June 19, 2024

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Rosalind Pichardo, who founded Operation Save Our City in Philadelphia, sprays a container of Narcan during a demonstration Sept. 8 at the Health and Human Services Humphrey Building in Washington, DC. Health officials held the event to mark the availability, without a prescription, of the opioid overdose-reversal drug.

AP Photo/Mark Schiefelbein


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AP Photo/Mark Schiefelbein


Rosalind Pichardo, who founded Operation Save Our City in Philadelphia, sprays a container of Narcan during a demonstration Sept. 8 at the Health and Human Services Humphrey Building in Washington, DC. Health officials held the event to mark the availability, without a prescription, of the opioid overdose-reversal drug.

AP Photo/Mark Schiefelbein

Earlier this month, drug stores and pharmacies nationwide began stocking and selling the country’s first over-the-counter version of naloxone, a medication that can stop a potentially fatal overdose from opioids. It’s sold as a nasal spray under the brand name Narcan.

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Coming off a year with a record number of drug overdose deaths in the United States — nearly 110,000 in 2022, according to the CDC’s National Center for Health Statistics – community health workers and addiction medicine experts were hopeful that the arrival of Narcan on retail shelves might make it easier for people to get the medication.

The urgent and ultimate goal is to prevent more fatal overdoses.

But it’s unclear if the move will actually expand access to Narcan. Experts worry that its retail price, sporadic availability on store shelves, or general consumer confusion about potentially having to ask a pharmacist to retrieve it will mean that fewer people than expected will purchase Narcan and actually have it at the ready when an overdose occurs.

That means that more education and outreach will be needed to get this lifesaving medication into more hands. Those already engaged in the opioid epidemic – community health workers and nonprofits focused on harm reduction – will have to stay intensely involved. Over-the-counter Narcan will be an additional tool, alongside prescription and free versions of the drug.

“It’s not by any means a game changer. I don’t think it’s a step in the wrong direction. I just think it’s a tiny, tiny baby step that does not deserve a round of applause,” says Shoshana Aronowitz, a family nurse practitioner and assistant professor at the University of Pennsylvania’s School of Nursing in Philadelphia.

“We should not be under any illusion that this is going to meaningfully change things for a lot of people,” she says. “But we need to be moving in this direction, we just need to be doing it faster and with an understanding that this is just way overdue.”

Over-the-counter can mean behind the counter

The U.S. Food and Drug Administration approved over-the-counter marketing and sales of Narcan in March. It’s manufactured by Emergent BioSolutions, and started arriving in stores in early September, with a suggested retail price of $44.99 for a two-dose package.

As an over-the-counter product, Narcan should ideally appear on store shelves in the same way as

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