Narcan available over the counter: what you need to know

Narcan, the first opioid overdose drug approved for over-the-counter purchase, is shipping to drugstore and grocery store chains nationwide, its maker announced Wednesday. Big box retailers like Walgreens, CVS, Walmart and Rite Aid said they expect Narcan to be available online and in many stores early next week.

Public health experts have long called for greater accessibility to the drug, which they describe as a key weapon against rising overdose rates. There have been more than 100,000 opioid overdose deaths in each of the past two years in the United States.

Narcan is already a staple for emergency personnel and street outreach teams. Today, scientists and health officials hope that Narcan will one day become commonplace in public libraries, subways, dormitories, corner delis and street vending machines.

They also predict that this product could become a staple of medicine cabinets as more people realize that street drugs like cocaine and counterfeit Xanax pills can be contaminated with the deadly opioid fentanyl. .

Here’s what you need to know about buying this life-saving drug.

How Narcan Works

Narcan is a nasal spray version of the drug naloxone, which blocks the effects of an opioid on the brain, saving someone defeated by drugs like fentanyl, heroin or oxycodone.

A person can overdose if their breathing is slowed or stopped and the pupils of the eyes narrow to a specific point. Naloxone is generally considered so safe that experts say that in the face of a possible overdose, it is better to risk using it than to hesitate.

Each carton contains two palm-sized plunger devices, each filled with four milligrams of naloxone. The rescuer inserts the spray tip into the patient’s nostril and depresses the plunger.

Usually, one dose is enough to reverse an overdose in two to three minutes. But addiction experts have warned that in areas where the supply of fentanyl is large enough, a second dose may be needed.

How much will it cost?

Cost is likely to dictate the scale of Narcan adoption. The manufacturer, Emergent BioSolutions, suggests $44.99 as the price for the two-dose box.

“People with a bit of money and motivation will seek out this product, which is fantastic,” said Brendan Solaner, addiction policy expert at the Johns Hopkins Bloomberg School of Public Health. “This may include worried family members.”

But those who need Narcan the most may not be able to afford it, he added, saying “this includes people who are homeless or financially insecure and who are at greatest risk.” of overdose”.

When Narcan was only available by prescription, public and private insurance easily covered it. But these plans usually limit over-the-counter drug coverage.

Some state Medicaid programs have already announced that they will cover Narcan as soon as it becomes available over-the-counter. These states include Missouri, California, Massachusetts, Washington, Rhode Island, and Oregon.

Emergent said prices would be lower for wholesale sales to public interest groups and state health departments, which in turn will distribute Narcan to community organizations and local clinics.

How can I find Narcan in stores?

Retailers often place the most expensive products or those at risk of theft behind a counter or in a locked display case. But behavioral health experts say customers may be reluctant to ask store employees for Narcan, fearing raised eyebrows and dismissive comments – hallmarks of the pervasive stigma surrounding drug use and addiction.

Through a spokeswoman, Rite Aid said Narcan would be available over the counter in its pharmacy and in pain care aisles. Many stores, including CVS, will also have it on hand. Rite Aid, Walgreens, Walmart and CVS also said Narcan could be purchased next week through their online sites, offering greater privacy.

“The stigma will always be there, but I think there’s been a sea change in how the public perceives naloxone over the last decade, and a lot more people are willing to carry it around,” said said Dr. Solaner.

And after?

Although Narcan is the first overdose drug to be sold without a prescription, the market will likely soon be crowded with cheaper competitors.

A generic naloxone spray from Teva Pharmaceuticals is still available by prescription, which means it’s usually covered by public and private insurance policies. Pharmacists in most states rely on a “standing order” for the spray, which means they don’t need a doctor’s prescription to dispense it. For someone on Medicaid or commercial insurance, generic naloxone might well cost less than $10.

CVS encourages customers to ask for Narcan over the counter at the pharmacy “so that our pharmacy teams can check a patient’s insurance plan for potential savings on prescription naloxone products,” a carrier said. word.

Earlier this summer, the Food and Drug Administration gave over-the-counter approval to RiVive, a naloxone spray expected in early 2024. RiVive, made by Harm Reduction Therapeutics, is intended to be an inexpensive product largely aimed at people neighborhood groups.

Other forms of naloxone, some in higher strengths and some in syringes, are already available by prescription.