Narcan to be available over the counter soon, though questions remain about cost

Narcan doses
Doses of Narcan spray (Emily Kwong/KCAW)

The overdose-reversing drug Narcan soon will be available over-the-counter. The U.S. Food and Drug Administration said this week it approved the product for use without a prescription, with the goal of reducing opioid deaths and making it easier for people to access the life-saving emergency medication.

It will be a while before Narcan is available on pharmacy and grocery store shelves. The FDA estimates it could take months to jump through some regulatory hoops.

But Shari Conner with Change 4 the Kenai said she thinks having it available over-the-counter will help reduce stigma and help Alaskans stay prepared. Conner is the project coordinator with the local coalition, which works to prevent substance abuse on the Kenai Peninsula.

“Really, no one’s immune from having an overdose in your home,” Conner said.

She said anyone who takes an opiate prescription following a surgical or dental procedure has access to opiates, in their house. Having Narcan on hand, she said, is like having a fire extinguisher nearby.

“As Alaskans, we have a little kit of emergency stuff that we take out camping and fishing,” Conner said. “It’s just a safety measure, just like anything else.”

Narcan contains 4 milligrams of naloxone — a medication that quickly reverses the effects of an opioid overdose.

It comes in a nasal spray, and since 2015, has been available by prescription. Today, there are emergency kits around Alaska at libraries and health centers. On the Kenai Peninsula, there are kits available at Kenai Public Health and the Change 4 the Kenai building, for example. Alaskans can find emergency kits in fish processing plants and other high-traffic areas, through Project Gabe. And many emergency service providers carry the drug with them — as well as the more powerful Kloxxado, which contains an 8-milligram dose of naloxone.

It’s been an especially important tool as the state’s drug overdose death rate has shot up. Alaska saw the largest percent increase of any state from 2020 to 2021, according to data from the Alaska Department of Health. A big culprit has been fentanyl, a synthetic opioid that’s more potent than other narcotics.

Conner said there’s still a lot to learn about the way over-the-counter Narcan will be rolled out.

But she said Wednesday’s approval is a good step forward.

“I think we’re going in the right direction, for sure,” she said. “I just wonder what the cost will be.”

Today, prescription Narcan is available in a two-dose pack for less than $10 when it’s not covered by Medicaid or private insurance. But over the counter, those prices could be much higher, health economists and advocates warn — especially when it remains the only over-the-counter overdose reversal drug on the market.

Conner said her organization, Change 4 the Kenai, is hosting an emergency Narcan kit-building event soon. She says they’re trying to plant more Project Gabe boxes across the community, as well, to make Narcan as ubiquitous as possible.

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