Narcan is available now without a prescription.
Harm reduction advocates, recovery groups, and treatment organizations like Workit Health were excited in March 2023 when the FDA announced that they were approving naloxone for sale over-the-counter, without a prescription. Now in September 2023, this rescue medication is on the shelves, available for purchase.
What is Narcan (naloxone)?
Naloxone is an opioid antagonist, which means that it binds to opioid receptors in the brain without activating them. Because it binds so effectively with the opioid receptors, it dislodges and blocks opioids that might have otherwise fill those receptors. This means that if a person is experiencing an opioid overdose, naloxone can be administered to rapidly reverse the overdose.
Narcan is a brand-name version of naloxone that has been approved by the FDA for sale without a prescription. It comes in the form of a nasal spray, premeasured into the approved dose.
Why is it important that Narcan can be purchased without a prescription?
Narcan saves lives! Opioid overdose can be fatal, but naloxone can halt and reverse an overdose in progress. It is such an important harm reduction measure that many local and state harm reduction organizations count dispensing naloxone to the public as their primary focus. But for those who don’t have access to (or don’t know how to find) those groups, Narcan has previously required a prescription. Making this life-saving medication more accessible removes one more barrier between the people at risk of overdose and a rescue.
Are other brands of naloxone also available over the counter?
At this time, Narcan’s 4 mg nasal spray is the only naloxone medication that is both approved by the FDA for over-the-counter sale and available in stores. The FDA has approved a naloxone nasal spray with the brand name RiVive, but it is not yet on shelves. It is anticipated to become available in early 2024.
How else can I get Narcan (naloxone)?
Narcan is now available over-the-counter at pharmacies and other stores, but how else can you get ahold of it?
- Ask your doctor for a prescription. Even though Narcan is now available without a prescription, having one will allow you to use a prescription savings plan. Some popular programs (with which we are not affiliated) include GoodRX, WellRX, SingleCare, and Optum Perks. Your insurance plan may also cover Naloxone if your doctor prescribes it. Check your insurance plan’s drug list or formulary.
- Contact your local county. Some states will mail naloxone to you if you request it. Keep in mind that they might have requirements before they send it out (like requiring you to take an online lesson about how to use it). They also might have a program allowing you to obtain naloxone for free from specific pharmacies.
- Vending machines. Some states and counties have established vending machines to dispense free naloxone. These are mostly found in public libraries and on college campuses. Do an internet search for “naloxone vending machine” in your area. Some of these require you to register in order to access the vending machine, so pay attention to any requirements.
- Look in your community. Do an internet search for “Harm reduction in [CITY],” “Naloxone distribution in [CITY],” or “Syringe exchange in [CITY].” If the organizations you find don’t dispense Narcan, they are still likely to be good resources on how to obtain naloxone in your specific area.
- NEXT Distro. NEXT Distro is a wonderful harm-reduction resource. They cover many states and will ship out naloxone or direct you to the closest resource center to obtain naloxone and other harm-reduction supplies.
Once I have Narcan, when and how should I use it?
It’s important to keep Narcan on hand if you or anyone you know uses drugs, even casually. That way you can quickly access it if someone experiences an overdose. Signs of an opioid overdose include:
- The person doesn’t wake up or respond when you talk to them and touch them. (One suggested touch is firmly rubbing their sternum with your knuckles, which is very uncomfortable and will usually cause a response if the person is just sleeping.)
- Breathing is shallow and weak, very slow, or has stopped.
- Pin-point-sized pupils when you look at their eyes.
- Color of lips and nails. In lighter-skinned people, these may look blue-purple; in darker-skinned people, they would more likely appear ashen or gray.
- The person is making choking sounds or a snore-like gurgling noise
The Narcan website provides instructions and education about administering this medication. The steps they recommend are:
- Lay the person on their back and tilt their head so their airways are clear.
- Spray by inserting the nasal spray device into either nostril and pressing the plunger firmly.
- Stay with the person and call 911 immediately. Continue to administer doses as needed and wait with the person until help arrives.
While it would be wonderful if no one needed Narcan, that’s just not the reality we live in. If you or someone you know has a prescription for opioid medication, takes opioids illicitly, or uses other drugs (which are at increasing risk of being contaminated with opioids), having Narcan on hand can save a life. And now that it is available without a prescription, it is easier to access than ever before.