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Life-saving opioid reversal drug, Narcan, now available for OTC use

Narcan, which is also known by its generic name naloxone, is available for individuals 14 years or older to request from participating pharmacies. – Photo by Pennsylvania Department of Health / Facebook

An advisory committee to the Food and Drug Administration recently recommended that Narcan be approved to be sold over the counter. Narcan, which is also known by its generic name naloxone, is a life-saving nasal spray and opioid deterrent often used in drug-related emergencies.

Lewis Nelson, the chair of the Department of Emergency Medicine and chief of the division of Medical Toxicology at the New Jersey Medical School, said that opioids are the primary cause of death for individuals that use substances.

He said substances like heroin, oxycodone and fentanyl are types of opioids that can significantly impair and even stop breathing due to the lack of oxygen entering the brain.

"It is not an instantaneous process (to die from an opioid overdose)," he said. "It takes minutes, not hours, of not breathing, but there is a period of time you can intervene and save somebody."

Nelson said there is an opioid receptor within the brain that accounts for how we experience pain and pleasure and manages how we control our breathing.

He said that Narcan works against this receptor and will undo the opioid’s effects in order to keep the victim breathing. Nelson said individuals have approximately 5 minutes to administer the drug after an overdose to save a life.

He said that individuals do not need to go to a pharmacy to access Narcan because community health groups and harm reduction facilities provide free treatment.

He also said that before Narcan was allowed to be distributed over the counter, pharmacies would provide the treatment "behind the counter," where individuals without a prescription would ask the pharmacist for the treatment before purchasing it.

Nelson said that the existence of a standing order from the New Jersey Department of Health now legally allows pharmacists to provide individuals with the treatment without needing permission from doctors.

Nelson said that allowing Narcan to be sold without a prescription will make the drug more accessible, though people will still need money to purchase the product or rely on their insurance to cover the cost.

He said that insurance companies might refrain from alleviating the cost of Narcan because it is a product only used on someone else rather than the individual purchasing the treatment.

"By prescription or over-the-counter does not imply free," he said. "It is not cheap–it was selling for about $120 for a two-pack. The price has come down because the company lowered the price as generic competition started."

The New Jersey State Legislature has drafted legislation for state universities and colleges to create a program that facilitates and maintains the use and delivery of Narcan on campuses.

Nelson said he thinks institutions or employers should not control distribution because the treatment needs to be at hand to help the individual suffering from an overdose.

"Having access to (Narcan) will not eliminate the opioid epidemic. What it will do is it will keep somebody alive so that they can get into treatment," he said. "Naloxone does not prevent drug use. It just prevents death from drug overdose."

Coinciding with recent news surrounding Narcan, in January, Gov. Phil Murphy (D-N.J.) announced a plan to make Narcan available and free of cost to individuals aged 14 or older.

New Jersey is already the first state to offer a distribution program for free and easy access to Narcan by applying through a website and requesting a shipment. But, this program only gives access to the medical community, not individual patients.

Murphy’s administration unveiled the initiative to make Narcan available to individuals in hopes of helping combat the opioid epidemic and reduce deaths from drug overdoses statewide.

The state recorded 424 suspected drug deaths this year as of March 1, along with 2,893 suspected drug deaths in 2022, according to the Office of the Chief State Medical Examiner.

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