Last week, the Food and Drug Administration (FDA) approved Narcan, a name-brand naloxone nasal spray, for over the counter (OTC) use. Naloxone is a life-saving medication that can reverse the effects of an opioid overdose when administered in a timely manner to a person experiencing an opioid overdose. Narcan is the first naloxone product approved for OTC use which means it will be available without a prescription. Narcan’s OTC status will allow various settings such as gas stations and supermarkets to stock it. This has the potential to vastly increase its availability and use during an opioid overdose emergency. The timeline for OTC availability of Narcan is still unknown, but it will likely be in summer 2023.
Narcan currently retails for about $130, however the cost when it’s purchase over the counter is unknown. In contrast, injectable intramuscular naloxone, which still requires a prescription, costs less than $30. Given this price difference, NACCHO has urged the FDA to extend OTC approval to injectable naloxone as well. Another naloxone nasal spray, RiVive, is currently under FDA review for OTC use as well. RiVive’s makers, Harm Reduction Therapeutics, aim is to make the nasal spray free or inexpensive as possible. The FDA is slated to make a decision on RiVive later this spring.
As exciting as this announcement is, and its implications to reduce fatal opioid overdoses, cost remains a significant barrier that must be addressed to ensure broader access to naloxone. Harm reductionists, people who use drugs (PWUD), and many public health officials have called for greater availability of naloxone products, while also acknowledging that naloxone access is only one component in a much larger effort needed to address the ongoing overdose crisis in the US.
Harm reduction programs led by people who use drugs began distributing naloxone in the community as an act of love. Over the years, this approach has become more widely adopted in mainstream public health and healthcare. Local health departments (LHDs) have been integral to many broader efforts to dispense naloxone products, including Narcan, free of charge to people who use drugs and their loved ones—those who are best positioned to quickly respond to an opioid overdose. LHDs and their community partners have a continued role to play in ensuring equitable access to naloxone and reducing fatal opioid overdoses.
NACCHO supports this vital work of LHDs through our Overdose Prevention and Harm Reduction teams, as well as by funding innovative projects and providing technical assistance. In our policy statements, NACCHO has also expressed its support for LHDs implementing harm reduction practices, such as offering or supporting syringe services programs (SSPs), naloxone distribution, fentanyl test strip distribution and other drug checking services, and LHD-wide efforts to support PWUD and their loved ones across all programs, including sexual and perinatal health programs. NACCHO also hosts a bimonthly Harm Reduction Community of Practice to increase the capacity of LHDs to implement or scale up SSPs and other harm reductions strategies.
NACCHO will continue to push for expanded OTC approval of naloxone products and work with LHDs and their community partners to increase equitable and low-barrier access for PWUD, their loved ones and communities, while also supporting broader LHD efforts to bring evidence-based harm reduction practices to scale, as well as reduce stigma and barriers to care for PWUD.
Stay up to date on these efforts and future funding opportunities by joining our Harm Reduction listserv.
