West End Healthline
What to know about Narcan becoming available over the counter
By steven quam, MD
There have been some exciting new developments this spring as America continues to try to address the opioid epidemic. According to the New York Times, over 100,000 people have died from opioid related deaths in each of the past couple of years. Common opioids include prescription drugs like oxycodone or morphine as well as street drugs like heroin. Recently, the opioid epidemic has become even more deadly as the potent opioid fentanyl has been added to a variety of street drugs. Fentanyl is a drug with legitimate medical purposes, but when used recreationally it can have unintended consequences. Opioids such as fentanyl can cause the body to breathe too shallowly and slowly. Many people who use drugs can be unaware of fentanyl contamination in the drugs they are using, and this can result in a deadly overdose.
Naloxone, brand name Narcan, works by reversing the effects of opioids rapidly. It is often given as a spray into someone’s nose. This reverses the effect of opioids and can allow somebody who has accidentally overdosed to start breathing again. While naloxone is very effective to prevent overdose, it needs to be readily available to be able to save a life. Thirty states (including Minnesota) have already expanded access to naloxone by creating standing orders that allow anybody to get access to naloxone through a pharmacy without a prescription. This still requires meeting with a pharmacist in person and asking for the medicine. This is similar to getting a flu shot and makes naloxone more accessible but still requires taking the initiative to meet with a pharmacist. While this is better than having to get a prescription medication, it does create a barrier for many people who do not realize it is available without a prescription and may not have another reason to visit a pharmacy. It can be intimidating for many folks to meet with medical professionals like pharmacists to ask for naloxone. This is why naloxone is often still not readily available when an overdose happens.
In March of this year, the Federal Drug Administration took an essential step to expand the access of naloxone. They granted the ability to have naloxone be sold over the counter, similar to buying a bottle of acetaminophen (Tylenol). This is expected to fully take effect by late summer 2023. When this happens, anybody will be able to go and get naloxone at a store that sells other common medications without having to speak to anybody first. This should make it much easier and hopefully less stigmatizing for anybody to get access to this life-saving medicine. Naloxone is not only an essential medicine to increase the safety of people who use opioids, either prescription opioids or as street drugs, but it’s also a great medicine for anybody to have on hand. This is because naloxone can give you the ability to save the life of a stranger on the street, in a restaurant or on the bus if they have overdosed.
Some people may have questions about naloxone. One common question is how you can tell whether a stranger may benefit from naloxone. The answer is that naloxone is worth trying on anyone who is found to be unconscious and you cannot wake up. After somebody receives naloxone, it is essential someone calls 911 so further rescue interventions can be taken to make sure they stay safe and stable. Another common question is whether naloxone encourages opioid use. Research has clearly shown that naloxone saves lives and does not encourage more use of opioids. Naloxone is a way to help reduce the harm of opioids. While naloxone does not cure opioid use disorder, it gives people another chance to treat their chronic disease. In the end, there is no downside to carrying naloxone with you wherever you go.
Keep your eye out for over-the-counter Narcan this summer!
Dr. Quam is a family physician at Allina Health United Family Physicians, 233 Grand Ave, Saint Paul, MN 55102, phone 651-241-5200.