Opioid overdose antidote Narcan will be widely available over the counter next week

The opioid overdose antidote Narcan will be available over the counter in the coming days, a move that’s hoped to increase access to the lifesaving medication amid the country’s worsening opioid epidemic.

Emergent BioSolutions, which makes the drug, said Wednesday that shipments were on their way to major retailers, including Walgreens, Walmart, Rite Aid and CVS. It could also be available to buy online from some businesses this week.

Dr. Scott Hadland, an addiction specialist at Mass General for Children in Boston said the move to over the counter “will help to mainstream Narcan, to make it more normalized for people and their families to carry with them and have at home for safety, which is critical to reducing the rising number of overdose deaths occurring nationally.”

The cost of the drug, however — $44.99 for a box of two doses — may put it out of reach for some. 

“Unfortunately, for many people who live with addiction or want to protect a loved one living with addiction, this cost will be too high,” Hadland said. “I know, because I see this in my own practice, in which medications that cost this much are simply out of reach.”

Overdoses are the leading cause of accidental death in the U.S. and the fourth-leading cause of death overall in the country. In 2021, there were more than 107,000 overdose deaths, an all-time high, according to the Centers for Disease Control and Prevention. Fentanyl, a powerful synthetic opioid, was involved in more than 71,000 of those deaths.

Narcan can quickly reverse overdoses from fentanyl and other opioids, including heroin and prescription painkillers. 

It was previously prescription-only, although many states created workarounds that allowed people to get it directly from pharmacists. In many places, it’s also available free at community centers, local health departments and needle-exchange programs.  

The Food and Drug Administration’s approval of Narcan for over-the-counter use this year means it can be sold in even more places, including convenience stores, airports and even vending machines. 

Emergent is shipping “several hundred thousand” boxes of Narcan to major retail chains in the first week, followed by more boxes to smaller chains over September, said Paul Williams, a senior vice president. Any business that wants to provide the drug can buy it directly through a wholesaler. 

In addition to being available on store shelves, the product will be available for orders online — important for those who don’t want to interact with other people to get the medication. 

“The timing is right,” Williams said of the shift to over-the-counter use, “particularly within the last two years with the number of opioid deaths significantly increasing.”

Tricia Moriarty, a spokesperson, said Walmart will have over-the-counter Narcan in some of its stores and online as soon as this weekend. 

Walgreens will begin selling the over-the-counter version in some of its retail stores on Sept. 5, followed by its entire fleet on Sept. 7, said Dr. Kevin Ban, its chief medical officer.  

Narcan won’t be directly sold on Walgreens’ shelves, however. Instead, people who want to buy it will need to pick up a card from the pain management section and hand it to an employee, who will then supply the drug, Ban said. Walgreens has taken a similar approach to other products, including Sudafed.

Heather Saunders, a postdoctoral fellow at the program on Medicaid and the Uninsured at KFF, a nonpartisan group that studies health policy issues, said that offering Narcan over the counter has the potential to reduce stigma around opioid use but that its price “raises concerns.”

Insurance, she said, typically doesn’t cover the cost of over-the-counter products.

“At about $45, its cost may be too high for many,” she said, “including friends and family who wish to carry Narcan as a precaution.” 

Williams, of Emergent, said many people will still be able to get Narcan free from community organizations and local health departments. 

“The opportunity to have Narcan available in the form of what retailers can provide, online and expanding that is critically important,” he said.