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Narcan Nasal Spray Available Over-the-Counter

Narcan, a drug that prevents opioid overdoses, became widely accessible without a prescription last week.

This change to over-the-counter access was approved by the Food and Drug Administration in March and comes at a crucial time. Overdoses are the fourth-leading cause of mortality nationwide and the primary cause of accidental deaths in the United States. According to the Centers for Disease Control and Prevention, there were an all-time high of more than 107,000 overdose deaths in 2021. Over 71,000 of those fatalities used the potent synthetic drug fentanyl.

The manufacturer of the drug, Emergent BioSolutions, reported shipments to Walgreens, Walmart, Rite Aid, and CVS. A box of two doses of the medicine costs $44.99.

What is Naloxone?

Naloxone is a safe and effective medication that reverses an opioid overdose and saves lives. Expanding naloxone availability is a step that communities can take to enhance public health and reduce overdose fatalities. Effective nationwide naloxone distribution programs provide training and distribute doses to first responders, community-based organizations, public health departments, people who use drugs and their caregivers, employers, school systems, transportation partners, and jails and prison systems. Another approach that states have implemented is co-prescribing of naloxone with opioid prescriptions (Banjo, 2014).

Clear Evidence

Naloxone is a life-saving medication used to reverse an opioid overdose in an emergency with clear scientific evidence that increased availability reduces overdose deaths. A 2013 study of the Massachusetts Overdose Education and Naloxone Distribution Programs (OENDPs) found that opioid overdose death rates were reduced by 21% in communities where OENDPs were implemented, compared with communities with no implementation (Townsend, 2020).

Researchers also found that 87% of naloxone rescue attempts were performed by people who use drugs, that the person performing the rescue was usually a friend of the person who overdosed, and that naloxone was successful in 98% of the rescue attempts (Townsend, 2020).

First-responder distribution of naloxone is a highly effective strategy for reducing overdose deaths. A recent study using a decision-analytic model to analyze the cost-effectiveness of eight naloxone distribution strategies found that the maximum distribution of naloxone to laypeople, police and firefighters, and paramedics could reduce overdose deaths by 21% compared to the minimum distribution of naloxone (Walley, 2013). Another study conducted in Lorain County, OH shows that after police officers began carrying naloxone nasal spray, overdose deaths decreased by 18% (Rando, 2015).


Banjo, O., Tzemis, D., Al-Qutub, D., Amlani, A., Kesselring, S., & Buxton, J. A. (2014). A quantitative and qualitative evaluation of the British Columbia Take Home Naloxone program. CMAJ open, 2(3), E153–E161.

Rando, J., Broering, D., Olson, J. E., Marco, C., & Evans, S. B. (2015). Intranasal naloxone administration by police first responders is associated with decreased opioid overdose deaths. The American journal of emergency medicine, 33(9), 1201–1204.

Townsend, T., Blostein, F., Doan, T., Madson-Olson, S., Galecki, P., & Hutton, D. W. (2020). Cost-effectiveness analysis of alternative naloxone distribution strategies: First responder and lay distribution in the United States. The International journal on drug policy, 75, 102536.

Walley, A. Y., Xuan, Z., Hackman, H. H., Quinn, E., Doe-Simkins, M., Sorensen-Alawad, A., Ruiz, S., & Ozonoff, A. (2013). Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: Interrupted time series analysis. BMJ, 346, f174.


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