A Step Forward: Narcan Approved for Over-the-Counter Sale

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Narcan, a nasal spray capable of reversing an opioid overdose, has garnered great interest in the media as of late – and it made the news again after it was approved by the FDA for over-the-counter sales on Wednesday.

Naloxone is a powerful medication which can restore breathing to the victim of an opioid overdose by reversing the effects of opioids on the brain’s receptors. It’s available in various versions, but it’s by far the most popular in its nasal spray form, known by the brand name Narcan. Narcan is highly effective and surprisingly simple to administer – its small plastic nozzle is inserted into the victim’s nostrils, and the plunger is depressed, releasing the lifesaving fluid into the airways and restoring breathing.

Until now, Narcan was kept behind pharmacy counters and was available by prescription only, limiting access to the drug to those who most needed it. But lawmakers and public health officials have been pushing to have the critical medication made more widely available, and the FDA has heeded their request. Now, Narcan can be obtained over the counter in most pharmacies, and will soon be available without a prescription. FDA Commissioner Dr. Robert M. Califf says this OTC authorization comes in response to a “dire public health need”, in the hope that it will reduce the nation’s growing numbers of drug overdose deaths.

Officials are hoping to soon see Narcan available for sale in big-box chain stores, groceries, gas stations and online. According to the New York Times, the City of New York even plans to install Narcan vending machines in neighborhoods later this year.

This new authorization may seem like a small matter, but for individuals addicted to opioids, it can spell the difference between life and death. Will Montero, a Client Engagement Specialist at Avenues Recovery Center and a former heroin addict, shared his story in an interview with Meg Farris of 4WWWL News.

After a disastrous car crash as a teen, Will became addicted to the painkillers he had been prescribed, and soon developed a full-blown heroin addiction. He continued along that dark path until one day, he overdosed – but was pulled back from the edge by his grandmother’s timely administration of CPR and three doses of Narcan.

“I know for a fact that if it wouldn’t have been for the Narcan, I wouldn’t be sitting here right now,” he said. “It really scared me. I felt something I never felt before; I felt like I was dying. I just begged my higher power – if you pull me through this, I will never touch that stuff again.”

Will attended rehab at Avenues Recovery Center, and he now works for the treatment center that restored his life.

Dr. Ricky Phillips, a nurse practitioner at Avenues, said that making Narcan available OTC is a step in the right direction. 70% of overdose deaths are caused by opioids, he said, and that is the category of drugs that can be treated by Narcan. Across the country, emergency medical services had over 400,000 Narcan calls.

“The reality is that a lot of the people find their way to us after an overdose, after having been saved by Narcan”, Dr. Phillips shared. He added that one downside of making Narcan readily available is that drug abusers may view it as a safety net, and then push their use to the very limit. “It’s a possibility, but I still think that lives can be saved, and it should be made available for the greater good.”


Although Naloxone is only capable of reversing an opioid overdose, with increasing amounts of America’s illegal drug supply being tainted with fentanyl, it’s still highly worthwhile to administer in the event of any overdose. “Naloxone is safe and effective, and with increasing fentanyl in our drug supply, we need it everywhere in order to save lives”, said Dr. Ashwin Vasan, health commissioner of NYC.

Although Wednesday’s new ordinance makes Narcan more readily available than ever before, one deterrent remains: its price. For those with government insurance, prescription Narcan can be obtained for free or with a copay of under $10. But people with commercial insurance or no coverage at all will have to pay out-of-pocket – and the OTC price for a two-pack of Narcan can run slightly south of $100 in some chain pharmacies. The FDA is now urging all prescription Naloxone manufacturers to come forward with an offer and apply for OTC approval, to make pricing more competitive and hopefully lower prices to a normal range.

A side effect of Narcan’s hefty price tag is its placement. Because high-ticket products are naturally susceptible to shoplifting, they are generally kept behind the counter or in locked display boxes. And this defeats one of the purposes of increased Narcan availability – helping customers avoid awkward conversations with pharmacists, so that  shame should not prevent them from getting the medication they need. With OTC Narcan kept under lock and key, the stigma remains, keeping Narcan still out of reach.

Efforts continue to have Narcan made easily available in every major store aisle, and to lower prices so it can be afforded by all.

If you or a loved one are struggling with substance addiction, know that there is hope, and there is healing. Contact Avenues Recovery Center to begin your journey home today!

Find lasting sobriety at Avenues.

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