Narcan - Overdose Prevention

According to provisional data reported by the Centers for Disease Control, there were 105,452 overdose deaths in the United States in 2022 (CDC, 2023). While that number is 2% lower than the 2021 statistics, it’s still alarming. The overdose crisis in the United States continues.

We have explored the opioid overdose crisis in some detail in the past - considering its history and the drugs involved as well as the roles played by stigma and barriers to treatment and appropriate care. Today, we’re focusing on overdose prevention in the form of a drug that is now available in all 50 states, the District of Columbia, and Puerto Rico without a prescription. That drug is Naloxone or Narcan.

Naloxone is an opioid antagonist, which means that it binds to opioid receptors in the brain and blocks or reverses the effect of opioid drugs like heroin, oxycodone, morphine, and fentanyl (Gragnoloti, 2022). Opioid antagonists were first discovered in 1915. The first was called Nalodeine or N-allyl Norcodeine (Pasternak & Pan, 2013). Nalodeine blocked the effects of morphine in lab animals, but it was never marketed for human use. The second, Nalorphine which was actually an agonist/antagonist was introduced in 1954 (Campbell, 2022). Nalorphine was used to reverse overdoses in emergency rooms and surgery suites, used by law enforcement officials to identify narcotics addicts using a challenge test called The Nalline Test, and used to block the “kick” of heroin (Campbell, 2022).

Naloxone was approved by the FDA in 1971 and replaced Nalorphine for the treatment of overdose in 1979. Initially, it was used by paramedics and emergency room doctors; later it was prescribed by some doctors to patients taking opioid medications for pain. In response to the ongoing overdose crisis in the United States, naloxone has been available without a prescription in all 50 states, the District of Columbia, and Puerto Rico since 2022.

Here are 4 things you should know about Naloxone:

1. Naloxone is marketed under different names (Gragnolati, 2022). Narcan, Zimhi, and Kloxxado are 3 brand names. The medication is available as an injection (Narcan and Zimhi) and as a nasal spray (Narcan and Kloxxado) (Gragnolati, 2022).
2. Naloxone became available without a prescription in 2022. Consumers could purchase Naloxone from their healthcare providers and local pharmacies (Gragnoloti, 2022). Until recently, most pharmacies carried naloxone behind the counter, but on March 29, 2023, the FDA approved 4mg Narcan nasal spray as an over-the-counter (OTC) drug (FDA, 2023) making it easier to access by more people.
3. Naloxone may be covered by insurance, and when insurance isn’t an option, there may be other ways to afford naloxone. All state Medicaid programs include some coverage for Naloxone, and some states mandate that private insurance carriers include some coverage as well. For those whose insurance providers don’t provide coverage and those without insurance or financial means, some community action groups may offer it free to people at risk of opioid overdose.
4. Some pharmacy chains, like CVS, Walgreens, and RiteAide are involved in state programs that provide naloxone for free, and some cities and counties across thenation have free programs too (Network for Public Health Law, N.D. & Williams, 2022).

The Opioid Overdose Crisis continues to plague the United States. The fact that Naloxone is becoming more accessible to more people is a positive step. If you or someone in your household uses opioids, whether by prescription or otherwise, know the signs of opioid overdose (pale/clammy skin, blue or purple fingernails or lips, vomiting, inability to speak or unconsciousness, and slow or stopped breathing or heartbeat) and obtain and keep Naloxone on hand. It’s a powerful, life-saving medication, but it only works if it’s used right away.

If you or someone you know is struggling with substance use or addiction, we may be able to help. Call us at 1-844-770-2101.