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Narcan, the first opioid overdose reversal medication approved for over-the-counter purchase, is now being shipped to drugstore and grocery chains nationwide. Popular retailers like Walgreens, CVS, Walmart, and Rite Aid have announced that Narcan will be available online and on store shelves in the coming week. Public health experts have long advocated for easier access to Narcan, as it is considered a critical tool in combating the rising rates of opioid overdose. With over 100,000 opioid overdose fatalities reported in the United States in each of the last two years, the availability of Narcan is seen as a significant step forward in tackling this crisis.
While Narcan has been commonly used by emergency personnel and street outreach teams, scientists and health officials now hope to make it readily available in public libraries, subways, dorms, corner delis, and even street vending machines. The goal is to ensure that Narcan becomes a commonplace item, potentially even in medicine cabinets, as more people become aware of the dangers posed by illicit drugs like cocaine and counterfeit Xanax pills, which may be laced with the deadly synthetic opioid fentanyl.
How Narcan Works
Narcan is a nasal-spray version of the drug naloxone, which acts by blocking opioids’ effects on the brain and reviving a person who has overdosed on drugs like fentanyl, heroin, or oxycodone. Signs of an opioid overdose include slowed or stopped breathing and pinpoint pupils in the eyes. Naloxone is considered safe enough that in cases of a suspected overdose, it is recommended to administer it without hesitation. Each box of Narcan contains two 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 within two to three minutes, but in areas with potent fentanyl supplies, a second dose may be required.
How Much Will It Cost?
The cost of Narcan may influence its accessibility and usage. The manufacturer, Emergent BioSolutions, has suggested a price of $44.99 for a box containing two doses. While individuals with financial means may seek out and afford this product, there are concerns about those who are most at risk of overdose, such as the unhoused or financially insecure. Previously, when Narcan was available only by prescription, public and private insurance plans typically covered it. However, coverage for over-the-counter drugs is often restricted. Some state Medicaid programs, including those in Missouri, California, Massachusetts, Washington, Rhode Island, and Oregon, have announced plans to cover Narcan when it becomes available over the counter. Additionally, lower prices will be offered for bulk sales to public interest groups and state health departments, which will distribute Narcan to local outreach organizations and clinics.
How Will I Find Narcan in Stores?
Retailers may place pricier products or those prone to theft behind a counter or in a locked case. However, customers might hesitate to approach store workers for fear of judgment due to the stigma surrounding drug use and addiction. Each retailer will have its specific plans. Rite Aid has stated that Narcan will be available at its pharmacy counter and in pain care aisles. Many stores, including CVS, will also have it available near the front register. Online purchase options will be available through Rite Aid, Walgreens, Walmart, and CVS websites, offering a higher level of privacy. While stigma surrounding drug use may persist, there has been a shift in public perception of naloxone over the last decade, with more people open to carrying it.
What’s Next?
Narcan is the first over-the-counter overdose reversal medication, but the market is expected to see the arrival of less expensive competitors soon. Generics of the naloxone spray, available through Teva Pharmaceuticals with a prescription, are already covered by most public and private insurance policies. Pharmacists in most states can dispense the spray without a physician’s prescription, relying on a “standing order” instead. This makes generic naloxone an affordable option, potentially costing less than $10 for individuals with Medicaid or commercial insurance. In addition, the FDA has recently granted over-the-counter approval to RiVive, a naloxone spray manufactured by Harm Reduction Therapeutics. RiVive is expected to be released in early 2024 and aims to provide a low-cost option primarily targeted at outreach groups. Other forms of naloxone, including higher concentration variants and syringe-loaded options, are already available by prescription.
