In a landmark decision aimed at combating the opioid crisis, Narcan nasal spray, a life-saving medication used to reverse opioid overdoses, has been approved for over-the-counter (OTC) purchase in pharmacies across the United States.
Effective September 2023, individuals can now obtain Narcan nasal spray without a prescription at major retailers such as Target, CVS, Walgreens, and various other drug stores. The announcement came just five months after the U.S. Food and Drug Administration (FDA) approved Narcan to be distributed and sold without a prescription. A two-pack retails for $44.99.[1]
While Narcan was previously available without a prescription, individuals still had to go to the pharmacy and ask a pharmacist for the medication. But now, individuals can purchase it over the counter without having to ask a pharmacist. This approval marks a pivotal step in expanding access to a crucial intervention for opioid overdose emergencies–especially in people who may be reluctant to ask a pharmacist for the medication.
Understanding Naloxone (Narcan)
Naloxone, often referred to as a “rescue drug,” is a fast-acting opioid antagonist that can rapidly reverse the effects of an overdose, potentially saving lives when administered promptly. Naloxone is the active ingredient in Narcan.
When someone overdoses on opioids like heroin, fentanyl, or prescription painkillers, these drugs can slow down or stop breathing, leading to potentially fatal consequences. However, naloxone essentially competes with opioid drugs for space on the opioid receptors in the brain. Once administered, it binds strongly to these receptors, displacing the opioids and knocking them off of opioid receptors. The result is that the effects of opioids, as well as overdose, are reversed. After it is administered, naloxone can rapidly restore normal breathing and consciousness in someone experiencing an opioid overdose.
The nasal spray form of naloxone is designed for easy and swift use by bystanders or caregivers in emergency situations. It is easy and quick to administer, as it is given intranasally with a simple press of a plunger.
It’s important to note that some opioids can produce effects that last longer than the effects of naloxone. As a result, the naloxone can wear off before the opioids leave the body, potentially resulting in another overdose. Individuals who have been given naloxone should always obtain medical help and supervision to avoid this from occurring.
The Significance of Making Naloxone Available Over-the-Counter
This decision to make Narcan nasal spray available OTC supports the United States’ ongoing efforts to address the alarming rise in opioid-related fatalities. In a recent press release for UT Southwestern Medical Center, experts report that an estimated 187 people in the U.S. die every day as a result of opioid overdoses, most of which involve fentanyl.[2] However, many of these overdoses can be prevented with naloxone.
Previously accessible primarily through healthcare providers or community programs, the move to sell Narcan nasal spray OTC intends to break down barriers that may have limited its availability to those who need it during critical moments. By making this medication readily accessible in pharmacies without the need for a prescription, the hope is to empower more individuals to take proactive measures in emergency situations involving opioid overdoses.
Now, instead of having to ask someone else for Narcan and face the fear of feeling judged or ashamed due to one’s drug use, individuals can access the life-saving drug while maintaining their privacy and anonymity.
Healthcare professionals and public health advocates have emphasized the importance of widespread Narcan distribution as a crucial tool in preventing opioid-related deaths for many years. And with its newfound OTC status, it’s anticipated that more people, including family members of individuals struggling with opioid use disorder and those who live in high-risk communities, will have easier access to this life-saving medication, and fewer lives will be lost.
Administering Narcan: What You Need to Know
While making Narcan available to all represents a significant stride forward in the battle against opioid addiction, it’s important to be educated on how to use and administer it. Pharmacies offering Narcan are also encouraged to help people recognize the signs of an opioid overdose and how to administer Narcan effectively.
Signs of opioid overdose include:
- Slowed or shallow breathing
- Extreme drowsiness or unconsciousness
- Pinpoint pupils
- Limpness or weakness
- Pale, cold, or clammy skin
- Blue lips or fingernails
- Vomiting or gurgling noises
To administer Narcan:
- Lay the person on their back, tilt their head back slightly to open the airway.
- With the person’s head tilted back, carefully place the tip of the nasal spray into one nostril.
- Press the plunger firmly to release the spray, administering the entire dose.
- Wait two minutes and administer another dose of Narcan if the person does not respond.
- Turn the person onto their side to prevent choking if they vomit.
- Even after administering naloxone, it’s crucial to call emergency services immediately and continue to monitor the person until help arrives.
If you or someone you love are addicted to opioids, it is a good idea to receive naloxone training. Training takes approximately 20 minutes and can be obtained at https://www.getnaloxonenow.org/#gettraining.
References:
- https://www.nbcnews.com/health/health-news/opioid-overdose-antidote-narcan-will-widely-available-counter-week-rcna101611
- https://www.utsouthwestern.edu/newsroom/articles/year-2023/aug-q-a-opioid-abuse-risks-treatment.html
