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With over-the-counter Narcan coming soon, here’s how you can save lives

Increased availability of Narcan nasal spray could equip people to help those experiencing overdoses, but there are still many questions regarding financial costs.

Young woman standing against shelf in pharmacy searching for medicine. Narcan nasal spray is expected to be available in local pharmacies, supermarkets and other locations for the general public to purchase late this summer. (Getty Images)

By Sara McCloskey

The U.S. Food and Drug Administration (FDA) approved the over-the-counter sales of a lifesaving opioid overdose treatment in late March. The availability of the Naloxone nasal spray, commonly known as Narcan, means people can buy the medication in neighborhood pharmacies, supermarkets and more locations.

The wider availability of Narcan to the public is seen as a critical tool in addressing the ongoing opioid epidemic in the United States. From 1999 to 2020, federal health data shows more than 564,000 people died from an opioid overdose, including prescription and illicit opioids. President Donald Trump declared the opioid crisis a public health emergency in October 2017, which President Joe Biden has continued since he took office.

“Making Narcan available over the counter will give access to everyone, potentially preventing needless death,” said Sharon Gatewood, Pharm.D., an associate professor in the Virginia Commonwealth University School of Pharmacy’s Department of Pharmacotherapy and Outcomes Science.

VCU Health News asked Gatewood what community members need to know before this medication becomes available over-the-counter late this summer.

How does Narcan work inside of the body when someone is experiencing an overdose?

When someone uses an opioid, the drug’s molecules attach to an opioid receptor in the body; this is what causes the body to experience the effects from the opioids. When Narcan, or naloxone, is administered during an overdose, the naloxone binds more strongly to the opioid receptor than the opioid does. Therefore, the opioids are removed temporarily from the receptor and replaced by the naloxone. This wakes the person up from an overdose.

What are some of the signs that someone may need Narcan? 

The most common symptoms of someone overdosing include:

  • Pale and clammy skin
  • Shallow breath or not breathing
  • Making a gurgling or deep snore sound
  • Unresponsive to touch or other stimuli
  • Fingertips and/or lips are blue
  • A slowed or undetectable pulse

What should I be aware of if I need to administer Narcan? Is special training involved?

You need to be aware of the signs and symptoms of an overdose. If you think someone is overdosing, then you need to administer naloxone. Specialized training is not required to administer naloxone as a nasal spray. However, if desired there are resources through the health department, community health organizations and health professionals that offer education on how to use Narcan.

No consent is required; the person administering the Narcan is covered by what is known as the Good Samaritan law, meaning a person trying sincerely to help someone at risk would not be at risk of being sued.

Would I be in any danger if I touch someone who may have fentanyl or another opioid on their skin or clothes?

No, you will not be in danger. Fentanyl and other opioids are not easily absorbed through casual contact. If there is a possibility that you have come in contact with an opioid, it is recommended that you wash your hands before touching your eyes, nose or mouth.

How much will over-the-counter Narcan cost customers?

It is still unknown what the cost will be and if insurance will still cover the medication. In Virginia, pharmacists can prescribe naloxone through a statewide protocol. Therefore, if the cost of over-the-counter Narcan is too expensive, the pharmacist can prescribe the medication and submit it to insurance to see if it is covered.

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