Opioid Reversal Drug Narcan Approved For OTC Purchase

Olivia Silvey ’25

Managing Editor

The Food and Drug Administration approved the overdose reversal drug Narcan for over-the-counter purchase on Wednesday, March 29. This increases availability of the drug, which is a nasal spray that is administered in the event of an opioid overdose. Narcan, also known as naloxone hydrochloride, is the first of its kind to be approved without a prescription. 

While the over-the-counter status was approved recently, the FDA stated that it could still take months for manufacturers to determine availability and price, which would then allow Narcan to be on shelves. The company that produces Narcan, Emergent BioSolutions, expressed that their aim is to make Narcan available in stores by late this summer, but they did not state the cost. The FDA assured the public that they will continue to “work with all stakeholders” to ensure that Narcan is available during the time it takes to implement its nonprescription status. The Administration notes that other forms of the reversal drug, like the injectable version, will remain available by prescription only. 

National Public Radio reported that in a recent 12-month period, 110,000 people died from a drug overdose. To compare, the number of national drug-involved overdose deaths topped 100,000 for the first time ever in 2021 according to the Centers for Disease Control and Prevention (CDC). Of that number, around 80,000 were from any opioids, and of that, 17,000 from prescription opioids. Especially with the current rise of fentanyl-related overdoses, the increased availability of over-the-counter Narcan is vital for many. 

In the past, Narcan has been available through harm-reduction groups and local government agencies. In some states and localities, Narcan has been available without a prescription for a while. Some harm-reduction agencies, while celebrating the newest approval, continue to push for Narcan to be free of charge, since cost can still be a barrier to some just like a prescription. 

The injectable version of naloxone can be found for as little as $5 in some areas, making it a popular choice for harm-reduction groups. However, nasal spray versions of the drug—like the one most recently approved—can range anywhere from $23 to $70 for one dose. The name brand Narcan is even more expensive, costing around $175 for two doses without insurance. When searching online, there is not a clear answer to how much it costs. 

Narcan use and approval has a long history. First approved as injectable-only in the 1970s, it has only come in nasal spray form in the last 10 years. Now with its over-the-counter approval, it will be available to buy in places like grocery stores, gas stations, and pharmacies. 

According to the CDC, signs of an opioid overdose include small pupils, shallow breathing, choking, blue or cold skin, loss of consciousness, and limp limbs. It is always best to treat a situation like an overdose in case you are not sure, which includes calling 911, administering naloxone, keeping the person awake and breathing, putting the person on their side to prevent choking, and staying with them until emergency personnel arrive. Visit narcan.com to find out how to get Narcan in your area.