OTC Narcan: What Does it Mean For You?

Folks can be forgiven if they thought OTC Narcan was already a thing. After all, most states approved widespread access to the life-saving antidote during the pandemic. Heck, many even issued Statewide Standing Orders permitting free dispensing by community organizations and the like. Apparently though obtaining Narcan over-the-counter was still a Federal no-no.

Well, as of March 29, 2023, OTC Narcan is no longer a Federal no-no. How do we know? The FDA said so – in a press release, no less.

To wit:

Today, the U.S. Food and Drug Administration approved Narcan, 4 milligram (mg) naloxone hydrochloride nasal spray for over-the-counter (OTC), nonprescription, use – the first naloxone product approved for use without a prescription. Naloxone is a medication that rapidly reverses the effects of opioid overdose and is the standard treatment for opioid overdose. Today’s action paves the way for the life-saving medication to reverse an opioid overdose to be sold directly to consumers in places like drug stores, convenience stores, grocery stores and gas stations, as well as online.

Now before you give the Feds a standing ovation, consider the big picture. Yes, we need naloxone to be as widely available as possible. And yes, the FDA’s move will undoubtedly make it more so. But this is far from a cure-all. In fact, it’s not even close.

In the first place, this applies only to Narcan. Other naloxone brands have to file separately. Yep, that includes generics. Which means Emergent BioSolutions can basically price the life-saver at whatever price they’d like. Right now, that price lies in the $150 to $175 range, for a package of two inhalers. Those with drug coupons however, may be able to get a double dose for as little as $40.

So Who’ll Buy OTC Narcan?

If you think even $40 is beyond the price of what most addicts will be willing to pay, you’d be thinking correctly. That’s way beyond most addicts’ means, especially if it means not getting straight.

So who exactly would be purchasing this OTC Narcan?

To answer that and other pertinent OTC Narcan questions, PBS Newshour’s John Yang got with Dr. Andrew Kolodny, a senior scientist at Brandeis University’s Heller School for Social Policy and Management.

Dr. Kolodny believes naloxone should be on hand everywhere from Starbucks and airplanes, not to mention in the homes of every pain pill prescription holder in the land. If the homes of their illicitly skewed brethren were also included, that would be a plus. In other words, while the good doctor agreed the FDA’s move would indeed make an impact on access, that impact is likely to be “small.”

What’s really needed, insisted Dr. Kolodny, is more “prevention and treatment.” Mostly though, Dr. K wants the Feds to make a commitment on par with AIDS. Back then, noted the doc, a “new funding stream” was created so every patient received inhibitors, regardless of ability to pay.

It would be especially helpful if the Biden administration would follow-up on the extensive OUD plan it ran upon, added Dr. Kolodny.

Whether or not coffee shop chains and airline companies will be running out and buying OTC Narcan is anyone’s guess. We can only hope.

A Stronger OTC Narcan

And what about Narcan anyway? Is it really the best naloxone that we’ve got?

Maybe not. It’s certainly not the most loaded. And considering most overdoses require multiple doses, we need a more loaded alternative.

Kloxxado does just that. The nasal spray packs 8mg of naloxone per dose, compared to Narcan’s 4mg. Another brand, Zimhi, comes in at 5mg, however right now it’s only injectable (like an Epi-pen). Again though, since the FDA is requiring each individual company to file separately, we’re unsure when either naloxone option will be granted over-the-counter status. And again, we can only hope.

Nalaxone for Everyone

Healing Properties of course is all for the mass dissemination of naloxone, no matter what the brand. So we’re definitely on board with OTC Narcan. We wholeheartedly hope though that the FDA will fast-track other naloxone alternatives. It wouldn’t be fair to permit one company to hold a monopoly on the OTC market, especially if the drug is going to be so egregiously overpriced.

We also wholeheartedly hope that the Feds up the ante as far as prevention and treatment. We hope the states do so too, especially now that they’re starting to receive the opioid lawsuit money. In fact, the state’s now are perfectly poised to fully address the issue. Let’s hope they don’t squander this golden opportunity.

How about you? Has Narcan played a part in your life? Have you been on the receiving end? The giving? Will OTC Narcan make a difference to you? To your loved ones? Would you like to be in a place beyond naloxone? Where overdose isn’t even an issue anymore? Well, then please give us a call. We’ll help get you over the hump and back into an opioid-free life. And you can keep OTC Narcan on hand for someone else’s emergency.

Image courtesy Emergent BioSolutions.