone and syringe sales; and (5) barriers to naloxone provision due to cost concerns and stigma towards people who use drugs. **Conclusion:** Community pharmacists across four states identified important knowledge, training, and stigma-related gaps. Results reflect rich and positive experiences of community-based pharmacists participating in the educational intervention and provide face validity for the content of the modules and intervention materials as a means of addressing identified gaps.
