Narcan, a brand-name prescription nasal spray effective at reversing opioid overdoses, can be sold over the counter, the Food and Drug Administration decided today. Narcan’s active agent is naloxone.
Narcan’s broader availability, anticipated by late summer, will likely have only a modest effect on reducing the national wave of overdoses among users of illicitly produced fentanyl, heroin and other opioids, said Caleb Banta-Green, a researcher and addictions expert at the University of Washington School of Medicine.
The FDA decision is “certainly a worthwhile thing to do, and it's most likely to be of value to people who are already going to the corner drugstore and getting medications for other things,” Banta-Green said. But this population, he said, is less likely to witness or respond to an overdose than people who have family members or friends who use illicit drugs.
Having Narcan available over the counter also might help to normalize the idea that saving someone’s life in event of overdose “is something that anybody can do and should be prepared to do,” he said.
Prescription Narcan’s cost varies but can be offset by insurance copays. While Narcan’s manufacturer has not announced the nasal spray’s over-the-counter cost, Banta-Green expressed concern that anything more than a few dollars would be cost-prohibitive for the population at greatest risk for overdose.
By contrast, he noted, injectable naloxone formulations are currently available for less than $5, and those “are more likely to be used by people who do use illicit drugs because they're more comfortable with syringes.”
Banta-Green characterized naloxone as a starting point to help someone out of addiction, and called for more support of long-term treatment medications such as methadone and buprenorphine. Improving access to those treatments, he said, would be more likely to reduce overdose deaths dramatically.