The U.S. Food and Drug Administration on Wednesday approved selling naloxone without a prescription, setting the overdose-reversing drug on course to become the first opioid treatment drug to be sold over the counter.

It’s a move that some advocates have long sought as a way to improve access to a life-saving drug, though the exact impact will not be clear immediately.

A local pharmacist expects NARCAN will be sold over-the-counter at the end of summer. He also said it should be cheaper for the patient. Right now, it costs about $100 without insurance.

“The price usually does go down,” Michael Fink said. He’s a pharmacist at Pharmacy of Grace in Kansas City, Kansas.

Fink and Emily Hage agree — this news is a relief for pharmacists and the community. Hage is the president and CEO of First Call, a nonprofit organization that focuses on alcohol/drug prevention and recovery.

“Both Kansas and Missouri are seeing double digit increase in overdose deaths year after year,” Hage said, “which means we need to pull different tools out of our tool belt.”

NARCAN is one of those tools.

Hage said this opioid problem rears its head in our community in multiple ways — including chronic drug use, but also through more unsuspecting ways, like counterfeit pills containing fentanyl.

“Our young people are dying at very alarming rates by purchasing counterfeit pills, and overdosing as a result of a very small, experimental use,” Hage said. “So, NARCAN would be a lifesaving tool in that situation, as well.”

Hage said parents need to pe equipped, “We want NARCAN to be in every person’s first aid kit.”

Fink said NARCAN is generally safe. You don’t need to worry about harming the patient, and it may take two doeses for them to regain conciousness.

“Administer the NARCAN, lay the patient on their side until recovery,” Fink said, “but an important step is calling 911 to get the emergency services on their way.”

First Call offers NARCAN for free to those who need it.

You can also call their 24/7 Crisis Call line at 816-361-5900.


The approved branded nasal spray from Gaithersburg, Maryland-based Emergent BioSolutions is the best-known form of naloxone.

It can reverse overdoses of opioids, including street drugs such as heroin and fentanyl and prescription versions including oxycodone.

Making naloxone available more widely is seen as a key strategy to control the nationwide overdose crisis, which has been linked to more than 100,000 U.S. deaths a year. The majority of those deaths are tied to opioids, primarily potent synthetic versions such as fentanyl that can take multiple doses of naloxone to reverse.

Advocates believe it’s important to get naloxone to the people who are most likely to be around overdoses, including people who use drugs and their relatives.

Police and other first responders also often carry it.


Narcan will become available over-the-counter by late summer, the company said.

Other brands of naloxone and injectable forms will not yet be available over the counter, but they could be soon.

The nonprofit Harm Reduction Therapeutics Inc., which has funding from OxyContin maker Purdue Pharma, has an application before the FDA to distribute its version of spray naloxone without a prescription.


Even before the FDA’s action, pharmacies could sell naloxone without a prescription because officials in every state have allowed it.

But not every pharmacy carries it. And buyers have to pay for the medication — either with an insurance co-pay or for the full retail price. The cost varies, but two doses of Narcan often go for around $50.

The drug is also distributed by community organizations that serve people who use drugs, though it’s not easily accessible to everyone who needs it.

Emergent has not announced its price and it’s not clear yet whether insurers will continue to cover it as a prescription drug if it’s available over the counter.


It clears the way for Narcan to be made available in places without pharmacies — convenience stores, supermarkets and online retailers, for instance.

Jose Benitez, the lead executive officer at Prevention Point Philadelphia, an organization that tries to reduce risk for people who use drugs with services including handing out free naloxone, said it could help a lot for people who don’t seek services — or who live in places where they’re not available.

Now, he said, some people are concerned about getting naloxone at pharmacies because their insurers will know they’re getting it.

“Putting it out of the shelves is going to allows people just to pick it up, not have stigma attached to it and readily access this life-saving drug,” he said.

But it remains to be seen how many stores will carry it and what the prices will be. The U.S. Centers for Medicaid and Medicare Services, which now cover prescription naloxone for people on the government insurance programs, says that coverage of over-the-counter naloxone would depend on the insurance program. The centers have not given any official guidance.

Maya Doe-Simkins, a co-director of Remedy Alliance/For The People, which launched last year to provide low-cost — and sometimes free — naloxone to community organizations, said her group will continue to distribute injectable naloxone.


One concern is whether people who buy Narcan over-the-counter will know how to use it properly, said Keith Humphreys, a Stanford University addiction expert, though the manufacturer is responsible for clear directions and online videos on that.

One benefit of having pharmacists involved, he said, is that they can show buyers how to use it. One key thing people need to be reminded of: Call an ambulance for the person receiving naloxone after it’s been administered.

He also said there are fears that if the drug isn’t profitable as an over-the-counter option, the drugmaker could stop producing it.